消炎利胆片联合哌拉西林钠他唑巴坦钠治疗慢性胆囊炎的临床研究

Clinical study on Xiaoyan Lidan Tablets combined with piperacillin sodium and tazobactam sodium in treatment of chronic cholecystitis

目的探讨消炎利胆片联合哌拉西林钠他唑巴坦钠治疗慢性胆囊炎的临床效果。方法选取2018年10月—2020年10月天津泰达医院收治的126例慢性胆囊炎患者,运用随机数字表法将其随机分成对照组(n=63)和治疗组(n=63)。对照组静脉滴注注射用哌拉西林钠他唑巴坦钠,2.25 g加入5%葡萄糖注射液250 mL充分稀释后给药,2次/d。治疗组在对照组基础上口服消炎利胆片,6片/次,3次/d。两组均连续治疗2周。观察两组临床疗效及患者典型症状的缓解时间,并比较治疗前后两组胆囊壁厚度、胆囊排空率、胃电图相关参数及血清总胆汁酸(TBA)、白细胞介素(IL)-6和瘦素(Lep)水平的变化情况。结果治疗后,治疗组总有效率为95.2%,显著高于对照组的81.0%(P<0.05)。治疗后,治疗组各项典型症状(右上腹痛、右上腹不适、胆源性消化不良)的缓解时间均显著短于对照组(P<0.05)。治疗后,两组胆囊壁厚度均显著降低,但胆囊排空率均显著增加(P<0.05);治疗后,治疗组胆囊壁厚度和胆囊排空率改善优于对照组(P<0.05)。治疗后,两组餐后正常胃电慢波百分比、餐后/餐前功率比均显著高于本组治疗前,但餐后胃电节律紊乱百分比均显著低于本组治疗前(P<0.05);治疗后,治疗组胃电图参数改善优于对照组(P<0.05)。治疗后,两组患者血清TBA、IL-6和Lep水平较本组治疗前均显著降低(P<0.05);且治疗后,治疗组血清学指标低于对照组(P<0.05)。结论消炎利胆片联合哌拉西林钠他唑巴坦钠治疗慢性胆囊炎具有确切的临床疗效,对患者的临床症状、胆囊壁厚度和胆囊收缩功能均有显著改善作用,同时有助于改善患者紊乱的胃电节律,减轻其肝脏损伤和体内炎症反应,值得临床推广应用。

Objective To investigate the clinical effect of Xiaoyan Lidan Tablets combined with piperacillin sodium and tazobactam sodium in treatment of chronic cholecystitis. Methods A total of 126 patients with chronic cholecystitis admitted to Tianjin TEDA Hospital from October 2018 to October 2020 were selected and randomly divided into control group(n=63) and treatment group(n=63)by random number table method. Patients in the control group were iv administered with Piperacillin Sodium and Tazobactam Sodium for injection, 2.25 g was added into 5% Glucose injection 250 mL and fully diluted, twice daily. Patients in the treatment group were po administered with Xiaoyan Lidan Tablets on the basis of the control group, 6 tablets/time, three times daily. Both groups were treated continuously for 2 weeks. Clinical efficacy and relief time of typical symptoms of patients in the two groups were observed,and changes of gallbladder wall thickness, gallbladder emptying rate, parameters related to electrogastro, and serum total bile acid(TBA), interleukin(IL)-6 and leptin(LEP) levels in the two groups were compared before and after treatment. Results After treatment, the total effective rate of the treatment group was 95.2%, which was significantly higher than that of the control group(81.0%, P < 0.05). After treatment, the relief time of the typical symptoms(right upper abdominal pain, right upper abdominal discomfort,biliary dyspepsia) in the treatment group was significantly shorter than that in the control group(P < 0.05). After treatment, the gallbladder wall thickness in both groups was significantly decreased, but the gallbladder empty-rate was significantly increased(P <0.05). After treatment, the improvement of gallbladder wall thickness and gallbladder empty-rate in the treatment group was better than that in the control group(P < 0.05). After treatment, the percentage of normal slow wave and the ratio of power to power after meal in two groups were significantly higher than before, but the percentage of disturbance of rhythm after meal was significantly lower than before(P < 0.05). After treatment, the improvement of EEG parameters in treatment group was better than that in control group(P < 0.05). After treatment, the serum levels of total bile acid(TBA), interleukin(IL)-6 and leptin(LEP) in two groups were significantly decreased compared with before treatment(P < 0.05). After treatment, the serological indexes in the treatment group were lower than those in the control group(P < 0.05). Conclusion Xiaoyan Lidan Tablets combined with piperacillin sodium and tazobactam sodium has definite clinical effect in treatment of chronic cholecystitis, can significantly improve the clinical symptoms,gallbladder wall thickness and gallbladder systolic function of patients, and can improve the patients’ disordered gastric electric rhythm, reduce the liver injury and inflammation, which is worthy of clinical promotion and application.