熊去氧胆酸片联合氢溴酸山莨菪碱片用于胆石症术后机体功能恢复的临床疗效和安全性评估

Clinical Effect and Safety Evaluation of Ursodeoxycholic Acid Tablets Combined with Anisodamine Hydrobromic Acid Tablets in Body Function Recovery after Gallstone Surgery

目的 评估熊去氧胆酸片联合氢溴酸山莨菪碱片用于胆石症术后机体功能恢复的疗效和安全性,为临床合理用药提供依据。方法 选取2021年3月-2022年8月在本院治疗的胆石症术后患者168例。采用随机数字表分为试验组和对照组,两组均为保胆取石术后,术后给予常规护理,包括补液、抗感染、营养支持等,对照组在常规治疗基础之上加用熊去氧胆酸片口服,试验组在对照组基础之上,联用氢溴酸山莨菪碱片口服。比较两组用药总有效率、不良反应及用药前后VAS评分、胃肠功能水平、炎性因子水平、肝功能指标等。结果试验组总有效率优于对照组,两组比较差异有统计学意义(P<0.05)。用药后1个月,试验组与对照组VAS评分、胃肠功能水平比较,差异均有统计学意义(P<0.05)。用药后1个月,试验组与对照组炎性因子水平比较,差异均有统计学意义(P<0.05)。用药后1个月,试验组与对照组总胆红素(TBIL)、丙氨酸氨基转移酶(ALT)、结石残留率水平比较,差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P=0.115)。结论 熊去氧胆酸片联合氢溴酸山莨菪碱片用于胆结石术后较单用熊去氧胆酸片效果更佳,可有效止痛、排石、排胆汁、恢复胃肠功能和肝功能,且安全性较高。

Objective To evaluate effect and safety of ursodeoxycholic acid tablets combined with anisodamine hydrobromic acid tablets in body function recovery after cholelithiasis,provide basis for clinical rational drug use.Methods The paper chose 168 cases cholelithiasis patients in our hospital from March 2021 to August 2022,and divided them into two groups with randomized number table,experiment group and control group.Both groups were treated with routine nursing after surgery of bile conservation and stone extraction,including fluid replacement,anti infection,nutritional support,etc.Control group was treated with ursodeoxycholic acid tablets orally on the basis of routine treatment,with a daily dose of 8×10 mg/kg and a course of treatment of 1 month,on the basis of control group,experiment group was orally administered with anisodamine hydrobromic acid tablets(specification:5mg/tablet,2 tablets/time,tid)for one month from application of ursodeoxycholic acid tablets.Total effective rate,VAS scores,gastrointestinal function level,inflammatory factor level,liver function indicators and adverse reactions were compared between two groups before and after medication.Results In experimental group,35 cases were significantly effective,46 cases were effective,with total effective rate of 96.43%.In control group,25 cases were significantly effective,48 cases were effective,with total effective rate of 86.90%.Difference in total effective rate between two groups was statistically significant(P<0.05).After one month of medication,there was statistically significant difference in VAS scores and gastrointestinal function levels between experimental group and control group(P<0.05).After one month of medication,there was statistically significant difference in levels of inflammatory factors between experimental group and control group(P<0.05).After one month of medication,there was statistically significant difference in total bilirubin(TBIL),alanine aminotransferase(ALT)and stone residue rates between experimental group and control group(P<0.05).11 cases of adverse reactions occurred in experimental group,with an incidence rate of 13.10%;5 cases of adverse reactions occurred in control group,with an incidence rate of 6.0%.There was no statistically significant difference in incidence of adverse reactions between two groups(P>0.05).Conclusion To sum up,ursodeoxycholic acid tablet combined with anisodamine Hydrobromic acid tablet can achieve better effect than ursodeoxycholic acid tablet only in treatment of postoperative cholelithiasis,can relieve pain,expel stones,bile,restore gastrointestinal function and liver function effectively with high safety,which is worthy of further clinical promotion.