疏肝利胆汤配合内镜治疗老年胆总管结石疗效观察

Preliminary study elderly patients with common bile duct stones treated by Shuganlidan decoction combined with therapeutic endoscopy

目的观察疏肝利胆汤联合内镜治疗老年胆总管结石的临床疗效。方法对80例老年(>60岁)胆总管结石患者内镜治疗,术后随机分为2组,对照组40例给予常规抗感染、抑酸和补液治疗;治疗组40例在对照组治疗基础上加疏肝利胆汤。检测2组患者术后第3、7 d直接胆红素、白细胞计数、丙氨酸氨基转移酶(ALT)、C-反应蛋白及7 d平均胆汁引流量。结果 80例患者全部内镜治疗成功,无严重并发症,无死亡病例;治疗组术后第3 d直接胆红素、白细胞计数、ALT及C-反应蛋白下降幅度均显著优于对照组(P<0.05);治疗组术后第7 d直接胆红素较对照组同期下降(P<0.05),7 d平均胆汁引流量多于对照组(P<0.05)。结论内镜治疗老年胆总管结石安全、高效,联合疏肝利胆汤可以使患者恢复更快。

Objective To observe the effect of endoscopic treatment combined with Shuganlidan decoction on elderly patients with common bile duct stones. Methods 80 elderly patients with common bile duct stones which received therapeutic endoscopy were randomly divided into two groups postoperation. 40 cases in control group re ceived conventional antibiotics, acid suppression and rehydration therapy. 40 cases in treatment group received Shu ganlidan decoction on the basis of control group treatment. Direct bilirubin,white blood cell count, alanine aminotrans ferase （ALT）, C -reactive protein, bile drainage was detected ＇after the first 3,7 day of operation. Results All 80 patients＇ endoscopic treatment was success ; there were no serious complications and no deaths. Decline of Direct bili rubin, white blood cell count, ALT, C - reactive protein in treatment group was superior to that in control group after first 3 day of operation （P 〈 0.05 ）. Volume of bile drainage in treatment group was more than that in control group （ P 〈 0.05 ）. Conclusion Endoscopic treatment combined with Shuganlidan decoction has safety and high effective, and can short hospital stay on elderly patients with common bile duct stones.