多烯磷脂酰胆碱联合舒胆汤对保胆取石术后患者胆囊功能恢复的影响

The effect of polyene phosphatidylcholine combined with Shudan decoction on the recovery of gallbladder function after fallbladder-preserving cholecystolithotomy

目的探讨多烯磷脂酰胆碱联合舒胆汤对保胆取石术后患者胆囊功能恢复的影响。方法回顾性选取2018年6月至2021年7月北京中医药大学深圳医院(龙岗)收治的胆囊结石行保胆取石手术患者60例,按随机数字表法分为对照组和观察组,每组30例,对照组术后予以多烯磷脂酰胆碱胶囊治疗,观察组在对照组基础上联合舒胆汤治疗,两组均连续治疗30 d。比较两组治疗前后中医症状积分、胆囊功能和血清碱性磷酸酶(ALP)、丙氨酸氨基转移酶(GGT)水平,比较两组不良反应发生率和临床疗效。结果观察组治疗后腹胀、腹痛、纳差症状积分均低于对照组,差异有统计学意义(P<0.05)。观察组治疗后胆囊壁厚度低于对照组[(2.62±0.29)mm比(3.21±0.32)mm]、胆囊收缩率高于对照组[(74.17±6.49)%比(62.03±6.05)%],差异有统计学意义(P<0.05)。观察组治疗后GGT、ALP水平低于对照组[(132.32±30.09)U/L比(150.27±30.33)U/L、(56.12±14.89)U/L比(75.07±16.22)U/L],差异有统计学意义(P<0.05)。观察组总有效率高于对照组[96.67%(29/30)比80.00%(24/30)],差异有统计学意义(χ^(2)=4.04,P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论多烯磷脂酰胆碱联合舒胆汤用于胆囊结石患者保胆取石术后疗效确切,可有效促进胆囊功能恢复,安全性较好。

Objective To investigate the effect of polyene phosphatidylcholine combined with Shudan decoction on the recovery of gallbladder function after gallbladder-preserving cholecystolithotomy.Methods Sixty patients with gallbladder stone admitted to Shenzhen Hospital(Longgang),Beijing University of Chinese Medicine from June 2018 to July 2021 were selected.All patients were received gallbladder-preserving cholecystolithotomy,and they were divided in two groups by random number table,each group with 30 patients.The control group was treated with polyene phosphatidylcholine capsule after the operation,while the observation group was treated with Shudan decoction on the basis of the control group.After 30 d of continuous treatment,the traditional Chinese medicine symptoms score,gallbladder contraction function and the levels of serum alkaline phosphatase(ALP),gamma-glutamine transferase(GGT),incidence of adverse reactions,clinical efficacy were compared between the two groups.Results After treatment,the scores of abdominal distension,abdominal pain and anorexia in the observation group were lower than those in the control group(P<0.05).After treatment,the thickness of the gallbladder wall in the observation group was lower than that in the control group and the the gallbladder contraction rate was higher than that in the control group:(2.62±0.29)mm vs.(3.21±0.32)mm,(74.17±6.49)%vs.(62.03±6.05)%,there were statistical differences(P<0.05).After treatment,the levels of GGT and ALP in the observation group were lower than those in the control group:(132.32±30.09)U/L vs.(150.27±30.33)U/L,(56.12±14.89)U/L vs.(75.07±16.22)U/L,there were statistical differences(P<0.05).The total effective rate in the observation group was higher than that in the control group:96.67%(29/30)vs.80.00%(24/30),there was statistical difference(χ^(2)=4.04,P<0.05).The adverse reactions in the two groups had no significant differences(P>0.05).Conclusions Polyene phosphatidylcholine combined with Shudan decoction has a definite efficacy for patients with cholecystolithiasis after gallbladder-preserving cholecystolithotomy,and can effectively promote the recovery of their gallbladder function and with good safety.