大柴胡汤对慢性结石性胆囊炎围手术期患者的影响

Influence of Major Bupleurum Decoction on Patients with Chronic Lithogenous Cholecystitis in Perioperative Period

目的:探讨大柴胡汤对慢性结石性胆囊炎围手术期患者的影响。方法:选取2016年1—12月本院收治的慢性结石性胆囊炎患者120例,所有患者均行腹腔镜胆囊切除术,随机分为对照组和观察组,每组各60例。对照组围手术期给予常规西药进行治疗,观察组在对照组基础上联合大柴胡汤治疗。观察两组患者的临床疗效,比较两组患者手术前后症状积分变化及胃肠道功能恢复情况(术后肠鸣音恢复时间、排气、排便时间),检测两组患者手术前后白细胞(white blood cell,WBC)、C反应蛋白(C reactive protein,CRP)、总胆红素(total bilirubin,TBIL)及直接胆红素(Direct bilirubin,DBIL)水平。结果:观察组有效率为96.67%,对照组有效率为81.67%,两组患者临床疗效比较,差异具有统计学意义(P<0.05)。观察组肠鸣音恢复时间、排气时间及排便时间均短于对照组,差异具有统计学意义(P<0.05)。术后两组患者WBC、CRP较治疗前升高,TBIL、DBIL较治疗前下降,但术后观察组改善程度均优于对照组,差异具有统计学意义(P<0.05)。结论:大柴胡汤可显著改善慢性结石性胆囊炎围手术期患者临床症状,有效抑制术后炎症水平,促进胃肠道功能恢复,临床疗效显著,安全性高。

Objective： To explore the influence of Major Bupleurum Decoction on patients with chronic lithogenous cholecystitis in perioperative period. Methods： Totally 120 patients with chronic lithogenous cholecystitis treated in this hospital between January and December in 2016 were conducted laparoscopic cholecystectomy and randomized into control group and observation group,60 cases in each group. Control group were given conventional western medicine for the treatment while observation group were added with Major Bupleurum Decoction. The clinical effects in both groups were observed. The changes of symptom scores and recoveray of the gastrointestinal function after operation between two groups were compared. The levels of WBC,CRP,TBIL and DBIL in both groups were determined before and after treatment. Results： The effective rate was 96. 67% in observation group and 81. 67%in control group; the difference had statistical significance（ P〈0. 05）. Recovery time of borborygmus,evacuation time and defecation time in observation group were shorter than those in control group（ P〈0. 05）. The levels of WBC and CRP increased while levels of TBIL and DBIL decreased after treatment. After treatment,the improvement in treatment group was superior to that in control group,with statistical difference（ P〈0. 05）. Conclusion： Major Bupleurum Decoction can significantly improve the clinical symptoms of patients with chronic lithogenous cholecystitis in perioperative period,which can effectively inhibit the postoperative inflammation level and promote the recovery of gastrointestinal function. The clinical effects were remarkable with high safety.