基于“形神理论”探讨PTCD联合茵虎退黄方治疗梗阻性黄疸

Discussion on PTCD Combined with Yinhu Tuihuang Prescription in the Treatment of Obstructive Jaundice Based on"Appearance and Spirit Theory"

目的:运用"形神理论"研究经皮肝穿刺胆道引流术(percutaneous transhepatic cholangial drainage,PTCD)联合茵虎退黄方治疗梗阻性黄疸后"形""神"改善情况,并对其疗效做出相应评价。方法:选取60例行PTCD后梗阻性黄疸患者随机平均分为对照组和治疗组。对照组给予单纯护肝治疗,治疗组在常规护肝治疗基础上给予茵虎退黄方。运用"形神理论"评价两组治疗后疗效。其中"形"的疗效评价为实验室检查,"神"的疗效评价包括:视觉模拟评分法(visual analogue score,VAS)和中医症状评分。结果:治疗组治疗后患者"形"的改善效果明显,胆红素及酶学水平均显著下降(P<0.05);对照组患者治疗前后丙氨酸氨基转移酶(alanine transaminase,ALT)和天门冬氨酸氨基转移酶(aspartate transaminase,AST)水平比较,差异均无统计学意义(P>0.05);对照组治疗后胆红素及γ-谷氨酰转肽酶(γ-glutamyl transpeptadase,GGT)、碱性磷酸酶(alkaline phosphatase,ALP)水平显著降低。在缓解患者"神伤"方面,两组均可降低患者疼痛水平(VAS);治疗组患者症状的缓解率为67.0%,对照组患者症状的缓解率为40.8%,治疗组明显优于对照组(P<0.05)。结论:PTCD联合护肝治疗配伍茵虎退黄方治疗梗阻性黄疸疗效显著,可显著改善患者的"形""神"情况。

Objective:To study the effect of percutaneous transhepatic cholangial drainage(PTCD)combined with Yinhu Tuihuang Prescription on the improvement of"shape"and"spirit"in the treatment of obstructive jaundice by using"appearance and spirit theory".Methods:60 patients with obstructive jaundice after PTCD were randomly divided into control group and treatment group.The control group was given simple liver protection treatment,and the treatment group was given Yinhu Tuihuang Decoction on the basis of routine liver protection treatment.The curative effect of the two groups before and after treatment was evaluated by"appearance and spirit theory".Among them,the curative effect evaluation of"shape"is laboratory examination,and the curative effect evaluation of"spirit"includes visual analogue score(VAS)and TCM symptom score.Results:In the treatment group,the"shape"of the latter was significantly improved,and the levels of bilirubin and enzymes were significantly decreased(P<0.05);in the control group,the levels of alanine aminotransferase(ALT)and aspartate transaminase(AST)were significantly decreased before and after treatment.There was no significant difference in the levels of AST(P>0.05).After treatment,the levels of bilirubin,γ-glutamyl transpeptadase(GGT)and alkaline Phosphatase(ALP)in the control group were significantly decreased.In terms of relieving the"spirit injury",both groups could reduce the pain level(VAS score);the total remission rate of the treatment group was 67.0%,and that of the control group was 40.8%,which was significantly better than that of the control group(P<0.05).Conclusion:PTCD combined with liver protection therapy combined with Yinhu Tuihuang Prescription has significant effect in the treatment of obstructive jaundice,which can significantly improve the"shape"and"spirit"of patients.The curative effect is better than that of PTCD combined with simple liver protection.