柴金化瘀方联合内镜微创保胆取息肉术治疗胆囊息肉样变临床研究

Effect of Chaijin-Huayu decoction combined with minimally invasive surgery for the patients with cholecystic polyposis

目的 评价柴金化瘀方联合内镜微创保胆取息肉术治疗胆囊息肉样变的疗效。方法 将符合入选标准的胆囊息肉样变患者91例采用随机数字表法分为观察组46例与对照组45例。对照组给予内镜微创保胆取息肉术治疗，观察组在对照组基础上加服柴金化瘀方治疗。2组均治疗24周。采用中医症状积分量表对心下痞满、右胁胀满、嗳气症状进行评分，采用简明健康状况调查表（36-item Short Form Health Survey, SF-36）评价患者生活质量，记录术后并发症发生情况，评价临床疗效。结果 观察组总有效率为91.3%（42/46）、对照组为88.9%（40/45），2组比较差异无统计学意义（χ2=0.149，P=0.592）。治疗后，症状积分量表中，观察组心下痞满、右胁胀痛、嗳气评分均低于对照组（t值分别为2.431、3.560、2.891，P值均＜0.05）；SF-36量表中，观察组精神健康、社会功能、躯体疼痛、生理职能、情感职能、活力、生理功能、总体健康评分均高于对照组（t值分别为2.342、2.831、2.765、2.545、2.485、2.650、2.582、2.325，P值均＜0.05）。观察组术后并发症发生率为2.2%（1/46）、对照组为17.8%（8/45），2组比较差异有统计学意义（χ2=6.331，P=0.014）。结论 柴金化瘀方联合微创保胆术取息肉术可提高胆囊息肉样变患者的生活质量，有效减轻术后并发症，提高临床疗效。

Objective To observe the effect of Chaijin-Huayu decoction combined with endoscopic minimally invasive for gallbladder polyposis and its effect on quality of life. Methods A total of 91 patients with gallbladder polyposis were selected from March 2014 to early March 2017 outpatients and wards of Hebei Provincial Traditional Chinese Medicine Hospital. According to the method of random number table, the paitents were randomly divided into the observation group （n=46） and the control group （n=45）. After three courses of treatment, the total effective rate, TCM symptom score and quality of life were observed in both groups, and the postoperative complications of the two groups were compared. Results After three courses of treatment, the total effective rate of the observation group was 91.3% （42/46）, while that of the control group was 88.9% （40/45）.There was no significant difference between the two groups （χ2=0.149, P=0.592）. In the observation group, the scores of subcardiac pycnosis and belching, right flank distended pain and burp were lower than those of the control group （t were 2.431, 3.560 and 2.891 respectively, all P〈0.05）. In the SF-36 scale, the scores of mental health, social function, physical pain, physiological function, emotional function, vitality, physiological function and overall health of the observation group were higher than those of the control group（t were 2.342,2.831, 2.765, 2.545, 2.485, 2.650, 2.582, 2.325 respectively, all P〈0.05）;The incidence of surgical complications of the observation group was 2.2% （1/46）, while that of the control group was 17.8% （8/45）, and the difference between the two groups was statistically significant （χ2=0.149, P〉0.05）. Conclusions Chaijin-Huayu decoction combined with minimally invasive choledochoplasty could relieve symptoms, improve quality of life and reduce postoperative complications in patients with gallbladder polyposis.