大黄灵仙方对胆汁IL-6及TNF-α水平的影响研究

Study on the effect of Dahuang Lingxian Formula on the levels of IL-6 and TNF-αin bile

目的探讨中药大黄灵仙方对胆石症患者胆汁白介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)表达的影响。方法采集2017年12月—2019年12月在我科住院行“胆总管切开取石+T型管外流术”的胆石症患者90例,其中观察组60例,对照组30例,两组均在术后1周左右出院并嘱正常饮食并适当休息,观察组在术后第7 d时开始服用大黄灵仙方1个疗程(14 d)。两组T型管留置21 d后经造影检查确认无结石残留后拔除,若有残留者留置T管待术后第8周经T管窦道行胆道镜并钬激光碎石及取石治疗。两组均在无菌操作下分别采集患者术后第1 d、7 d、14 d、21 d清晨的空腹新鲜胆汁样本5 ml,应用酶联免疫方法检测两组胆汁标本中IL-6、TNF-α的蛋白浓度。结果术后第1 d、7 d、14 d、21 d IL-6观察组分别为(155.81±10.80)pg/ml、(122.27±6.64)pg/ml、(73.36±5.71)pg/ml、(18.15±3.27)pg/ml,对照组分别为(157.42±13.16)pg/ml、(121.52±6.21)pg/ml、(106.10±7.96)pg/ml、(38.40±3.71)pg/ml,第1 d、7 d两组比较差异无统计学意义(P>0.05);第14 d、21 d两组比较差异有统计学意义(P<0.05)。术后第1 d、7 d、14 d、21 d TNF-α,观察组分别为(81.45±4.67)pg/ml、(63.25±5.08)pg/ml、(40.71±2.52)pg/ml、(8.07±0.51)pg/ml,对照组分别为(80.28±4.12)pg/ml、(61.19±5.45)pg/ml、(52.50±5.07)pg/ml、(19.93±2.00)pg/ml,第1 d、7 d两组比较差异无统计学意义(P>0.05);第14 d、21 d两组比较差异有统计学意义(P<0.05)。结论大黄灵仙方降低胆石症患者胆汁IL-6、TNF-α的浓度。

Objective To investigate the effect of Dahuang Lingxian Formula on the expressions of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in bile of patients with cholelithiasis.Methods A total of 90 cholelithiasis patients admitted to our department from December 2017 to December 2019 for“choledocholithotomy+T-tube drainage surgery”were selected,with 60 cases in the observation group and 30 cases in the control group.Both groups were discharged from hospital about 1 week after surgery and advised to have normal diet and appropriate rest.Patients in the observation group began to take Dahuang Lingxian Formula for one course of treatment(14 days)since the 7th day after surgery.The T-tubes indwelling for 21 days in two groups were removed after angiography examination which confirmed no residual stone.For those with residual stones,T-tubes were indwelt and the patients underwent choledochoscope holmium laser lithotripsy and lithotomy through T tube sinus at the 8th week after previous surgery.5 ml of fasting fresh bile samples were collected under aseptic operation in both groups on the 1st,7th,14th and 21st day after surgery.The protein concentrations of IL-6 and TNF-αin bile samples of two groups were detected by enzyme-linked immunosorbent assay.Results On the 1st,7th,14th and 21st day after operation,the concentrations of IL-6 were(155.81±10.80)pg/ml,(122.27±6.64)pg/ml,(73.36±5.71)pg/ml and(18.15±3.27)pg/ml respectively in the observation group and(157.42±13.16)pg/ml,(121.52±6.21)pg/ml,(106.10±7.96)pg/ml and(38.40±3.71)pg/ml respectively in the control group.There was no statistically significant difference in the level of IL-6 between two groups on the 1st and 7th day after operation(P>0.05),but there were statistically significant differences between two groups on the 14th and 21st day after operation(P<0.05).On the 1st,7th,14th and 21st day after operation,the concentrations of TNF-αwere(81.45±4.67)pg/ml,(63.25±5.08)pg/ml,(40.71±2.52)pg/ml and(8.07±0.51)pg/ml respectively in the observation group and(80.28±4.12)pg/ml,(61.19±5.45)pg/ml,(52.50±5.07)pg/ml and(19.93±2.00)pg/ml respectively in the control group.There was no statistically significant difference in the level of TNF-αbetween two groups on the 1st and 7th day after operation(P>0.05),but there were statistically significant differences between two groups on the 14th and 21st day after operation(P<0.05).Conclusion Dahuang Lingxian Formula reduces the concentrations of IL-6 and TNF-αin bile of patients with cholelithiasis.