利胆排石汤对胆结石患者治疗效果的临床研究

Pai Shi Tang Clinical Studies Gallbladder Gallstone Patients for Treatment

目的:通过观察分析利胆排石汤的临床疗效,以探究治疗胆结石的有效方法。方法:选取我院肝胆外科收治的胆结石患者80例,随机分为实验组和对照组,对照组40例,给予磺胺脒、熊去氧胆酸、阿司匹林等常规西药治疗,4周为1个疗程;实验组40例,在西药常规治疗的基础上加用利胆排石汤(柴胡10 g,枳实10 g,青皮10 g,陈皮10 g,虎杖根30 g,银花30 g,生大黄12 g,金钱草30 g,茵陈30 g,郁金12 g,川楝子12 g,元胡10 g,白芍12 g),每日1剂,4周为1个疗程。对比治疗前后患者血液分析(胆红素代谢、血清酶碱性磷酸酶ALP及血清铁与铜的含量)、影像学(B超)检查(胆囊内结石数量及大小)以及中医症状(包括腹部痛甚、心下痞满、憋闷气短)等参数。结果:1治疗后两组血中1 min胆红素与总胆红素之比有所下降,且实验组(35%)优于对照组(47%);血清酶碱性磷酸酶(ALP)水平有所下降,且实验组(37 U/L)优于对照组(45 U/L);血清铁与血清铜的比值有所上升,且实验组(0.8)优于对照组(0.6),差异有统计学意义(P<0.05)。2治疗后两组胆囊内结石数量及大小均有所改善,且实验组(9个、0.5cm)优于对照组(21个、1.2 cm),差异有统计学意义(P<0.05)。3治疗后两组患者腹部痛甚、心下痞满、憋闷气短等中医症状有所改善,且实验组总有效率高达90%,明显高于对照组77.50%,差异有统计学意义(P<0.05)。结论:加用利胆排石汤可有效降低1 min胆红素与总胆红素之比,降低血清酶碱性磷酸酶(ALP)水平,升高血清铁与血清铜的比值,减少结石数量、减小体积,对中医各症状有较显著优化作用。研究表明利胆排石汤是治疗胆结石的有效药物,对其临床治疗有指导意义。

Objective：By observing and analyzing the clinical efficacy of gallbladder row of stone soup,to explore an effective way to treat gallstones. Methods：Our hospital liver surgical treated 80 cases of patients with gallstones,randomly divided into experimental group and the control group,control group 40 cases,sulfaguanidine,bear to oxygen cholic acid,aspirin,such as conventional western medicine treatment,4 weeks for a period of treatment;the experimental group 40 cases,on the basis of conventional western medicine therapy combined with liver cholagogue decoction,daily 1 agent,4 weeks for a period of treatment. Contrast before and after treatment in patients with blood analysis（bilirubin metabolism,serum enzyme alkaline phosphatase（ALP）and serum iron and copper content,imaging（ultrasound）inspection（gall bladder calculi in quantity and size）and traditional chinese medicine symptoms,including abdominal pain,under the new heart full,depressive feeling shortness of breath）parameters. Results：（1）In the two groups after treatment 1 min bilirubin in the blood and the ratio of total bilirubin declined,and the experimental group（35%）is better than that of control group（47%）,serum alkaline phosphatase（ALP）enzyme levels have decreased,and the experimental group（37 U/L）is better than that of control group（45 U/L）,the ratio of serum iron and serum copper has increased,and the experimental group（0.8）is better than that of control group（0.6）,the difference was statistically significant（P〈0.05）,（2）In the two groups after treatment of gallbladder calculi in both quantity and size have improved,and the experimental group（9,0.5 cm）is better than that of control group（21,1.2 cm）,the difference was statistically significant（P〈0.05）.（3）In the two groups after treatment in patients with symptoms of traditional chinese medicine（including abdominal pain,the heart is very new,depressive feeling shortness of breath）have improved,and the experimental group is better than that of control group,the difference was statistically significant（P〈0.05）. Conclusion：Combined with liver cholagogue decoction can effectively reduce the 1 min bilirubin and the ratio of total bilirubin,delevated serum alkaline phosphatase（ALP）enzyme levels,elevated serum iron and serum copper ratio,reduce the number of stones,reducing the volume and effect on the symptoms of traditional Chinese medicine has the significantly optimized. Studies have shown that liver cholagogue decoction is an effective drug for treatment of gallstones,a guidance for the clinical treatment.