利胆方治疗肝胆湿热型慢性胆囊炎临床研究

Clinical Study on Lidan Formula(利胆方)in Treating Chronic Cholecystitis of Liver-Gallbladder Damp-Heat Syndrome

目的:探究利胆方对肝胆湿热型慢性胆囊炎患者临床疗效、氧化应激、胃肠激素和趋化因子的影响。方法:选择2020年7月至2022年4月在河北以岭医院治疗的肝胆湿热型慢性胆囊炎患者194例,采用随机数字表法将患者分为观察组和对照组各97例。对照组采用西医联合安慰剂治疗,观察组采用西医联合利胆方治疗。比较两组患者的临床疗效、中医证候积分、胆囊功能及氧化应激、胃肠激素和趋化因子水平。结果:治疗后两组右上腹隐痛、腹胀、恶心呕吐和舌红苔黄腻评分均较治疗前降低,且观察组低于对照组(P<0.001)。治疗后两组胆囊壁厚度、空腹胆囊容积和餐后残余容积均较治疗前降低,且观察组低于对照组(P<0.001);胆囊收缩率均较治疗前升高,且观察组高于对照组(P<0.001)。治疗后两组超氧化物歧化酶、谷胱甘肽过氧化物酶、胃动素、胃泌素水平均较治疗前升高,且观察组高于对照组(P<0.001);丙二醛、一氧化氮、血管活性肠肽和生长抑素水平均较治疗前降低,且观察组低于对照组(P<0.001)。治疗后两组单核细胞趋化蛋白-1和γ-干扰素诱导蛋白-10水平均较治疗前降低,且观察组低于对照组(P<0.001)。观察组临床总有效率为92.13%,对照组79.78%,疗效差异有统计学意义(P<0.05)。结论:利胆方能够提高慢性胆囊炎患者的临床疗效,改善临床症状和胆囊功能,抑制氧化应激,调节胃肠激素,降低趋化因子水平,具有多靶点优势。

Objective:To explore the effects of Lidan Formula(利胆方)on the clinical curative effect,oxidative stress,gastrointestinal hormones and chemokines in patients with chronic cholecystitis of liver-gallbladder damp-heat syndrome.Methods:Total 194 cases of chronic cholecystitis patients with liver-gallbladder damp-heat syndrome treated in Hebei Yiling Hospital from July 2020 to April 2022 were divided into the observation group and the control group by using random number table method,with 97 cases in each group.The control group received western medicine treatment combined with placebo,while the observation group received western medicine treatment combined with Lidan Formula.Compare the clinical efficacy,traditional Chinese medicine(TCM)syndrome score,gallbladder function,oxidative stress,gastrointestinal hormone and chemokine levels between the two groups.Results:After treatment,the scores of right upper abdominal dull pain,abdominal distension,nausea and vomiting,and red tongue coating and yellow greasy scores in both groups were lower those before treatment.and those scores in the observation group were lower than those in the control group(P<0.001).After treatment,the gallbladder wall thickness,fasting gallbladder volume and postprandial residual volume in both groups were lower than those before treatment,and the observation group was lower than the control group on this index(P<0.001);the gallbladder shrinkage rate increased in borh groups,and the observation group was higher than the control group on this index(P<0.001).After treatment,the levels of superoxide dismutase,glutathione peroxidase,motilin and gastrin in both groups were higher than those before treatment,and the observation group was higher than the control group on this index(P<0.001).The levels of malondialdehyde,nitric oxide,vasoactive intestinal peptide and somatostatin in both groups were lower than those before treatment,and the observation group was lower than the control group on this index(P<0.001).The levels of monocyte chemoattractant protein-1 and gamma-interferon-induced protein-10 in both groups were lower than those before treatment,and the observation group was lower than the control group on this index(P<0.001).The total clinical effective rate of the observation group was 92.13%,while the control group was 79.78%,and the difference in efficacy was statistically significant(P<0.05).Conclusions:Lidan Formula can improve the curative effect of patients with chronic cholecystitis,improve clinical symptoms and gallbladder function,inhibit oxidative stress,regulate gastrointestinal hormones,and reduce chemokine levels,which proves the multi-target advantage.