摘要
目的探讨柴芍疏肝利胆排石汤辅助腹腔镜胆囊切除术治疗慢性胆囊炎合并胆囊结石的疗效。方法将符合入选标准的2016年1月-2019年1月本院198例慢性胆囊炎合并胆囊结石患者采用随机数字表法分为2组,每组99例。2组均施以腹腔镜胆囊切除术,对照组在此基础上口服熊去氧胆酸,观察组在对照组基础上加服柴芍疏肝利胆排石汤,2组均治疗8周。分别于治疗前后进行中医症状、体征评分;采用双抗夹心ELISA法检测血清TNF-α、IL-6、超敏C反应蛋白(hs-CRP)、促胃液素(gastrin,GAS)、促胃动素(motilin,MOT)及生长抑素(somatostatin,SST)水平,记录不良反应,评价临床疗效。结果观察组总有效率为94.9%(94/99)、对照组为82.8%(82/99),2组比较差异有统计学意义(χ^(2)=7.364,P=0.007)。治疗后,观察组右胁胀痛、心烦易怒、脘腹满闷、厌油腻、恶心呕吐、嗳气评分均低于对照组(t值分别为7.229、4.773、4.442、2.302、5.887、4.235,P<0.05或P<0.01);血清TNF-α、IL-6、hs-CRP水平均低于对照组(t值分别为9.330、18.425、26.886,P<0.05);血清GAS[(104.53±2.13)ng/L比(96.61±3.29)ng/L,t=20.106]、MOT[(386.60±9.42)ng/L比(345.50±12.80)ng/L,t=25.731]水平均高于对照组,SST[(40.05±4.39)ng/L比(48.42±5.11)ng/L,t=12.362]水平低于对照组(P<0.01)。2组治疗期间均未发生严重不良反应。结论柴芍疏肝利胆排石汤辅助腹腔镜胆囊切除术可有效改善患者的临床症状,抑制炎症反应,改善胃肠功能,提高临床疗效。
Objective To investigate the effect of Chaishao-Shugan-Lidan-Paishi Decoction assisted with laparoscopic cholecystectomy in the treatment of chronic cholecystitis with gallstones.Methods According to the random number table method,198 cases of chronic cholecystitis combined with cholecystolithiasis were admitted to our hospital from January 2016 to January 2019 and were divided into two groups,99 cases in each group.Laparoscopic cholecystectomy was performed in both group.Then the control group was treated with Ursodeoxycholic Acid,and the observation group was treated with Chaishao-Shugan-Lidan-Paishi Decoction on the basis of the control group.Both groups were treated for 8 weeks.The clinical efficacy was evaluated after the treatment TCM symptoms and signs were scored before and after the treatment;the levels of TNF-a,IL-6,hs-CRP,gastrin(GAS),motilin(MOT)and somatostatin(SST)were detected by double antibody sandwich ELISA,and the adverse reactions during the treatment were recorded.Results The total effective rate of the observation group was 94.9%(94/99),the control group was 82.8%(82/99),the difference between the two groups was statistically significant(χ^(2)=7.364,P=0.007).The score of the right flank pain,the level of upset and irritable condition,the sense of fullness of epigastric cavity,greasiness,nausea and vomiting,belching score after the treatment in the observation group were significantly lower than those in the control group(t values were 7.229,4.773,4.442,2.302,5.887,4.235,respectively,P<0.05 or P<0.01).After the treatment,the levels of serum TNF-a,IL-6,hs-CRP in the observation group were significantly lower than those in the control group(t values were 9.330,18.425,26.886,respectively,all Ps<0.05),and the levels of serum GAS(104.53±2.13 ng/L vs.96.61±3.29 ng/L,t=20.106)and MOT(386.60±9.42 ng/L vs.345.50±12.80 ng/L,t=25.731)in the observation group were significantly higher than those of the control group,SST(40.05±4.39 ng/L vs.48.42±5.11 ng/L,t=12.362)in the observation group was significantly lower than that of the control group(P<0.01).No serious adverse reactions occurred during the treatment period in both groups.Conclusion Chaishao-Shugan-Lidan-Paishi Decoction assisted laparoscopic cholecystectomy in the treatment of chronic cholecystitis with gallstones can improve the clinical symptoms,inhibit inflammation,improve gastrointestinal function,improve clinical efficacy.
作者
陈俊宇
崔宇
Chen Junyu;Cui Yu(Department of Thoracic Surgery,Chongqing Southeast Hospital,Chongqing 401336,China)
出处
《国际中医中药杂志》
2021年第4期340-344,共5页
International Journal of Traditional Chinese Medicine
基金
重庆市科卫联合医学科研项目(2016MSXM040)。
关键词
胆囊炎
胆结石
柴芍疏肝利胆排石汤
胆囊切除术
腹腔镜
中西医结合
Cholecystitis
Cholelithiasis
Chaishao-Shugan-Lidan-Paishi Decoction
Cholecystectomy,laparoscopic
Integrated Traditional Chinese Medicine&Western Medicine
