清胆行气汤加减联合针刺治疗急性胆源性胰腺炎胆囊切除术后临床研究

Clinical Study on Modified Qingdan Xingqi Decoction Combined with Acupuncture for Acute Biliary Pancreatitis After Cholecystectomy

目的:观察清胆行气汤加减联合针刺治疗急性胆源性胰腺炎胆囊切除术后的临床疗效。方法:采用随机数字表法将拟行急性胆源性胰腺炎胆囊切除术患者102例分为观察组与对照组各51例。2组均行急性胆源性胰腺炎胆囊切除术治疗,对照组在术后给予常规西药治疗,观察组在对照组基础上加用清胆行气汤加减联合针刺治疗。比较2组临床疗效、住院时间及术后排气时间、排便时间;比较2组治疗前后McGill疼痛问卷简表(SF-MPQ)评分及免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)水平;比较2组不良反应发生率及满意度。结果:观察组脱落1例,纳入研究50例;对照组脱落4例,纳入研究47例。治疗后,与对照组比较,观察组总有效率、满意度升高(P<0.05),不良反应发生率降低(P<0.05)。治疗后,观察组术后排气时间、排便时间及住院时间均短于对照组(P<0.05)。治疗后,2组SF-MPQ评分及IgM、IgA、IgG水平较治疗前降低(P<0.05),观察组治疗后SF-MPQ评分低于对照组(P<0.05),但2组治疗后IgM、IgA、IgG水平比较,差异无统计学意义(P>0.05)。结论:清胆行气汤加减联合针刺治疗急性胆源性胰腺炎胆囊切除术后疗效确切,能够改善患者免疫功能及疼痛症状,减少不良反应发生,加快患者术后胃肠功能恢复,患者治疗满意度高。

Objective:To observe the clinical effect of the therapy of modified Qingdan Xingqi Decoction combined with acupuncture on acute biliary pancreatitis after cholecystectomy.Methods:A total of 102 patients who were to be treated by cholecystectomy for acute biliary pancreatitis were divided into the observation group and the control group according to the random number table method,with 51 cases in each group.The two groups were given cholecystectomy for treatment,after which the control group was treated routine western medicine and the observation group was additionally treated with modified Qingdan Xingqi Decoction combined with acupuncture based on the treatment of the control group.The clinical effects,hospital stay and postoperative farting time and defecation time were compared between the two groups;before and after treatment,the scores of McGill Pain Questionnaire Short-Form(SF-MPQ),and the levels of immunoglobulin M(IgM),immunoglobulin A(IgA)and immunoglobulin G(IgG)were compared between the two groups;the incidence of adverse reactions and satisfaction degrees of patients were compared between the two groups.Results:With 1 case in the observation group and 4 cases in the control group being dropped out,finally 50 cases in the observation group and 47 cases in the control group were included into the study.After treatment,compared with those in the control group,the total effective rate and satisfaction degree in the observation group were increased(P<0.05),and the incidence of adverse reactions was decreased(P<0.05).After treatment,the farting time,defecation time and hospital stay after surgery in the observation group were less than those in the control group(P<0.05).After treatment,the SF-MPQ scores and levels of IgM,IgA and IgG in both groups were decreased when compared with those before treatment(P<0.05);the SF-MPQ scores in the observation group were lower than those in the control group,and there was no significant difference being found in the comparisons of levels of IgM,IgA and IgG between the two groups(P>0.05).Conclusion:The therapy of modified Qingdan Xingqi Decoction combined with acupuncture has a definite curative effect on acute biliary pancreatitis after cholecystectomy,which can improve the immune function and symptoms of pain in patients,reduce the incidence of adverse reactions and promote the recovery of gastrointestinal function with high satisfaction degrees of treatment.