ENBD配合中药治疗阻塞性黄疸的临床研究

Advantages of ENBD Combined with Traditional Chinese Medicine in Treating Obstructive Jaundice over Other Conventional Therapies

目的：研究比较阻塞性黄疸ENBD配合中医药治疗的优势。方法：对50例阻塞性黄疸病人行ENBD后24～48h辅助中医药治疗。中药方剂以大柴胡汤为基本方，湿热型热重于湿则加茵陈、桅子等，毒炽热盛则加五味消毒饮，湿重于热则加茵陈五苓散。设立A、B两组肝功能接近正常值准则。结果：ENBD配合中医药治疗组治疗治愈率（95．3％）明显高于对照组（81．7％）。肝功能值接近正常值时间缩短3．96～7．66d。术后第7d血清总胆红素水平（26．79～4．38）μmol／L明显低于对照组（40．31±4．08）μmol／L。结论：在治疗阻塞性黄疸病人中，ENBD配合中药明显优于单纯药物护肝治疗或单纯ENBD＋常规护肝治疗。

Objective To evaluate the advantages of endoscopic nasal-biliary drainage（ENBD） combined with traditional Chinese medicine in treating obstructive jaundice over other conventional therapies Methods After being treated by ENDB for 24-48 hours, 100 patients with obstructive jaundice were randomly divided into 2 groups. 50 patient in group A were treated by conventional therapy, those in group B by adjuvant therapy with herbal medicine mainly ＂DaChaiHu（大柴胡） decoction＂. For patients in damp-heat syndrome, herbs such as capillaris and gardenia were added, for those patients in heat intoxication syndrome, herbal decoctions such as ＂WuWeiXiaoDuYin＂ （五味消毒饮） or ＂YinChenWuLingSan＂ （茵陈五苓散） were used. Normal hepatic function standard were determined.Results The healing rate in group B（95.3%） was significantly higher than that in group A（81.7%）. The average time of hepatic function recovery in group B was 3.96～7.66 days earlier than that in control group. Conclusion ENBD combined with traditional herbal medicine has many advantages over that with western medicine in the treatment of obstructive jaundice.