蒿芩清胆汤联合手术治疗老年胆囊炎的疗效研究

Study on Haoqinqingdan decoction combined with surgical treatment in elderly patients with cholecystitis

目的探究蒿芩清胆汤联合腹腔镜手术治疗老年胆囊炎病人的机制,为老年胆囊炎病人的临床治疗提供帮助。方法选取我院收治的160例老年胆囊炎病人,按随机数字表法将老年病人分为观察组和对照组,每组80例,对照组给予腹腔镜手术治疗,观察组在腹腔镜手术治疗的基础上给予蒿芩清胆汤治疗,治疗前和治疗后5 d检测并比较2组免疫细胞、免疫因子和应激反应因子变化情况。结果 2组治疗前血清相关免疫因子、免疫细胞、应激因子比较差异无统计学意义(P>0.05)。2组治疗后免疫球蛋白G(IgG)、IgA、IgM水平及CD3^+、CD4^+、CD8^+比例均明显降低,与治疗前比较,差异均有统计学意义(P<0.05);观察组治疗前后相关应激反应因子C反应蛋白(CRP)、空腹血糖(FPG)、白介素-6(IL-6)水平变化不明显,差异无统计学意义(P>0.05)。2组治疗后,观察组IgG、IgA、IgM水平及CD3^+、CD4^+、CD8^+比例均较对照组高,CRP、FPG、IL-6水平则较对照组低,组间差异有统计学意义(P<0.05)。结论蒿芩清胆汤联合腹腔镜手术治疗能够改善老年胆囊炎病人免疫功能和应激反应。

Objective To study the mechanism of Haoqinqingdan decoction combined with surgical treatment for cholecystitis in elderly patients. Methods 160 elderly patients with acute cholecystitis were selected and randomly divided into two groups,with 80 cases in each group. The patients in control group were treated with laparoscopic surgery and the patients in the observation group were treated with laparoscopic surgery combined with Haoqinqingdan decoction. Inflammatory factors（ IgG,IgA,IgM）,stress response factors[C reactive protein（ CRP）,fasting plasma glucose（ FPG）,interlukin（ IL-6） ] and immune cells（ CD3~＋,CD4~＋,CD8~＋） were dectected and compared before and after treatement. Results Before treatment,there were no significant difference in the levels of inflammatory factors,stress response factors,immune cells between two groups. The levels of IgG,IgA,IgM and the ratio of CD3~＋,CD4~＋,CD8~＋cells in two groups decreased significantly than those before treatment（ P〈0. 05）. Compared to before treatment,there were no significant difference in the levels of CRP,FPG,IL-6 in observation group（ P〉0. 05）. After the treatment,the levels of IgG,IgA,IgM and the ratio of CD3~＋,CD4~＋,CD8~＋were significantly higher and the levels of CRP,FPG,IL-6 were significantly lower in observation group than those in control group（ all P〈 0. 05）. Conclusions Laparoscopic surgery combined with Haoqinqingdan decoction may improve the inflammatory reaction and stress response in the elderly patients with acute cholecystitis.