大黄芍药汤联合腹腔镜手术治疗老年人急性化脓性胆囊炎的临床观察

Clinical effect of traditional Chinese medicine rhubarb peony decoction combined with laparoscopic surgery in the treatment of aged patients with acute suppurative cholecystitis

目的探讨大黄芍药汤联合腹腔镜手术治疗老年人急性化脓性胆囊炎的临床效果。方法选取2016年3月至2017年4月浙江省中医院安吉分院收治的老年急性化脓性胆囊炎患者52例作为研究对象，根据治疗方式不同可分成对照组和观察组两组各26例。对照组予腹腔镜手术治疗；观察组在腹腔镜手术治疗的基础上再给予大黄芍药汤。观察两组患者的临床治疗效果、住院时间、白细胞恢复正常时间、退热时间、使用抗生素时间、并发症发生情况以及患者对治疗的满意程度。结果观察组患者对治疗的满意程度为96.15%，明显优于对照组的73.08%（χ^2＝18.093，P＝0.001）；观察组的住院时间、抗生素使用时间、退热时间、白细胞恢复正常时间分别为（6.2±0.9）d、（4.4±0.6）d、（3.4±0.7）d、（4.1±1.1）d，均明显短于对照组（t＝14.706、13.425、12.604、13.102，P＝0.003、0.001、0.002、0.001）；观察组的治疗有效率、并发症发生率分别为96.15%、7.69%，均显著优于对照组（χ^2＝96.150、9.082，P＝0.001、0.001）。结论对老年急性化脓性胆囊炎患者采用腹腔镜手术联合大黄芍药汤治疗，可以明显缩短患者的住院时间、退热时间、白细胞恢复正常时间以及使用抗生素时间，减少患者术后并发症的发生，从而提高患者的临床效果。

Objective To investigate the clinical effect of traditional Chinese medicine rhubarb peony decoction combined with laparoscopic surgery in the treatment of elderly patients with acute suppurative cholecystitis.Methods From March 2016 to April 2017, 52 patients with acute suppurative cholecystitis who were surgically treated in Anji Branch of Zhejiang Province Traditional Chinese Medical Hospital were selected in this study.According to different treatment Methods , the patients were divided into control group and observation group, with 26 cases in each group.The control group was given laparoscopic surgery, the observation group was given traditional Chinese medicine rhubarb peony decoction based on laparoscopic surgery.The clinical treatment effect, hospitalization time, leukocyte recovery time, antipyretic time, antibiotic use time, occurrence of complications, and patients＇ satisfaction with treatment were observed.Results The patients’ satisfaction rate with the treatment of the observation group was 96.15%, which was significantly higher than 73.08% of the control group （χ^2=18.093, P=0.001）. The hospitalization time, antibiotic use time, defervescence time and leukocyte recovery time of the observation group were （6.2±0.9）d, （4.4±0.6）d, （3.4±0.7）d, （4.1±1.1）d, respectively, which were significantly shorter than those in the control group （t=14.706, 13.425, 12.604, 13.102; P=0.003, 0.001, 0.002, 0.001）. The treatment effective rate, incidence rate of complication in the observation group were 96.15%, 7.69%, respectively, which were significantly better than those in the control group （χ^2=96.15, 9.082; P=0.001, 0.001）.Conclusion Laparoscopic surgery combined with traditional Chinese medicine rhubarb peony decoction for elderly patients with acute suppurative cholecystitis can significantly shorten the length of hospital stay, defervescence time, leukocyte recovery time and antibiotic use, and reduce the incidence of postoperative complications, improve the patients’ clinical effect of surgery.In addition, this method can also improve the patients’ satisfaction with the treatment, which can be used in clinical practice.