疏肝排石方联合耳穴压豆疗法治疗肝胆管结石术后患者临床研究

Clinical Study on Shugan Paishi Prescription Combined with Auricular Acupoint Pressing with Beans for Patients after Surgery for Hepatolithiasis

目的:观察疏肝排石方联合耳穴压豆疗法对肝胆管结石术后患者住院时间、胆汁生化指标、肝功能、疼痛及结石残留率的影响。方法:选取70例肝胆管结石术后患者,按随机数字表法分为对照组和治疗组各35例。对照组给予常规抗炎、止痛等西医方法治疗,治疗组在对照组基础上加用疏肝排石方内服联合耳穴压豆疗法。记录2组住院时间,比较2组患者治疗前后血清胆汁生化指标、肝功能指标、疼痛评分及残石率。结果:2组住院时间分布情况比较,差异无统计学意义(P>0.05)。治疗后,2组总胆汁酸(TBA)、总胆红素(TBil)、直接胆红素(DBil)水平均较治疗前降低(P<0.01);治疗组TBA、TBil、DBil水平均低于对照组(P<0.01)。治疗后,2组谷丙转氨酶(ALT)、谷草转氨酶(AST)水平均较治疗前下降(P<0.01),前白蛋白(PA)水平均较治疗前上升(P<0.01);治疗组ALT、AST水平均低于对照组(P<0.01),PA水平高于对照组(P<0.01)。治疗6 h、12 h、24 h、48 h,治疗组数字分级法(NRS)疼痛评分均低于对照组(P<0.05)。治疗后,治疗组结石残留率低于对照组(P<0.05)。结论:疏肝排石方联合耳穴压豆疗法可以增加肝胆管结石术后患者的胆汁分泌量,促进残石排出,减轻术后疼痛。

Objective:To observe the effect of Shugan Paishi prescription combined with auricular acupoint pressing with beans on biochemical indexes, the liver function, pain and the rate of residual stones of patients after surgery for hepatolithiasis. Methods:A total of 70 cases of patients after surgery for hepatolithiasis were divided into the control group and the treatment group according to the random number table method, 35 cases in each group. The control group was treated with routine western medicine methods such as anti-inflammation and analgesia, and the treatment group was additionally treated with oral administration of Shugan Paishi prescription combined with auricular acupoint pressing with beans based on the treatment of the control group. The hospitalization time in the two groups was recorded. Before and after treatment,the biochemical indexes of serum and bile,the indexes of the liver function,the scores of pain and the rates of residual stones in the two groups were compared. Results:There was no significant difference being found in the distribution of hospitalization time in the two groups(P > 0.05). After treatment,the levels of total bile acid(TBA),total bilirubin(TBil) and direct bilirubin(DBil) in the two groups were decreased when compared with those before treatment(P < 0.01),and the above levels in the treatment group were all lower than those in the control group(P < 0.01). After treatment,the levels of alanine aminotransferase(ALT) and aspartate aminotransferase(AST) in the two groups were decreased when compared with those before treatment(P < 0.01),and the levels of prealbumin(PA) were increased when compared with those before treatment(P < 0.01);the levels of ALT and AST in the treatment group were lower than those in the control group(P < 0.01),and the level of PA was higher than that in the control group(P < 0.01). After treatment for 6 h,12 h,24 h and 48 h,the scores of pain of Numerical Rating Scale(NRS) in the treatment group were lower than those in the control group respectively(P < 0.05).After treatment, the rate of residual stones in the treatment group was lower than that in the control group(P < 0.05).Conclusion:The therapy of Shugan Paishi prescription combined with auricular acupoint pressing with beans for patients after surgery for hepatolithiasis can increase the volume of bile secretion,promoting the excretion of residual stones and relieve postoperative pain.