小柴胡汤加减联合熊去氧胆酸片治疗慢性胆囊炎合并胆结石的疗效分析

Effect of Xiaochaihu Decoction Combined with Ursodeoxycholic Acid Tablets in Treatment of Chronic Cholecystitis Complicated with Gallstones

目的:研究小柴胡汤加减联合熊去氧胆酸片治疗慢性胆囊炎合并胆结石的疗效。方法:选择2015年9月-2017年12月期间在本院治疗的82例慢性胆囊炎合并胆结石患者进行回顾性研究,依据随机数法分对照组、观察组,各41例。对照组接受熊去氧胆酸片治疗,观察组患者则在对照组基础上给予小柴胡汤加减内服。对比两组治疗的临床效果,评价中医证候积分,B超监测胆囊壁厚度,测定血清中总胆汁酸、胆红素、总胆固醇等生化指标水平,检测肝功能指标。结果:治疗组有效率为87.80%,较对照组的有效率68.29%明显升高,(P<0.05);治疗后,观察组患者的右胁痛、呕吐纳呆、腹胀低热、心下痞满等主要临床症状的中医证候积分明显低于对照组(P<0.05);同时间比较,胆囊壁厚度B超结果较对照组减小更为明显(P<0.05),以治疗12周后的胆囊壁最薄(P<0.05);总胆汁酸、胆红素、总胆固醇水平下降较对照组更明显(P<0.05);肝功能指标ALP、AST、TBIL、ALT水平均低于对照组(P<0.05)。结论:小柴胡汤加减联合熊去氧胆酸片利于减轻慢性胆囊炎合并胆结石患者的临床症状,改善胆囊功能,且能降低对患者肝功能的影响,值得临床推广。

Objective:To study the curative effect of Xiaochaihu Decoction combined with ursodeoxycholic acid tablets in the treatment of chronic cholecystitis with gallstones.Methods:The retrospective study was performed on 82 patients with chronic cholecystitis complicated with gallstones who were treated in our hospital from September 2015 to December 2017.According to the random number method,the patients were divided into the control group and the observation group,41 cases in each.The control group was treated with ursodeoxycholic acid tablets,and the observation group received Xiaochaihu Decoction on the basis of treatment in the control group.The purpose of this paper was to compare the clinical effects of the two groups,evaluate the TCM syndrome score,monitor the thickness of gallbladder wall with b-ultrasound,measure the level of total bile acid,bilirubin,total cholesterol and other biochemical indicators in serum,and detect the liver function indicators.Results:The effective rate of the treatment group was 87.80%,which was significantly higher than that of the control group(68.29%)(P<0.05).After treatment,the TCM syndrome score of the main clinical symptoms of patients in the observation group,such as right flank pain,vomiting and numbness,abdominal distension and low fever and subxin ruffian,was significantly lower than that of the control group(P<0.05).Compared with the control group,the thickness of the gallbladder wall was significantly reduced by B-ultrasound(P<0.05),and the gallbladder wall was the thinnest after 12 weeks treatment(P<0.05).The levels of total bile acid,bilirubin and total cholesterol were significantly lower than those in the control group(P<0.05).The ALP,AST,TBIL and ALT levels of liver function indexes were all lower than those of the control group(P<0.05).Conclusion:Xiaochaihu Decoction combined with ursodeoxycholic acid tablets can reduce the clinical symptoms of patients with chronic cholecystitis complicated by gallstones,improve the function of the gallbladder,and reduce the impact on the liver function of patients,worthy of clinical promotion.