胆总管结石患者ERCP取石术后利胆排石汤辅助治疗效果评价

Evaluation of Adjuvant Therapeutic Effect of Lidan Paishi Decoction after ERCP for Patients with Choledocholithiasis

目的:探究胆总管结石患者内镜下逆行胰胆管造影(ERCP)取石术后利胆排石汤辅助治疗效果。方法:选本院2017年8月-2020年8月收治的ERCP取石术患者86例为研究对象,采用随机信封法分为对照组43例与观察组43例,对照组术后给予西医常规治疗,观察组给予利胆排石汤辅助治疗。观察两组治疗后中医证候疗效、治疗前后中医症状积分、实验室指标改善情况、排石率及并发症发生情况。结果:观察组中医证候疗效改善率(97.67%)高于对照组(86.05%),差异有统计学意义(P<0.05);治疗后观察组中医症状积分[(7.41±1.30)分]低于对照组[(9.37±2.57)分],总胆红素(13.52±3.16)μmol/L,淀粉酶(48.82±10.34)U/L,丙氨酸转氨酶(33.74±5.05)U/L,天门冬氨酸转氨酶(31.47±5.13)U/L,低于对照组的(30.33±8.47)μmol/L、(109.42±17.65)U/L、(60.17±8.45)U/L、(59.43±9.84)U/L,差异有统计学意义(P<0.05);观察组排石率(100%)高于对照组(79.07%),并发症发生率(4.65%)低于对照组(18.60%),差异有统计学意义(P<0.05)。结论:胆总管结石患者ERCP取石术后利胆排石汤辅助治疗效果显著,可有效改善临床症状与实验室指标,提升排石率,降低并发症发生率。

Objective:To explore the adjuvant therapeutic effect of Lidan Paishi Decoction after endoscopic retrograde cholangiopancreatography (ERCP) lithotomy for choledocholithiasis.Method:A total of 86 patients with ERCP lithotomy admitted to our hospital from August 2017 to August 2020 were selected as study subjects,and were divided into control group (43 cases) and observation group (43 cases) by random envelope method.The control group was given routine western medicine treatment after operation,while the observation group was given Liddan Paishi Decoction as auxiliary treatment.The therapeutic effect of TCM syndromes after treatment,TCM symptom score,laboratory index improvement,stone discharge rate and complications before and after treatment were observed in the two groups.Result:The improvement rate of TCM syndrome effect in the observation group (97.67%) was higher than control group (86.05%),and the difference was statistically significant (P<0.05).After treatment,the score of TCM symptoms in the observation group was (7.41±1.30) points which was lower than (9.37±2.57) points in the control group (P<0.05).Total bilirubin (13.52±3.16) μmol/L,amylase (48.82±10.34) U/L,alanine transaminase (33.74±5.05) U/L,aspartate transaminase (31.47±5.13) U/L were lower than (30.33±8.47) μmol/L,(109.42±17.65) U/L,(60.17±8.45) U/L,(59.43±9.84) U/L in the control group,and the differences were statistically significant (P<0.05).The stone discharge rate (100%) of the observation group was higher than the control group (79.07%),and the complication rate (4.65%) of the observation group was lower than the control group (18.60%),with statistically significant differences (P<0.05).Conclusion:Lidan Paishi Decoction is a significant adjuvant therapy for patients with choledocholithiasis after ERCP,which can effectively improving clinical symptoms and laboratory indicators,increasing the rate of expulsion,and reducing the incidence of complications.