利胆排石汤辅助双镜联合保胆取石术治疗肝胆湿热型胆囊结石患者的效果  

Efficacy of Lidan Paishi Decoction Assisted by Double Mirror Combined with Gallbladder Preservation and Lithotripsy in the Treatment of Patients with Liver and Gallbladder Damp-Heat Type Cholecystolithiasis

作　　者：夏吉敏 周书娟 朱现民[2] XIA Jimin;ZHOU Shujuan;ZHU Xianmin(Department of Traditional Chinese Medicine,the Second People’s Hospital of Xichuan County,Nanyang 474450,China;Department of Pain of Integrated Traditional Chinese and Western Medicine,the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,China)

机构地区：[1]淅川县第二人民医院中医科,河南南阳474450 [2]河南中医药大学第三附属医院中西医结合疼痛科,河南郑州450000

出　　处：《河南医学研究》2022年第15期2824-2827,共4页Henan Medical Research

摘　　要：目的分析利胆排石汤辅助双镜联合保胆取石术治疗肝胆湿热型胆囊结石患者的效果。方法纳入淅川县第二人民医院2019年4月至2020年2月接受治疗的110例肝胆湿热型胆囊结石患者作为研究对象,根据治疗方法分为手术组(55例)和联合组(55例)。手术组患者接受双镜联合保胆取石术;联合组患者在双镜联合保胆取石术的基础上加用利胆排石汤。比较两组患者治疗总有效率、入组时与术后3个月胆囊功能指标(胆囊收缩率、胆囊壁厚度)、血清炎症因子水平[白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白介素-4(IL-4)]、胆汁成石成分水平[钙离子(Ca^(2+))、非结合胆红素(UCB)、总胆汁酸(TBA)]、随访6个月复发率。结果联合组治疗总有效率(96.36%)较手术组(85.45%)高(P<0.05);术后3个月,联合组胆囊收缩率、血清IL-4、TBA水平较手术组高,胆囊壁厚度、血清IL-6、TNF-α、UCB、Ca^(2+)水平较手术组低(P<0.05);随访6个月,联合组复发率(3.77%)较手术组(19.15%)低(P<0.05)。结论利胆排石汤辅助双镜联合保胆取石术治疗肝胆湿热型胆囊结石,可提升治疗效果,改善患者胆囊功能,减轻炎症反应,调节胆汁成石成分水平,降低复发率。Objective To analyze the effect of Lidan Paishi decoction assisted by double mirror combined with gallbladder preservation and lithotripsy in the treatment of patients with cholecystolithiasis caused by damp-heat in the liver and gallbladder.Methods A total of 110 patients with cholecystolithiasis with damp-heat type of liver and gallbladder who were treated in the Second People’s Hospital of Xichuan County from April 2019 to February 2020 were collected prospectively as research objects.They were randomly divided into operation group(55 cases)and combined group(55 cases)according to treatment methods.The operation group were treated with double-endoscopy combined with gallbladder-preserving lithotomy,and the combined group were treated with Lidan Paishi decoction based on the operation group.The total effective rate,gallbladder function indexes(gallbladder contraction rate,gallbladder wall thickness),serum inflammatory factor levels[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),interleukin-4(IL-4)],bile lithogenic component levels[calcium ion(Ca^(2+)),unconjugated bilirubin(UCB),total bile acid(TBA)]at the time of enrollment and 3 months after operation,recurrence rate at 6 months follow-up were compared between the two groups.Results The total effective rate in the combined group(96.36%)was higher than that in the operation group(85.45%)(P<0.05).At 3 months after operation,the gallbladder contraction rate,serum levels of IL-4 and TBA in the combined group were higher than those in the operation group,and the levels of IL-6,TNF-α,UCB and Ca^(2+)were lower than those in the operation group(P<0.05).After 6 months of follow-up,the recurrence rate in the combined group(3.77%)was lower than that in the operation group(19.15%)(P<0.05).Conclusion Lidan Paishi decoction assisted by double mirror combined with gallbladder preservation and lithotripsy in the treatment of liver and gallbladder damp-heat cholecystolithiasis can improve the therapeutic effect,improve the patient’s gallbladder function,reduce infl

关 键 词：利胆排石汤 双镜联合保胆取石术 肝胆湿热型 胆囊结石 炎症因子 

分 类 号：R259[医药卫生—中西医结合]