疏肝利胆排石为主治疗胆囊切除术后综合征的临床观察

Effect of the Method of Soothing the Liver and Normalizing the Function of Gallbladder to Dissolve Calculi for the Postcholecystectomy Syndrome

为寻求降低胆囊切除术后综合征（ｐｏｓｔｃｈｏｌｅｃｙｓｔｅｃｔｏｍｙｓｙｎｄｒｏｍｅ，ＰＣＳ），尤其是有胆道残留或再发结石的ＰＣＳ发病率及再手术率的中医药治疗方法，以具有疏肝利胆、清热祛湿、理气通腑、消石化瘀作用的中药方剂治疗了ＰＣＳ３５例（其中有术后胆道残留、再发结石者３２例），并与以西药常规治疗的对照组３７例作对照观察。结果两组近期疗效相仿（Ｐ＞０．０５）；但远期追踪观察，中药组３年内再发作率２２．８６％，对照组３年内再发作率８６．４９％，差异有显著性（Ｐ＜０．０１）。提示：中医疏肝利胆、清热祛湿、理气通腑、消石化瘀法对大多数有胆道内原因的胆囊切除术后综合征切中病机。

Lidan Paishi Tang (LPT) is a self-prepared preparation with the actions of soothing the liver and normalizing the secretion and discharge of bile, removing heat and dampness, regulating the flow of qi to free the movement of Fu organs and resolving calculi. To explore a Chinese medicine therapy for the decrease of incidence of postcholecystectomy syndrome (PCS), especially for that of residual bile duct and the recurrence rate of PCS, 35 cases of PCS (32 of residual bile duct and stone relapse) were treated with LPT and 37 served as the control. The results showed that the curative rate and total effective rate in the treatment group were 20% and 91.43 % respectively, while 2.7 % and 83.78% in the control group respectively (P> 0.05 ), without significant differences. Follow_up was set up for 3 years and it was found that the recurrence rates in the treatment group and control group were 22.86% and 86.49% respectively (P< 0.01 ), the differences being significant. It is suggested that persistent and intermittent administration of LPT is an effective therapy for preventing and treating PCS.