茵陈汤联合经皮经肝胆管穿刺引流术治疗胆管癌合并梗阻性黄疸患者的临床疗效

Clinical efficacy of Yinchen Decoction combined percutaneous transhepatobiliary puncture and drainage for cholangiocarcinoma complicated with obstructive jaundice

目的探讨茵陈汤联合经皮经肝胆管穿刺引流术治疗胆管癌合并梗阻性黄疸患者的临床疗效。方法将112例胆管癌合并梗阻性黄疸患者根据治疗方式的不同分为对照组(n=56)和观察组(n=56)。对照组患者采取经皮经肝胆管穿刺引流术,观察组患者在对照组的基础上采取茵陈汤联合治疗。比较两组患者的临床疗效、中医证候积分、肝功能指标以及并发症发生情况。结果治疗后,观察组患者总有效率高于对照组,差异有统计学意义(P﹤0.05)。治疗后,两组患者黄染、皮肤瘙痒、胁肋痛、纳差、乏力评分均较治疗前降低,且观察组患者黄染、皮肤瘙痒、胁肋痛、纳差、乏力评分均低于对照组,差异均有统计学意义(P﹤0.05)。治疗后,两组患者总胆红素(TBIL)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)水平均较治疗前降低,且观察组患者TBIL、ALT、AST水平均低于对照组,差异均有统计学意义(P﹤0.05)。观察组患者并发症总发生率明显低于对照组,差异有统计学意义(P﹤0.01)。结论茵陈汤联合经皮经肝胆管穿刺引流术能够改善胆管癌合并梗阻性黄疸患者纳差、乏力等临床症状及肝功能,提高患者临床疗效,降低患者并发症发生率。

Objective To investigate the clinical efficacy of Yinchen Decoction combined percutaneous transhepato-biliary puncture and drainage for cholangiocarcinoma complicated with obstructive jaundice.Method A total of 112 pa-tients with cholangiocarcinoma complicated with obstructive jaundice were divided into control group(n=56,treated with percutaneous transhepatobiliary puncture and drainage)and observation group(n=56,treated with percutaneous tran-shepatobiliary puncture and drainage+Yinchen Decoction)according to different treatment methods.The clinical efficacy,TCM syndrome score,liver function indexes and the occurrence of adverse reactions were compared between the two groups.Result After treatment,the total effective rate of observation group was higher than that of control group(P<0.05);the scores of yellow staining,skin pruritus,hypochondriac pain,poor appetite and fatigue in two groups were lower than those before treatment,with lower scores in observation group than those in control group(P<0.05);the levels of to-tal bilirubin(TBIL),alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in two groups were lower than those before treatment,with lower levels in observation group than those in control group(P<0.05).The total incidence of adverse reactions in observation group was lower than that in control group(P<0.01).Conclusion Yinchen Decoc-tion+percutaneous transhepatobiliary puncture and drainage can improve the clinical symptoms such as poor appetite and fatigue and liver function in patients with cholangiocarcinoma complicated with obstructive jaundice,improve the clinical efficacy and reduce adverse reactions.