芍药甘草汤对肝胆湿热型胆总管结石取石术术后患者的疗效观察  

Observation on the therapeutic effect of Shaoyao Gancao Decoction in the treatment of choledocholithiasis patients with the syndrome of dampness-heat of the liver and gallbladder after an endoscopic retrograde cholangiopancreatography

作　　者：陈晓东 黄金鑫[1] 唐睿[1] 李甫[1] 丁俊[1] 张晞文[1] CHEN Xiaodong;HUANG Jinxin;TANG Rui;LI Fu;DING Jun;ZHANG Xiwen(Department of Pancreaticobiliary Surgery,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院胰胆外科,上海201203

出　　处：《吉林中医药》2023年第7期789-792,共4页Jilin Journal of Chinese Medicine

基　　金：国家自然科学基金资助项目(81904017);上海市科委“科技创新行动计划”临床医学领域项目(19401972400);上海中医药大学附属曙光医院中西医结合研究专项(SGZXY-201905)。

摘　　要：目的观察芍药甘草汤在肝胆湿热型胆总管结石患者内镜逆行胰胆管造影术后的治疗效果。方法选择201例肝胆湿热型胆总管结石患者,按照随机数表法分为研究组与对照组,研究组100例,对照组101例。2组均给予常规西医基础治疗,研究组同期加用芍药甘草汤,药物为配方颗粒,每袋4.9 g,每次1袋,每日2次,温水冲服,疗程28 d。比较2组治疗前后中医证候评分,血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBIL)水平,胆汁中胆固醇和总胆汁酸的浓度以及并发症发生情况。结果201例患者中,11例患者脱落,可评价患者190例,研究组与对照组各95例。治疗后,2组中医证候评分较治疗前均显著降低(P<0.01),且研究组出院中医证候评分低于对照组(P<0.01)。治疗后,研究组ALT、AST、TBIL水平均较对照组显著降低(P<0.01)。治疗后,研究组胆汁中胆固醇的浓度较对照组显著降低(P<0.01),研究组胆汁中总胆汁酸浓度较对照组显著升高(P<0.01)。治疗后,研究组术后并发症总发生率低于对照组(P<0.05)。结论芍药甘草汤应用于肝胆湿热型胆总管结石患者内镜逆行胰胆管造影术后具有较好的临床疗效,可减轻患者临床症状,促进肝功能指标恢复,改变患者胆汁成分,降低术后并发症发生率。Objective To observe the therapeutic effect of Shaoyao Gancao Decoction in the treatment of choledocholithiasis patients with the syndrome of dampness-heat of the liver and gallbladder after an endoscopic retrograde cholangiopancreatography.Methods A total of 201 choledocholithiasis patients with the syndrome of dampness-heat of the liver and gallbladder were selected and randomly divided into an experimental group and a control group,with 100 cases in the experimental group and 101 cases in the control group.Both groups were given a conventional western medicine basic treatment,and the experimental group was given Shaoyao Gancao Decoction at the same time,which was formula granules,4.9 g per bag,one bag per time,twice a day,taken with warm water for 28 days.The TCM symptom scores,the serum levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBIL),the concentrations of cholesterol and total bile acid in bile,and the incidence of complications were compared between the two groups before and after treatment.Results Among the 201 patients,11 patients fell out,and 190 patients could be evaluated,with 95 patients in each group.After treatment,the TCM syndrome scores of both groups were significantly decreased compared with before treatment(P<0.01),and the TCM syndrome score of the experimental group was lower than that of the control group(P<0.01).After treatment,the levels of ALT,AST and TBIL in the experimental group were significantly lower than those in the control group(P<0.01).After treatment,the cholesterol concentration in the bile of patients in the experimental group was significantly lower than that of the control group(P<0.01),while the total bile acid concentration in the experimental group was significantly higher than that of the control group(P<0.01).After treatment,the total incidence of postoperative complications in the experimental group was lower than that in the control group(P<0.05).Conclusion Shaoyao Gancao Decoction has a good clinical effect in choledoc

关 键 词：内镜逆行胰胆管造影 胆总管结石 芍药甘草汤 肝胆湿热证 

分 类 号：R657[医药卫生—外科学]