| 引用本文: |
单秋旺,霍鹏,李琳琳,王宏斌,孙秀娟,田楠.中药消炎利胆汤联合常规西药对胆结石微创术后患者胆囊功能、炎性因子和临床疗效的影响[J].湖南中医药大学学报,2019,39(11):1399-1402[点击复制] |
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| 中药消炎利胆汤联合常规西药对胆结石微创术后患者胆囊功能、炎性因子和临床疗效的影响 |
| 单秋旺,霍鹏,李琳琳,王宏斌,孙秀娟,田楠 |
| (保定市第五医院普外肛肠科, 河北 保定 071051) |
| 摘要: |
| 目的 观察中药消炎利胆汤联合西药治疗胆结石微创术后患者的临床疗效，探讨其临床应用价值。方法 选取2017年10月至2018年6月本院收治并采用微创保胆取石术治疗的胆石症患者78例，采用随机数字表法分为观察组和对照组，每组39例。对照组在患者行微创术后胃肠功能恢复之时，予以熊去氧胆酸片口服；观察组在对照组的基础上加用中药消炎利胆汤治疗。观察患者治疗前后胆囊壁厚度、胆囊收缩率、炎性因子[白介素-6（interleukin 6，IL-6）、肿瘤坏死因子-α（tumor necrosis factor-α，TNF-α）]水平，治疗后临床疗效、不良反应及复发情况。结果 （1）治疗后，两组患者较治疗前胆囊壁厚度降低、胆囊收缩率增加（P<0.05），且观察组胆囊壁厚度低于对照组、胆囊收缩率高于对照组（P<0.05）；（2）治疗后，两组患者IL-6、TNF-α均较治疗前下降（P<0.05），且观察组低于对照组（P<0.05）；（3）治疗后，观察组的总有效率高于对照组（P<0.05），两组均未出现明显不良反应；（4）治疗后12个月内，观察组出现2例结石复发，对照组出现7例，两组复发率比较差异有统计学意义（P<0.05）。结论 采用中药消炎利胆汤联合西药治疗微创保胆取石术后患者可改善胆囊功能和周围炎症，降低结石复发率，临床疗效显著且优于单纯西药治疗，值得临床推广。 |
| 关键词: 胆结石 微创术 消炎利胆汤 胆囊功能 炎性因子 |
| DOI：10.3969/j.issn.1674-070X.2019.11.024 |
| 投稿时间：2019-09-03 |
| 基金项目:河北省中医药管理局课题题目（2019373）。 |
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| Effects of Xiaoyan Lidan Decoction Combined with Routine Western Medicine on Gallbladder Function, Inflammatory Factors and Clinical Efficacy in Patients with Gallstone after Micro-invasive Surgery |
| DAN Qiuwang,HUO Peng,LI Linlin,WANG Hongbin,SUN Xiujuan,TIAN Nan |
| (Department of General Anorectal Medicine, The No.5 Hospital of Baoding, Baoding, Hebei 071051, China) |
| Abstract: |
| Objective To observe the clinical efficacy of Xiaoyan Lidan Decoction combined with western medicine in the treatment of patients with gallstones after micro-invasive surgery, and to explore its clinical application value. Methods A total of 78 patients with cholelithiasis treated by micro-invasive cholelithotripsy from October 2017 to June 2018 were randomly divided into an observation group and a control group, with 39 cases in each group. The control group was given ursodeoxycholic acid tablets orally when gastrointestinal function was recovered after micro-invasive surgery, while the observation group was treated with Xiaoyan Lidan Decoction on the basis of the control group. The thickness of gallbladder wall, gallbladder contraction rate, levels of inflammatory factors[interleukin-6 (IL-6), tumor necrosis factor-A (TNF-a)] and clinical efficacy, adverse reactions and recurrence were observed before and after treatment. Results (1) After treatment, the thickness of gallbladder wall decreased and the contraction rate of gallbladder increased in both groups (P<0.05). The thickness of gallbladder wall in the observation group was thinner than that in the control group, while the contraction rate of gallbladder was higher (P<0.05). (2) After treatment, the levels of IL-6 and TNF-a in both groups were decreased than those before treatment (P<0.05) and the levels of IL-6 and TNF-a in observation group was lower than the control group. (3) After treatment, the total effective rate of the observation group was higher than that of the control group (P<0.05), and there were no obvious adverse reactions in both groups. (4) Within 12 months after treatment, 2 cases of stone recurrence occurred in the observation group and 7 cases in the control group. There was a significant difference between the 2 groups (P<0.05). Conclusion Xiaoyan Lidan Decoction combined with western medicine can improve gallbladder function and peripheral inflammation after micro-invasive cholecystolithotomy, and reduce the recurrence rate of gallstones. The clinical effect is significant and superior to that of western medicine alone. It is worthy of clinical promotion. |
| Key words: gallstones micro-invasive surgery Xiaoyan Lidan Decoction gallbladder function inflammatory factors |
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