疏肝利胆汤联合胆总管切开取石术治疗老年胆囊合并胆总管结石的观察

Observation of Shugan Lidan Decoction Combined with Common Bile Duct Incision and Stone Removal Surgery for Treatment of Senile Gallbladder Combined with Common Bile Duct Stones

目的探讨疏肝利胆汤联合胆总管切开取石术治疗老年胆囊合并胆总管结石的临床效果。方法选择2017年10月—2018年6月在医院进行治疗的胆囊结石合并胆总管结石老年患者86例,依据随机数字的方法将患者分为对照组和观察组各43例,对照组采用胆囊切除与胆总管切开取石手术治疗,观察组在对照组治疗方法基础上给予疏肝利胆汤辅助治疗。比较两组治疗前后的肝功能指标[谷丙转氨酶(ALT),谷草转氨酶(AST)],胆汁成分指标(胆固醇,总胆红素)。对两组的胆汁引流量进行对比。对两组的治疗效果进行比较。结果经过治疗后,对照组的ALT从(97.86±6.77)IU/L降低到(40.35±8.06)IU/L,AST从(70.36±7.25)IU/L降低到(41.22±8.15)IU/L,胆固醇从(118.65±9.78)mmol/L降低到(89.61±8.74)mmol/L,总胆红素从(685.67±127.58)μmol/L降低到(273.57±89.81)μmol/L,观察组的ALT从(96.87±7.05)IU/L降低到(27.36±9.11)IU/L,AST从(71.67±7.69)IU/L降低到(28.91±7.56)IU/L,胆固醇从(120.71±11.27)mmol/L降低到(75.67±7.08)mmol/L,总胆红素从(710.57±118.94)μmol/L降低到(144.83±48.97)μmol/L,观察组的变化幅度大于对照组,数据差异均具有统计学意义(t=7.003,7.261,8.127,8.253,P<0.05),观察组的胆汁引流量[(427.83±132.03)d VS.(237.02±98.92)d]大于对照组,数据差异具有统计学意义(t=7.584,P<0.05),观察组的治疗效果优于对照组,数据差异具有统计学意义(z=-4.442,P<0.05)。结论使用疏肝利胆汤联合胆总管切开取石术治疗胆囊合并胆总管结石的老年患者,可以保护肝功能,调节胆汁成分,提升治疗效果,值得临床推广。

Objective To explore the clinical effect of Shugan Lidan Decoction combined with common bile duct incision and stone removal surgery for the treatment of senile gallbladder combined with common bile duct stones.Methods Eighty-six patients with gallstones complicated with common bile duct stones were treated in our hospital between October 2017 and June 2018.Patients were divided into control group(n=43)and observation group(n=43)according to the method of random number.The control group was treated with cholecystectomy and common bile duct incision.The patients in the observation group were treated with Shugan Lidan Decoction on the basis of the control method.The liver function indexes[(alanine aminotransferase(ALT),aspartate aminotransferase(AST),bile component(cholesterol,total bilirubin)]before and after treatment were compared between the two groups.Biliary drainage was compared between the two groups.The comparison of treatment effects between the two groups was carried out.Results After treatment,the ALT level of the control group decreased from(97.86±6.77)IU/L to(40.35±8.06)IU/L,and the AST level decreased from(70.36±7.25)IU/L to(41.22±8.15)IU/L.The cholesterol level decreased from(118.65±9.78)mmol/L to(89.61±8.74)mmol/L,and the total bilirubin decreased from(685.67±127.58)μmol/L to(273.57±89.81)μmol/L.The ALT level of the observation group decreased from(96.87±7.05)IU/L to(27.36±9.11)IU/L,and the AST level decreased from(71.67±7.69)IU/L to(28.91±7.56)IU/L,and the cholesterol level reduced from(120.71±11.27)mmol/L to(75.67±7.08)mmol/L,and the total bilirubin was decreased from(710.57±118.94)μmol/L to(144.83±48.97)μmol/L.The change of the observation group was larger than that of the control group,and the data was statistically significant(t=7.003,7.261,8.127,8.253,P<0.05).The bile drainage volume of the observation group[(427.83±132.03)d VS.(237.02±98.92)d]was greater than that of the control group,and the data was statistically significant(t=7.584,P<0.05).The therapeutic effect of the observation group was better than that of the control group,and the data was statistically significant(z=-4.442,P<0.05).Conclusion Elderly patients with Shugan Lidan Decoction combined with common bile duct incision and stone removal surgery for gallbladder complicated with common bile duct stones can protect liver function,regulate bile components and the improve therapeutic effect.It is worthy of clinical promotion.