扶正利胆汤对贲门癌术后胆囊收缩障碍的临床疗效观察

The Clinical Pharmacodynamics Study of Fuzhenglidantang on Dysfunction of Gallbladder Contraction after Resection of Cardiac Cancer

目的研究扶正利胆汤对贲门癌术后胆囊收缩障碍的临床治疗作用及其机制探讨。方法选择120例贲门癌术后患者,随机分为试验组60例和对照组60例;试验组患者,在术后第10天开始口服扶正利胆汤,连服20天;对照组患者,在术后第10天口服等体积的水,连服20天;在实验治疗期间,对上述两组患者均进行常规抗炎、补液等治疗。所有患者分别于术前3天、术后30天对胆囊进行超声波指标测定,测定条件是空腹、服用脂餐0.5小时后、服用脂餐1小时后,应用超声波测定胆囊最大纵切面积、长径、短径,计算胆囊超声容积、排空率指标,并在术前3天、术后30天测定空腹血清胆囊收缩素浓度。比较两组患者手术前后胆囊的容积、排空、排空率及空腹血清胆囊收缩素浓度。结果1)两组患者手术前后胆囊收缩功能比较:对照组患者术后胆囊容积较术前明显增大(P<0.05),治疗组患者术后胆囊容积较术前没有显著性改变;术前治疗组和对照组患者胆囊容积无显著差别(P>0.05);术后试验组胆囊容积比对照组患者的胆囊容积明显缩小,两组比较具有显著性差异(P<0.05)。2)两组患者手术前后空腹血清胆囊收缩素(CCK)浓度比较:术前两组CCK浓度无明显差别(P>0.05);术后对照组患者CCK浓度较术前明显下降(P<0.05),治疗组患者术后CCK浓度较术前无明显改变(P>0.05),术后试验组患者较对照组血清CCK浓度明显升高,两组比较有显著性差异(P<0.05)。结论贲门癌术后出现胆囊排空障碍,术后胆囊容积与术前相比明显增大。扶正利胆汤可以提高血清CCK浓度,改善术后胆囊容积,对于贲门癌术后的胆囊收缩障碍有一定的治疗作用。

Objective To explore the clinical treatment effect and its mechanism of the traditional Chinese medicine Fuzhenglidantang on dysfunction of gallbladder contraction after resection of cardiac cancer. Methods We selected 120 cases of resection of cardiac cancer in Hebei General Hospital All the patients were randomly divided into two groups. The treated group including 60 cases： Fuzhenglidantang was used on the 10th day after operation. The duration was 20 days. The control group including 60 cases： routine treatments such as anti- inflammatory and rehydration were used. On the third day preoperatively and the 30th day postoperatively all of the patients took type-B ultrasonic examination to measure the maximum longitudinal section, long diameter and short diameter, and to calculate the gallbladder volume, emptying rate, etc before and at 0.5, 1 hour following meal intake. And the fasting serum concentration of CCK was measured on the same days. Comparisons were made between the preoperative and postoperative results, and also between two groups. Results 1. The contrast of gallbladder contraction function in preoperation and postoperation： The postoperative gallbladder volume increased obviously compared with preoperative gallbladder volume in control group （P〈 0.05）, but had no significant increase in treated group （P〈 0.05）. There was no significant difference between two groups in gallbladder contraction function preoperatively （P〉0.05）. The gallbladder volume increased more obviously and the gallbladder contraction function declined more significantly in control group than in treated group, and there were statistically significant differences （P〈0.05）. 2. The contrast of concentration of CCK in preoperation and postoperation： The postoperative concentration of CCK declined obviously compared with preoperative concentration in control group （P〈0.05）, but had no significant increase in treated group （P）0.05）. There was no significant difference in preoperative concentration of CCK between two groups （P〈0.05）. The postoperative concentration of CCK increased more obviously in treated group than that in control group, and there were statistically significant differences （P〈0.0 5）. Conclusion After resection of cardiac cancer gallbladder emptying disorders occurred, postoperative gallbladder volume increased obviously compared with preoperative. Traditional Chinese medicine Fuzhenglidantang could improve fasting serum concentration of CCK and postoperative gallbladder volume, and might have certain therapeutic effect on dysfunction of gallbladder contraction after resection of cardiac cancer.