利胆消黄汤对胆总管结石患者术后恢复及血清炎症因子的影响

Effect of Lidanxiaohuang Decoction on Postoperative Recovery and Serum Inflammatory Factors of Patients with Choledocholithiasis

目的观察利胆消黄汤对胆总管结石患者术后恢复及血清炎症因子的影响。方法选取2022年2月—2023年2月期间西南医科大学附属医院收治的胆总管结石行胆道探查手术患者108例,按随机数字表法分为对照组和观察组,每组各54例。对照组给予常规治疗,观察组在对照组基础上联合利胆消黄汤治疗,连续治疗5 d。观察比较两组患者临床疗效、术后恢复时间(胃肠功能恢复时间、黄疸消退时间、腹痛缓解时间、住院时间),治疗前后中医证候积分、血清炎症因子[C反应蛋白(C-reactive Protein,CRP)、白细胞介素-1(Interleukin-1,IL-1)、白细胞介素-6(Interleukin-6,IL-6)]水平及肝功能指标[天冬氨酸氨基转移酶(Aspartate Aminotransferase,AST)、丙氨酸氨基转移酶(Alanine Aminotransferase,ALT)、γ-谷氨酰转肽酶(γ-glutamyl Transpeptidase,γ-GT)、碱性磷酸酶(Alkaline Phosphatase,ALP)]。结果治疗后观察组总有效率96.30%(52/54)高于对照组85.19%(46/54),差异有统计学意义(P<0.05)。治疗后两组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组低于对照组,差异有统计学意义(P<0.05)。术后观察组胃肠功能恢复时间、黄疸消退时间、腹痛缓解时间、住院时间均明显少于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清炎症因子CRP、IL-1、IL-6水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者肝功能AST、ALT、GGT、ALP均较治疗前降低,差异有统计学意义(P<0.05);且观察组低于对照组,差异有统计学意义(P<0.05)。结论胆总管结石术后加用利胆消黄汤有促进患者术后恢复、降低血清炎症因子水平及改善肝功能等作用,治疗效果较好。

Objective To investigate the effect of Lidanxiaohuang Decoction on postoperative recovery and serum inflammatory factors of patients with choledocholithiasis.Methods A total of 108 patients who underwent biliary tract exploration surgery for choledocholithiasis at Affiliated Hospital of Southwest Medical University from February 2022 to February 2023 were selected and divided into an observation group(Lidanxiaohuang Decoction+conventional treatment,54 cases)and a control group(conventional treatment,54 cases)according to random number table method.The therapeutic effect,postoperative recovery time(gastrointestinal function recovery time,jaundice subside time,abdominal pain relief time,and hospital stay),TCM syndrome scores,C-reactive protein(CRP),interleukin-1(IL-1),interleukin-6(IL-6),aspartate aminotransferase(AST),alanine aminotransferase(ALT),γ-glutamyl transpeptidase(γ-GT),and alkaline phosphatase(ALP)were compared between the two groups before and after treatment.Results The total effective rate of the observation group was 96.30%(52/54),which was significantly higher than that of the control group 85.19%(46/54),with a statistically significant difference(P<0.05).TCM syndrome score after treatment was significantly lower than before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).Postoperative gastrointestinal function recovery time,jaundice subside time,abdominal pain relief time,and hospital stay time of the observation group were significantly lower than those of the control group(P<0.05).CRP,IL-1,and IL-6 in the two groups were significantly reduced after treatment(P<0.05),and the observation group was lower than the control group(P<0.05).The AST,ALT,GGT,and ALP of the two groups were significantly reduced after treatment(P<0.05),and the observation group was lower than the control group(P<0.05).Conclusion The application of Lidanxiaohuang Decoction after choledocholithiasis surgery can promote the postoperative recovery of patients,reduce the level of serum inflammatory factors,and improve liver function,and the therapeutic effect is good.