金石散溶解肝内外胆管结石的疗效分析

Clinical Study on Effect of Jinshisan on Dissolution of Extra-/Intrahepatic Biliary Stones

为探讨金石散溶解胆石的药效特点及其作用规律，组织临床协作治疗肝内外胆管结石１６４例，以Ｂ超为主的检查作治疗前后对比。结果表明：１６４例中痊愈２６例（１５．８５％），有效７３例（４４．５１％），无效６５例（３９．６３％），总有效率６０．３７％。右肝管结石８４例，服药后结石消失１０例，变小或减少者４４例；左肝管结石３４例，结石消失５例，变小或减少者１３例；胆总管结石２５例，结石消失及变小或减少各１０例；多处结石２１例．仅１例左、右肝管结石完全消失，除３例无效外，其余均有变小、减少或１处消失的变化。结石长径≤５ｍｍ者共１０例，有７例完全消失，仅２例无效，疗程以＞６个月为佳。胆汁分析显示，金石散具有增进胆汁酸和降低胆红素、粘液及－ＨＣＯ３－含量的作用。

In order to evaluate the role and mechanism of Jinshisan (JSS) in bile stone dissolution, 164 cases of extra-/intrahepatic biliary stone patients were treated by a collaborated group, the therapeutic effect was observed by B-ultrasonography before and after treatment. Results showed,(1)Among the 164 cases, 26 cases (15. 85%) were cured clinically: 73(44. 51%) were effective and 65 (39.63%) ineffective.(2) After treatment, in 84 patients of right hepatolith, the stone were diappeared in 10 cases, the size or number of stone decreased in 44 casess. In 34 patients with left hepatolith, the figure were 5 and 13 respectively. In 10 cases of choledocholith they were 10 and 10 respectively. While in 21 cases of multiple gallstone, only one case with stones of both sides disappeared, except 3 ineffective cases, others with stone decreased in size or number or disappeared unilaterally. (3) Gallston diappeared in 7 of 10 patients with size of stone ≤ 5 mm, only 2 of them were ineffective.(4) The effect were better in those with treatment course ＞ 6 months. (5) Analyis of bile showed that JSS could increase the amount of bile acid, decrease the bilirubin, mucous and bicarbonate radical in bile.