锦红片对肝胆湿热证胆石病术后证候影响的临床研究

Clinical Research on Impact of Jinhong Tablet on Post- Operation Cholelithiasis with Damp- Heat Syndrome

目的:探讨锦红片对肝胆湿热证胆石病术后证候变化的影响,为其围手术期的规范运用提供依据。方法:收集本院2010年1月—2011年12月期间住院手术治疗的肝胆湿热证胆石病患者100例,随机分为对照组和锦红片组各50例,其中对照组术后服用锦红片,锦红片组在术后配合服用锦红片。观察患者一般情况、热平时间及腹痛缓解时间等。制订《胆石病术后肝胆湿热证中医证候调查表》,分析锦红片对胆石病患者术后肝胆湿热证中医证候的影响。结果:两组之间的性别、年龄、手术方式均衡性良好,无统计学差异。锦红片组的热平时间、排便时间、抗生素使用时间明显低于对照组,有显著统计学差异(P<0.01)。锦红片组的腹痛缓解时间、排气时间低于对照组,有统计学差异(P<0.05)。治疗后5 d,锦红片组的腹部嘈杂、舌体胖大、舌质淡白的出现频次均高于对照组,有统计学差异(P<0.05);对照组的低热、手足心汗、呕吐苦水、口渴饮水不多、舌质红、舌苔薄黄腻的出现频次均高于锦红片组,有统计学差异(P<0.05)。结论:对肝胆湿热证胆石病患者围手术期应用锦红片,可以缩短发热时间、腹痛时间、抗生素使用时间,加快肠功能恢复。同时术后清除湿热疗效显著,但在术后5 d容易出现脾胃虚损和肝阴虚的证候,此时应酌加养肝柔肝之药以免伤阴太过,或酌加健脾和胃之品以顾护脾胃。

Objective： To investigate the impact of Jinhong Tablet on post- operation cholelithiasis with damp- heat syndrome and thus providing the evidence of its perioperative specification use. Methods： From January 2010 to December 2011,100 cholelithiasis patients with damp- heat syndrome hospitalized ready for operation were randomly divided into 2 groups（ control group and Jinhong Tablet group）,50 patients in each group and the control group without Jinhong Tablet,Jinhong Tablet group with oral Jinhong Tablet. The general situation,fever relief time and defecation time were observed. We developed the questionnaire to record basic and recovery situations of the 100 patients as well as the symptoms and signs 5 days after the operation. And then analyze the impact of Jinhong Tablet on post- operation cholelithiasis with damp- heat syndrome. Results： There were no significant differences of gender,age and surgical approach of the two groups. In the Chinese medicine group,the fever relief time,defecation time and antibiotic using time were significantly lower than the control group＇s（ P〈 0. 01）. And pain relief time and passage of flatus time were lower than the control group＇s（ P〈 0. 05）. 5 days after treatment,in the Chinese medicine group,the frequency of abdominal disgusting,physical fatigue,clear abundant urine,dripping urine,constipation,big fat tongue and pale tongue were significantly higher than the control group＇s（ P〈 0. 05）. In control group,the frequency of complexion like orange peel,low fever,the sweat in palm of hand and foot,vomiting bitter water,thirst but little drink,mental exhaustion,dizziness,shortness of breath,body move difficulties,itching,painful urination,stool viscosity,red tongue,tongue with yellow- thin greasy coating were significantly higher than the Chinese medicine group＇s（ P〈 0. 05）. Conclusion： Using Jinhong Tablet to treat cholelithiasis with liver- gallbladder damp- heat syndrome during peri- operation period can shorten the time of fever,abdominal pain and antibiotic given and speed up recovery of bowel function. It also can clear damp- heat syndrome significantly,but it appeared that the yin deficiency of liver and spleen and stomach deficiency emerge 5 days after surgery. Drug of nourishing to avoid injuring yin andstrengthening the spleen and stomach should be added.