疏肝利胆通络汤联合西药治疗慢性乙型病毒性肝炎合并慢性胆囊炎疗效观察

Observation on the curative effect of Shugan Lidan Tongluo Decoction combined with western medicine on chronic hepatitis B with chronic cholecystitis

目的观察疏肝利胆通络汤联合西药治疗对慢性乙型病毒性肝炎合并慢性胆囊炎患者病理生化指标及胆囊结构的影响。方法选择2018年1月—2019年1月在陕西省西安市第九医院治疗的86例慢性乙型病毒性肝炎合并慢性胆囊炎患者,随机分为2组,对照组给予西医常规治疗,观察组在对照组治疗基础上给予疏肝利胆通络汤治疗,2组均连续治疗8周。观察2组患者治疗后临床症状(右胁疼痛、嗳气频作、脘腹胀闷、恶心呕吐)积分、肝功能指标[谷草转氨酶(AST)、丙氨酸氨基转移酶(ALT)、谷氨酰转肽酶(GGT)]、胆囊超声评估指标(胆囊壁毛糙、胆囊壁增厚、胆汁透声差)变化情况,并评估2组临床疗效及治疗方案的安全性。结果2组治疗后右胁疼痛积分、嗳气频作积分、脘腹胀闷积分、恶心呕吐积分及AST水平、ALT水平、GGT水平均较治疗前明显降低(P均<0.05),且观察组均明显低于对照组(P均<0.05);观察组治疗后总有效率、胆囊壁毛糙改善率、胆囊壁增厚改善率及胆汁透声差改善率均明显高于对照组(P均<0.05);观察组治疗期间不良反应发生率为7.0%(3/43),明显低于对照组的23.2%(10/43)(P<0.05),所有患者不良反应症状均较轻微,治疗期间心电图、肾功能、二便常规检测无异常。结论疏肝利胆通络汤联合西药治疗慢性乙型病毒性肝炎合并慢性胆囊炎,能够显著改善患者中医症状、肝功能和胆囊超声改变,提高治疗有效率,且安全。

Objective It is to observe the effect of Shugan Lidan Tongluo Decoction combined with western medicine on the pathological and biochemical indexes and gallbladder structure of patients with chronic hepatitis B and chronic cholecystitis.Methods Eighty-six patients with chronic hepatitis B and chronic cholecystitis who were treated in the Ninth Hospital of Xi’an from January 2018 to January 2019 were randomly divided into 2 groups.The control group was given conventional western medicine treatment,and the observation group was given Shugan Lidan Tongluo Decoction on the basis of treatment in the control group,both groups were treated for 8 weeks.The changes of the clinical symptoms(right pleura pain,frequent belching,abdominal distension and fullness,nausea and vomiting)scores,liver function indicators[aspartate aminotransferase(AST),alanine aminotransferase(ALT),glutamyltransferase(GGT)],gallbladder ultrasound evaluation indicators(rough gallbladder wall,thick gallbladder wall,and poor acoustic transmission)after treatment were observed in the two groups,and the clinical efficacy and the safety of the treatment plan were evaluated.Results After treatment,the scores of right pleura pain,frequent belching,abdominal distension and fullness,nausea and vomiting,levels of AST,ALT and GGT were significantly lower than those before treatment in the two groups(P<0.05),and the observation group was significantly lower than the control group(P<0.05);the total effective rate,the improvement rate of gallbladder wall roughness,gallbladder wall thickening and poor acoustic transmission after treatment in the observation group were significantly higher than those in the control group(P<0.05).The incidence of adverse reactions during the treatment period was 7.0%(3/43)in the observation group,which was significantly lower than 23.2%(10/43)in the control group(P<0.05).The adverse reactions symptoms of all patients were slight,and the electrocardiogram,renal function,and routine urine and stool examination were normal.Conclusion Shugan Lidan Tongluo Decoction combined with western medicine can significantly improve the symptoms of traditional Chinese medicine,liver function and changes in gallbladder ultrasound,and improve the treatment efficiency with good safety in the treatment of chronic hepatitis B with chronic cholecystitis.