逍遥散加减治疗慢性结石性胆囊炎的疗效观察

Effect of Xiaoyao Powder Modified in the Treatment of Chronic Calculus Cholecystitis

目的 探讨逍遥散加减治疗肝郁脾虚证慢性结石性胆囊炎(chronic calculous cholecystitis,CCC)的临床疗效。方法 随机将2018年12月—2020年6月中国人民解放军联勤保障部队第921医院收治的118例肝郁脾虚证CCC患者分为两组,对照组59例,治疗组59例。对照组给予饮食干预、复方阿嗪米特肠溶片、熊去氧胆酸、非甾体类消炎止痛药等综合治疗,治疗组在对照组基础上加用逍遥散加减辨证治疗,两组疗程均为4周。统计分析两组的中医证候疗效和超声影像学疗效,比较两组治疗前后中医证候积分、健康状况调查简表(the MOS item short from health survey,SF-36)评分、胆囊功能的变化。结果 治疗组的中医证候总有效率94.92%(56/59),明显高于对照组83.05%(49/59),差异有统计学意义(P <0.05);治疗组超声总有效率89.83%(53/59),明显高于对照组74.58%(44/59),差异有统计学意义(P <0.05);治疗后,与对照组比较,治疗组中医证候积分降低,差异有统计学意义(P <0.05),SF-36量表评分升高,差异有统计学意义(P<0.05);治疗组可以增强患者的胆囊收缩功能、缩小胆囊壁厚度,差异有统计学意义(P <0.05)。结论 逍遥散加减治疗肝郁脾虚证慢性结石性胆囊炎可以改善症状,促进胆囊功能恢复,提高生活质量。

Objective To explore the clinical efficacy of Xiaoyao powder in the treatment of chronic calculous cholecystitis(CCC) with liver stagnation and spleen deficiency syndrome. Methods From December 2018 to June 2020, a total of 118 cases of CCC patients with liver depression and spleen deficiency syndrome admitted to 921 s t Hospital of Joint Logistics Support Forces of the Chinese People’s Liberation Army were randomly divided into 2 groups, 59 cases in the control group and 59 cases in the treatment group. The control group was given dietary intervention, compound azinamide entericcoated tablets, ursodeoxycholic acid, non-steroidal anti-inflammatory analgesics and other comprehensive treatments. The treatment group was treated with Xiaoyao powder modified differentiation treatment on the basis of the control group. The course of treatment of the two groups were 4 weeks. The efficacy of TCM syndromes and ultrasound imaging of the two groups were statistically analyzed, and the scores of TCM syndromes, the MOS item short from health survey(SF-36) scores, and changes in gallbladder function were compared between the two groups before and after treatment. Results The total effective rate of TCM syndromes in the treatment group was 94.92%(56/59), which was significantly higher than the control group 83.05%(49/59), the difference was statistically significant(P < 0.05);the total effective rate of ultrasound in the treatment group was 89.83%(53/59), significantly higher than the control group by 74.58%(44/59), the difference was statistically significant(P < 0.05);after treatment, compared with the control group, the TCM syndrome score of the treatment group decreased, the difference was statistically significant(P < 0.05), and the SF-36 scale score increased, the difference was statistically significant(P < 0.05). The treatment group can enhance the patient’s gallbladder contraction function and reduce the thickness of the gallbladder wall, the difference was statistically significant(P < 0.05). Conclusion Modified Xiaoyao powder can improve the symptoms of chronic calculous cholecystitis with liver depression and spleen deficiency syndrome, promote the recovery of gallbladder function, and improve the quality of life.