蒿芩清胆汤治疗急性梗阻性化脓性胆管炎(肝胆湿热证)的疗效分析  

Analysis of Clinical Efficacy of Haoqin Qingdan Decoction on Acute Obstructive Suppurative Cholangitis (Damp-heat Syndrome of Liver and Gallbladder)

作　　者：苏家辉[1] 谭嘉斌 陶银[1] 邝洁容[1] Su Jiahui;Tan Jiabin;Tao Yin;Kuang Jierong(Foshan Hospital of TCM,Guangdong,Foshan 528000,China)

机构地区：[1]广东省佛山市中医院,广东佛山528000

出　　处：《中国中医急症》2022年第5期872-875,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：佛山市卫生和计生局医学科研课题(20170078)。

摘　　要：目的 探讨分析蒿芩清胆汤治疗急性梗阻性化脓性胆管炎(肝胆湿热证)的临床疗效。方法 采用随机数字表法将患者80例分为观察组与对照组各40例,两组均行PTCD胆道引流,术后予以抗感染、护肝、利胆等西医对症治疗;观察组胃管注入或口服蒿芩清胆汤治疗;治疗2周后观察比较两组患者临床疗效,治疗前后的谷丙转氨酶(ALT)、谷草转氨酶(GOT)、总胆红素(TBIL)、直接胆红素(DBIL)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)、超敏C反应蛋白(hs-CRP)水平变化。结果 观察组黄疸减轻时间、腹痛减轻时间、体温恢复正常时间及总住院时间均明显短于对照组(P<0.05)。两组治疗前GOT、ALT、TBIL、DBIL、IL-6、IL-8、TNF-α、PCT、hs-CRP水平均无显著差异(P>0.05);治疗后观察组与对照组各肝功能相关指标、各炎症因子指标及PCT、hs-CRP水平均较治疗前明显降低(P<0.05);且观察组肝功能指标、炎症因子及PCT、hs-CRP水平均明显低于对照组(P<0.05)。结论 在西医治疗基础上予以蒿芩清胆汤治疗急性梗阻性化脓性胆管炎(肝胆湿热证)可获得较好的临床疗效,能明显减轻临床症状及炎症反应,改善肝功能,促进病情恢复,缩短住院时间。Objective:To investigate the clinical efficacy of Haoqin Qingdan Decoction on acute obstructive suppurative cholangitis(damp-heat syndrome of liver and gallbladder). Methods:80 patients were randomly divided into the observation group and the control group,40 cases in each. The control group was received PTCD biliary drainage,and postoperatively received western medicine and other symptomatic treatment,such as anti-infection,liver protection and cholagogue. The observation group was treated with gastric tube injection or oral Haoqin Qingdan Decoction based on the treatment of the control group. After 2 weeks′ treatment,the clinical effects of the two groups were observed and compared,as well as the changes of the levels of ALT,GOT,TBIL,DBIL,IL-6,IL-8,TNF-α,PCT and hs-CRP. Results:The jaundice reduction time,abdominal pain reduction time,body temperature recovery time and total hospitalization time in the observation group were significantly shorter than those in the control group(P< 0.05). There were no significant differences in ALT,GOT,TBIL,DBIL,IL-6,IL-8,TNF-α,PCT and hs-CRP between the groups before treatment. After treatment,liver function-related indicators,inflammatory factor indicators and the levels of PCT and hs-CRP in both groups were significantly lower than before treatment(P< 0.05),and those in the observation group were significantly lower than those in the control group(P<0.05). Conclusion:The treatment of acute obstructive suppurative cholangitis(liver and gallbladder damp-heat syndrome)can be achieved by applying Haoqin Qingdan Decoction on the basis of western medicine treatment. It can obviously reduce the clinical symptoms and inflammatory reaction,improve the liver function,promote the recovery of the disease,and shorten the length of hospitalization.

关 键 词：急性梗阻性化脓性胆管炎 蒿芩清胆汤 肝胆湿热证 临床疗效 

分 类 号：R657.4[医药卫生—外科学]