辨证治疗胆囊切除术后胆道功能障碍31例

Determination of Treatment Based on Syndrome Differentiation on PCBD,A Report of 31 Cases

目的:探讨中医辨证论治在胆囊切除术后胆道功能障碍(PCBD)诊治中的应用价值。方法:对临床上诊断为PCBD的31例患者进行中医辨证分为肝气郁结、肝血瘀阻型、肝胆湿热型3型,以柴胡疏肝散为基本方,根据辨证分型随证加减治疗。结果:临床治愈19例,好转9例,无效3例,总有效率为90.32%(95%CI=75.0%～98.1%)。所有病例均获随访3～6个月,未见复发。结论:说明中医辨证论治对于PCBD具有确切的治疗效果。

Objective： To approach the application value in diagnosing and treating functional disturbance of biliary passage after cholecystectomy （PCBD） with determination of treatment based on pathogenesis obtained through syndrome differentiation in TCM. Method： 31 cases of PCBD were divided into 3 patterns according to syndrome differentiation, which were group of depression of liver - QI, group of stasis of hepatic blood, and group of hepatochlic hygropyrexia. Bupleurum Liver - Soothing Powder was the fundamental formula, and modified by syndrome in clinic practice. Result： 19 cases were cured, 9 cases were effective, and 3 cases were ineffective. The total effective rate was 90.32% （95% CI =75.0% -98. 1% ）. All cases were follow - up visited for 3 to 6 months and no case was recurred. Conclusion： The therapeutic efficacy of determination of treatment based on pathogenesis obtained through syndrome differentiation in TCM on PCBD is exact and reliable.