中西医结合三步法治疗胆囊结石

Experience in Treatment of Gallstone Disease with Three-Step Therapy of Integrated Medicine.

目的 :探索胆囊结石的中西医结合有效疗法。 方法 :选择胆囊有一定功能的单纯胆囊结石患者 ,采用中西医结合系统三步疗法。首先运用中药、八卦拍打和肝胆俞穴位注射等疗法以疏肝利胆、化瘀通腑。然后应用纤维胆镜微创胆囊取石术。保胆取石 1周后 ,采用中西药物和体疗积极进行恢复胆囊功能、防止结石再生的治疗 ,并加强随访和指导调养。 结果 :94 3～ 99 2间应用中西医结合三步疗法治疗胆囊结石 393例 ,其中术后已满 3年者 178例 ,手术残石率 1 1% ,术后伤口感染0 5 % ,无胆漏、出血、腹腔感染等。患者术后 1～ 2月内症状完全消失者占 91 6 % (16 3/178)。 178例的 1年、2年、3年随访率分别为 92 7% (16 5 /178)、90 4% (16 1/178)、85 4% (15 2 /178) ,1年、2年、3年的结石复发率分别为 2 4% (4/16 5 )、3 7% (6 /16 1)、3 9% (6 /15 2 )。 结论 :中西医结合三步疗法“保胆取石” ,能有效清除胆囊结石、消除症状和防止胆石再生 ,治疗后 1年、2年、3年的结石复发率显著低于以往报道。该法可作为胆囊有一定功能的单纯胆囊结石患者的一种有效疗法。

to investigate the effective therapy of integrated traditional and western medicine for the gallstone diseases.Methods:the three step therapy is as follows:first,using Chinese herbal medicine,special Bagua patting,and acupoint injection to recuperate the gallbladder function,then performing mini invasive cholangioscopic cholecystolithotomy without gallbladder fistula,and being followed by comprehensive therapy as the third step mainly including herbal medicine,acupoint injection to further recuperate the gallbladder function and to decrease the gallstone recurrence rate.Results:393 cases were treated during the years of 1994～1999,of which 178 cases were followed for more than 3 years after the three step therapy.The 1 ,2 ,and 3 year follow up rate was 92.7%(165/178)、90.4%(161/178)、85.4%(152/178)respectively.The residue stone rate of cholecystolithotomy was 1.1%(2/178).One patient had wound infection(0.5%).There were no bile leakage nor other complications.The symptoms were disappeared among 91.6%(163/178)of the patients within 1～2 months after operation.The 1 ,2 ,and 3 year gallstone recurrence rate were 2.4%(4/165),3.7%(6/161)and 3.9%(6/152)respectively,remarkably lower than those reported in the literature.Conclusion:The three step therapy of integrated traditional and western medicine is effective in treating gallstone diseases while preserving the gallbladder and to decrease the gallstone recurrence remarkably.