清肝利胆汤联合腹腔镜手术对急性胆囊炎患者的疗效及血清TnI、M-CSF水平的影响  

Therapeutic Effect of Qinggan Lidan Decoction Combined with Laparoscopic Surgery for Patients with Acute Cholecystitis and Its Impacts on Serum TnI and M-CSF levels

作　　者：刘贇 韩月蕊[1] LIU Yun;HAN Yue-Rui(General Surgery and Minimally Invasive Surgery of Nanyang Central Hospital,Nanyang 473000 Henan,China)

机构地区：[1]河南省南阳市中心医院普通外科微创外科,河南南阳473000

出　　处：《广州中医药大学学报》2023年第3期615-620,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：河南省科技发展计划项目(编号:162102310230)。

摘　　要：【目的】探究清肝利胆汤联合腹腔镜手术对急性胆囊炎患者的疗效及血清肌钙蛋白I(TnI)、巨噬细胞集落刺激因子(MCSF)水平的影响。【方法】将80例急性胆囊炎肝胆湿热证患者随机分为手术组和联合组,每组各40例。手术组患者给予腹腔镜手术治疗,联合组给予清肝利胆汤联合腹腔镜手术治疗,连续服药2周。比较2组患者术后恢复情况(首次排气时间及发热症状、胃肠道症状、右上腹痛消失时间),观察2组患者治疗前后中医证候积分,血清TnI、M-CSF水平及氧化应激指标[皮质醇(COR)、超氧化物歧化酶(SOD)、活性氧(ROS)、谷胱甘肽过氧化物酶(GSH-Px)]的变化情况,并评价2组患者的临床疗效。【结果】(1)治疗2周后,联合组的总有效率为95.00%(38/40),手术组为75.00%(30/40),组间比较,联合组的疗效明显优于手术组(P<0.05)。(2)联合组患者的首次排气时间及发热症状、胃肠道症状、右上腹痛消失时间均低于手术组(P<0.01)。(3)治疗后,2组患者中医证候积分均较治疗前明显下降(P<0.01),且联合组的下降幅度明显优于手术组(P<0.01)。(4)治疗后,2组患者血清TnI、M-CSF水平均较治疗前明显下降(P<0.01),且联合组的下降幅度均明显优于手术组(P<0.01)。(5)治疗后,2组患者血清COR、ROS水平均较治疗前升高(P<0.01),血清SOD、GSH-Px水平均较治疗前下降(P<0.01),但联合组血清COR、ROS水平的升高幅度及血清SOD、GSH-Px水平的下降幅度均明显小于手术组(P<0.01)。【结论】清肝利胆汤联合腹腔镜手术治疗急性胆囊炎肝胆湿热证患者疗效确切,可有效降低患者血清TnI、M-CSF水平,减轻氧化应激反应,促进术后恢复。Objective To investigate the therapeutic effect of Qinggan Lidan Decoction combined with laparoscopic surgery for patients with acute cholecystitis,and to observe its effects on serum troponin I(TnI)and macrophage colony-stimulating factor(M-CSF)levels. Methods Eighty patients with acute cholecystitis of liver-gallbladder damp-heat syndrome were randomly divided into surgical group and combination group,with 40 patients in each group. The patients in the surgical group were given laparoscopic surgery, and the patients in the combination group were given Qinggan Lidan Decoction combined with laparoscopic surgery. The oral administration lasted for2 consecutive weeks. Postoperative recovery indicators of time for first anal exhaust after surgery and time for the relief of postoperative fever, gastrointestinal symptoms, right upper abdominal pain in the two groups were compared,and traditional Chinese medicine(TCM)syndrome scores of the two groups were observed before and after treatment. The changes in serum levels of TnI,M-CSF,and oxidative stress indexes of cortisol(COR),superoxide dismutase(SOD), reactive oxygen species(ROS), and glutathione peroxidase(GSH-Px)in both groups before and after treatment were observed,and the clinical efficacy of the two groups after treatment was also evaluated. Results(1)After 2 weeks of treatment,the overall effective rate of the combination group was 95.00%(38/40)and that of the surgical group was 75.00%(30/40). The intergroup comparison showed that the efficacy of the combination group was significantly superior to that of the surgical group(P<0.05).(2)The time for first anal exhaust after surgery and the time for the relief of postoperative fever,gastrointestinal symptoms and right upper abdominal pain in the combination group were shortened compared with those in the surgical group(P<0.01).(3)After treatment,the TCM syndrome scores in both groups were decreased significantly compared with those before treatment(P<0.01),and the decrease degree in the combination group was sign

关 键 词：急性胆囊炎 肝胆湿热证 腹腔镜手术 清肝利胆汤 肌钙蛋白I 巨噬细胞集落刺激因子 氧化应激反应 术后恢复 临床疗效 

分 类 号：R269.574[医药卫生—中西医结合]