炎调方改善老年急性胆囊炎PTGD后炎症指标的随机对照临床研究  

A randomized controlled clinical study on Yantiao Formula in improving inflammatory indicators in elderly patients with acute cholecystitis after PTGD

作　　者：刘加康 位锋 丁俊[1] LIU Jiakang;WEI Feng;DING Jun(Department of Traumatology and Emergency,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创伤急救科,上海201203

出　　处：《上海中医药大学学报》2024年第4期48-54,共7页Academic Journal of Shanghai University of Traditional Chinese Medicine

基　　金：上海市进一步加快中医药事业发展三年行动计划项目(ZY〔2018-2020〕-CCCX-2003-09);上海中医药大学产业发展中心医养结合科创项目(YYKC-2021-01-148);上海中医药大学附属曙光医院“中西医结合研究专项”项目(SGZXY-202205)。

摘　　要：目的:探讨炎调方对老年急性胆囊炎(AC)行经皮经肝胆囊穿刺置管引流术(PTGD)后患者的临床疗效。方法:采用随机、单盲、安慰剂对照临床研究方法。纳入72例老年AC行PTGD患者,随机分为对照组和治疗组,每组各36例。PTGD后所有患者均给予常规干预,在此基础上,对照组患者予以炎调方安慰剂口服治疗,治疗组患者予以炎调方口服治疗,治疗周期为4周。治疗前后检测并比较两组患者的炎症反应指标[包括白细胞(WBC)、中性粒细胞百分比(N%)、C反应蛋白(CRP)、降钙素原(PCT)、白介素(IL)-6]、肝功能指标[包括总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、谷氨酰转肽酶(GGT)、凝血酶原时间(PT)]水平,比较两组患者的中医临床症状总积分。结果:试验过程中,对照组4例患者被剔除,治疗组6例患者被剔除,最终纳入统计分析者对照组32例、治疗组30例。①治疗后,两组患者的WBC、N%、CRP、PCT、IL-6水平较治疗前均显著降低(P<0.05),且治疗组患者的CRP、PCT、IL-6水平低于对照组(P<0.05)。②治疗后,两组患者的TBIL、PT水平较治疗前均显著降低(P<0.05),但组间比较差异无统计学意义(P>0.05)。③治疗后,两组患者的中医临床症状总积分较治疗前均显著降低(P<0.01),且治疗组患者的总积分低于对照组(P<0.05)。结论:老年AC患者PTGD后使用炎调方内服有助于进一步减轻胆囊穿刺后的炎症反应、改善临床症状,值得临床推广应用。Objective:To explore the clinical efficacy of Yantiao Formula(YTF)in treating elderly patients with acute cholecystitis(AC)after percutaneous transhepatic gallbladder drainage(PTGD).Methods:A randomized,single-blind,placebo-controlled clinical study was conducted.A total of 72 elderly patients with AC undergoing PTGD were included and randomly divided into a control group and a treatment group,36 cases in each group.All the patients were given routine intervention after PTGD.Based on above,the patients in the control group were treated with YTF placebo orally,and the patients in the treatment group were treated with YTF orally,with a treatment course of 4 weeks.Before and after treatment,the levels of inflammatory response indicators[including white blood cell count(WBC),neutrophil percentage(N%),C-reactive protein(CRP),procalcitonin(PCT),interleukin(IL)-6],and liver function indicators[including total bilirubin(TBIL),alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),gamma-glutamyl transpeptidase(GGT),prothrombin time(PT)]were detected and compared,and the total scores of traditional Chinese medicine clinical symptoms were compared between the two groups.Results:During the trial,4 patients in the control group and 6 patients in the treatment group were excluded.Finally,32 cases in the control group and 30 cases in the treatment group were included in the statistical analysis.①After treatment,the levels of WBC,N%,CRP,PCT and IL-6 in both groups were significantly decreased compared with those before treatment(P<0.05),and the levels of CRP,PCT and IL-6 in the treatment group were lower than those in the control group(P<0.05).②After treatment,the levels of TBIL and PT in both groups were significantly decreased compared with those before treatment(P<0.05),but there were no statistically significant differences between the two groups(P>0.05).③After treatment,the total scores of traditional Chinese medicine clinical symptoms in both groups were significantly decreased compar

关 键 词：急性胆囊炎 经皮经肝胆囊穿刺引流术 炎调方 炎症指标 中西医结合 

分 类 号：R657.41[医药卫生—外科学]