熊去氧胆酸联合胆宁片对胆石症患者胆汁成分和成石趋势的影响

Effects of Ursodeoxycholic Acid combined with Danning tablets on bile components and lithogenesis trend in cholelithiasis patients

目的:探讨熊去氧胆酸联合胆宁片对胆石症患者胆汁成分和成石趋势的影响。方法:选择60例胆石症患者随机分为对照组和观察组两组,对照组采用熊去氧胆酸(UDCA)治疗,观察组采用熊去氧胆酸片联合胆宁片治疗,分别测定两组患者术后第1天、7天和14天的总胆红素(TB)、直接胆红素(DB)、胆固醇(CH)、磷脂(PHL)和总胆盐(TBS)含量,计算和比较致石指数(L.I.)、间接胆红素百分比(UCB%)和胆汁成石趋势综合值(Z值)的变化情况。结果:术后第1天和第7天两组的L.I.、UCB%和Z值间差异均无统计学意义(P>0.05),且Z值均>临界值(44.7);术后第14 d,观察组胆汁L.I.、UCB%以及Z值均明显下降,且Z值<临界值,差异均具有统计学意义(P<0.05);随访6个月后,联合治疗组的胆石复发率明显低于对照组,差异具有统计学意义(P<0.05)。结论:熊去氧胆酸联合胆宁片可有效调节胆汁成分,抑制胆石形成,降低结石复发,值得临床推广。

Objective To observe the effect of Ursodeoxycholic Acid combined with Danning tablets on bile components and lithogenesis trend in cholelithiasis patients. Method 60 patients with cholelithiasis were selected and randomly divided into control group and observation group. In control group,patients were treated by UDCA. In observation group,patients were treated by UDCA combined with Danning tablets. The levels of total bilirubin（ TB）,direct bilirubin（ DB）,cholesterol（ CH）,phospholipid（PHL） and total bile salt（TBS） were measured at 1 d,7 d and 14 d after operation. The variation of L. I.,indirect bilirubin percentage（ UCB%） and bile calculus trend（ Z value） were calculated and compared. Results There were no significant differences in the levels of L. I.,UCB% and Z between the two groups at 1 d,and 7 d after operation（ P〉0. 05）,and the Z values were exceed the critical value（44. 7）. At 14 d after operation,the levels of L. I.,UCB% and Z between were all declined in observation group. The Z value was lower than the critical value（44. 7）（ P〈0. 05）. After 6 months of follow-up,the recurrence rate of gallstones in the combination group was significantly lower than control group,and the difference was statistically significant（ P〈0. 05）. Conclusion Ursodeoxycholic acid combined with Danning tablets can effectively regulate the bile composition,inhibite gallstone formation,reduce the recurrence of gallstone.