十二味疏肝利胆冲剂联合ERCP治疗胆总管结石30例临床分析
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1. 安徽省中医药科学院外科研究所,安徽 合肥 230038;2. 安徽中医药大学第一附属医院,安徽 合肥 230031

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R256.4

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基金项目: 国家“十二五”重点专科建设项目(财社〔2013〕239号);安徽中医药大学科学研究基金项目(2015qn017) 收稿日期: 2015 - 08 - 11 作者简介: 周富海(1986-),男,安徽庐江人,医师,硕士,从事中西医结合外科的基础与临床研究。△通信作者:于庆生,E-mail:qsy6312@163.com


30 Cases Clinical Analysis of Shugan Lidan Granules Composed of Twelve TraditionalChinese Medicine Combined with Endoscopic Retrograde Cholangio-Pancreatographyin Treatment of Common Bile Duct Stones
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1. Institute of Surgery of Anhui Provincial Academy of Traditional Chinese Medicine, Hefei 230038, China;2. The First Affiliated Hospital of Anhui Traditional Chinese Medicine University, Hefei 230031, China

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    摘要:

    目的观察十二味疏肝利胆冲剂联合ERCP治疗胆总管结石的临床疗效。方法将60例胆总管结石的患者采用随机按数字表法分成对照组30例和研究组30例,对照组予以ERCP治疗,术后常规抑酶、抑酸、抗感染;研究组在对照组治疗的基础上给予十二味疏肝利胆冲剂口服。观察比较2组患者右上腹部疼痛、发热和黄疸的临床症状积分的改善情况及治疗前后血常规指标(白细胞、中性粒细胞、中性粒细胞百分比)、肝功能指标(谷丙转氨酶、谷草转氨酶、AKP)、血淀粉酶(AMY)、血清胆石形成生化指标(总胆汁酸、总胆红素、直接胆红素、间接胆红素)、鼻胆管引流量的变化。结果2组的症状积分较治疗前均明显好转(P<0.05),研究组优于对照组(P<0.05);2组能降低血常规指标、肝功能指标、血清胆汁生化指标和提高胆汁引流量,均较治疗前明显好转(P<0.05),研究组较对照组差异显著(P<0.05)。结论疏肝利胆冲剂联合ERCP治疗胆总管结石可以明显改善临床症状、控制术后胆总管炎症、促进肝功能早日恢复、降低术后淀粉酶和增加胆汁引流量,防治术后结石再生。

    Abstract:

    Objective To observe the clinical efficacy of Shugan Lidan Granules Composed of Twelve Traditional Chinese Medicine combined with endoscopic retrograde cholangio-pancreatography(ERCP) in treatment of common bile duct stones. Methods A randomized controlled trial was performed in patients with common bile duct stones, who were divided into study group(n=30) and control group(n=30). The control group underwent ERCP followed by Inhibition enzymes and anti-infective therapy, while the study group was orally given Shugan Lidan Granules composed of twelve traditional Chinese medicines in addition to the treatment for the control group. After treatment, the clinical outcomes, routine blood indices(leukocytes, neutrophils, and Percentage of neutrophils), liver function indices(aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and glutamyl transpeptidase), Serum amylase, serum bile acid and bilirubin levels(total bile acid, total bilirubin, direct bilirubin, and indirect bilirubin), and Nasal duct-tube drainage volume were evaluated. Results Compared with before treatment, there was significantly difference in clinical symptom, routine blood indices, liver function indices, and Serum amylase, serum bile acid and bilirubin levels(P<0.05); and significantly larger bile drainage volume compared with the control group(P<0.05). Conclusion ERCP combined with oral administration of Shugan Lidan Granules are helpful for controlling postoperative bile duct inflammation, promoting postoperative recovery of liver function, reducing postoperative amylase and removal of residual stones, and preventing stone recurrence.

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