疏肝利胆汤辅助治疗对老年胆囊炎胆石症患者术后康复及血清细胞因子的影响

Effect of Shugan Lidan Decoction on postoperative rehabilitation and serum cytokines in elderly patients with cholecystitis and cholelithiasis

目的:研究疏肝利胆汤对老年胆囊炎胆石症患者术后康复及对血清细胞因子的影响。方法:以我院进行胆道镜取石术治疗的70例老年胆囊炎胆石症患者(2019年1月~2022年12月)。随机将患者分为对照组、研究组,各35例。对照组采用熊去氧胆酸片治疗,研究组采用疏肝利胆汤辅助治疗。分析比较两组治疗4 w后临床疗效、中医证候积分、采用酶联免疫吸附法测定血清C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子(Tumor Necrosis Factor-α,TNF-α)、高迁移率族蛋白B1(High mobility group box 1 protein,HMGB1)水平,采用清蛋白一钴结合法检测缺血修饰白蛋白(Ischemia modified albumin,IMA)水平。结果:研究组临床总有效率显著高于对照组(P<0.05)。治疗后研究组术后排气时间、术后排便时间、疼痛缓解时间、白细胞恢复时间均显著短于对照组(P<0.05);治疗后,研究组中医证候积分显著低于对照组(P<0.05)。治疗后,研究组血清CRP、TNF-α、IMA、HMGB1水平均显著低于对照组(P<0.05)。结论:疏肝利胆汤辅助治疗老年胆囊炎胆石症术后患者疗效显著,可有效提升术后恢复情况,缓解临床症状,促进病情恢复。

Objective:To study the effects of Shugan Lidan Decoction on postoperative rehabilitation and serum cytokines in elderly patients with cholecystitis and cholelithiasis.Methods:70 elderly patients with cholecystitis and cholelithiasis were treated by choledochoscopy in our hospital(January 2019~December 2022).The patients were randomly divided into control group and study group,35 cases each.The control group was treated with ursodeoxycholic acid tablets,and the study group was treated with Shugan Lidan decoction.Analyze and compare the clinical efficacy,TCM syndrome scores,serum C-reactive protein(CRP)and Tumor Necrosis Factor-α(TNF-α)in the two groups after 4 weeks of treatment by enzyme-linked immunosorbent assay(ELISA).and High mobility group box 1 protein(HMGB1)levels were detected by albumin-cobalt binding.The level of ischemia-modified albumin(IMA)was detected.Results:The total clinical effective rate of the study group was significantly higher than that of the control group(P<0.05).After treatment,the postoperative exhaust time,postoperative defecation time,pain relief time and leukocyte recovery time of the study group were significantly shorter than those of the control group(P<0.05).After treatment,the TCM syndrome score of the study group was significantly lower than that of the control group(P<0.05).After treatment,the levels of CRP,TNF-α,IMA and HMGB1 in the study group were significantly lower than those in the control group(P<0.05).Conclusion:Shugan Lidan Decoction is effective in the adjuvant treatment of elderly patients with cholecystitis and cholelithiasis after operation,which can effectively improve the postoperative recovery,relieve clinical symptoms and promote the recovery of the disease.