摘要
背景：胆源性腹痛（BTP）是造成胆囊切除术后综合征（PCS）的主要原因,目前主要采取药物治疗.目的：观察马来酸曲美布汀联合胆舒胶囊治疗胆囊切除术后BTP患者的疗效和不良反应.方法：72例BTP患者随机分为马来酸曲美布汀联合胆舒胶囊治疗组（A组,36例）和胆舒胶囊治疗组（B组,36例）,选取20例无症状胆囊切除术后患者（C组）和40例正常体检者（D组）分别作为疾病对照和正常对照.以B超测量胆总管（CBD）直径,腹痛评分评估药物治疗的疗效.结果：BTP组和C组的平均CBD直径明显大于D组,BTP组又明显大于C组,BTP组中CBD直径〉10 mm者的比例高于C组,差异均具有统计学意义（P〈0.01）.治疗前,A、B组平均CBD直径差异无统计学意义（P〉0.05）.治疗6周后,A组的平均CBD直径明显缩小（P〈0.01）,B组较治疗前略有缩小,但差异无统计学意义（P〉0.05）.A组腹痛缓解的总有效率显著高于B组（88.9%对58.4%,P〈0.01）,两组总不良反应发生率差异无统计学意义（16.7%对13.9%,P〉0.05）.结论：马来酸曲美布汀联合胆舒胶囊治疗BTP的疗效明显优于单用胆舒胶囊,术后扩张的CBD明显缩小,且不良反应较轻微.
Background： Biliary-type pain （BTP） is the main component of postcholecystectomy syndrome （PCS）, and its main treatment is medication. Aims： To observe the efficacy and side effects of trimebutine maleate combined with Danshu capsule in treating patients with BTP after cholecystectomy. Methods： Seventy-two BTP patients were randomly assigned into trimebutine maleate combined with Danshu capsule treatment group （group A, 36 cases） and Danshu capsule treatment group （group B, 36 cases）. Twenty patients with no symptoms after cholecystectomy （group C） and 40 healthy volunteers （group D） were served as disease controls and normal controls. The mean common bile duct （CBD） diameter was measured by B-ultrasound. The efficacy was assessed according to score of abdominal pain. Results： The mean CBD diameter of BTP group and group C were larger than that of group D, and that of BTP patients was larger than that of group C （P〈0.01）. The percentage of BTP patients with CBD diameter 〉10 mm was higher than that of group C （P〈0.01）. Before treatment, the mean CBD diameter was not significantly different between group A and group B （P〉0.05）. After 6- week treatment, the mean CBD diameter in group A decreased significantly （P〈0.01）, and the decrease in group B was slight and with no statistical significance （P〉0.05）. The total efficacy rate of group A about the relief of abdominal pain was much higher than that of group B （88.9% vs. 58.4%, P〈0.01）. No significant difference about the incidence of side effects was seen between group A and group B （16.7% vs. 13.9%, P〉0.05）. Conclusions： The efficacy of trimebutine maleate combined with Danshu capsule is better than Danshu capsule alone in treating BTP patients, which could notably reduce the enlargement of CBD after cholecystectomy and with slight side effects.
出处
《胃肠病学》
2010年第10期591-594,共4页
Chinese Journal of Gastroenterology
