茵陈蒿汤加减联合腹腔镜手术治疗胆总管结石的疗效观察  

Curative effect of Yinchenhao decoction combined with laparoscopic operation on choledocholithiasis

作　　者：冯矗 赵芳[1] 苏玉霞 刘慧竹 FENG Chu;ZHAO Fang;SU Yuxia;LIU Huizhu(Department of General Surgery,Putuo People′s Hospital,School of Medicine,Tongji University,Shanghai 200060,China)

机构地区：[1]同济大学附属普陀人民医院普外科,上海200060

出　　处：《新疆医科大学学报》2023年第12期1670-1674,1679,共6页Journal of Xinjiang Medical University

基　　金：江苏大学医教协同创新基金项目(JDYY2023123);2022年度上海市普陀区卫生健康系统科技创新项目(ptkwws202211)。

摘　　要：目的 探讨茵陈蒿汤加减联合腹腔镜手术治疗胆总管结石的临床疗效。方法 回顾性分析2019年1月至2022年6月同济大学附属普陀人民医院普外科收治并接受手术治疗的80例胆总管结石患者,根据是否接受茵陈蒿汤加减辅助治疗将病例分为研究组(术后常规治疗联合茵陈蒿汤加减)和对照组(术后仅予以常规对症治疗),各40例。比较两组病例的术前、术后第3天、术后第2周部分肝功能指标[谷丙转氨酶(Alanine aminotransferase, ALT)、谷草转氨酶(Aspartate aminotransferase, AST)]、免疫功能指标[免疫球蛋白G(Immunoglobulin G,IgG)、免疫球蛋白A(Immunoglobulin A,IgA)、CD4~+/CD8~+T淋巴细胞比值(CD4~+/CD8~+ T lymphocyte ratio, CD4~+/CD8~+)]及胃肠道生活质量指数(Gastrointestinal qality of life index, GIQLI)等异同。结果 术后第14天,研究组患者肝功能指标ALT、AST低于对照组,IgG、IgA、CD4~+/CD8~+、GIQLI评分高于对照组,差异均有统计学意义(P<0.05)。结论 茵陈蒿汤加减联合腹腔镜手术能加速恢复胆总管结石患者的肝功能,增加患者个体免疫力和抵抗力,显著提高患者的生活质量,值得临床推广应用。Objective To investigate the therapeutic effect of modified Yinchenhao decoction combined with laparoscopic operation on choledocholithiasis.Methods Discuss the value of modified Yinchenhao decoction combined with laparoscopic operation in treatment of choledocholithiasis from the perspectives of liver function,immune function recovery and quality of life evaluation.A retrospective analysis was conducted on 80 patients with common bile duct stones admitted to the hospital from January 2019 to June 2022.Based on whether the patients received further adjuvant treatment with Yinchenhao decoction,the patients were divided into study group(postoperative routine treatment combined with Yinchenhao decoction)and control group(postoperative routine symptomatic treatment only),with 40 patients in each group.Statistical analysis of partial liver function indicators[alanine aminotransferase(ALT),aspartate aminotransferase(AST)],and preoperative,postoperative day 3 and postoperative week 2 in 2 groups of cases changes in immune function indicators such as immunoglobulin G(IgG),immunoglobulin A(IgA),CD4+/CD8+T lymphocyte ratio(CD4+/CD8+T lymphocyte ratio)and gastrointestinal quality of life index(GIQLI).ResultsOn the 14th day after the,operation,the liver function indicators ALT and AST of the patients in the study group were lower than those in the control group,and IgG,IgA,CD4+/CD8+and GIQLI scores were higher than those in the control group,and the differences were all statistically significant(P<0.05).ConclusionThe combination of modified Yinchenhao decoction and laparoscopic operation can accelerate the recovery of liver function in patients with choledocholithiasis,increase their individual immunity and resistance,and significantly improve their quality of life,which is worthy of clinical promotion.

关 键 词：茵陈蒿汤 腹腔镜 胆总管结石 术后恢复 

分 类 号：R725.6[医药卫生—儿科]