利胆退黄汤对梗阻性黄疸(肝胆湿热证)术后退黄、改善肝功能的临床疗效

Clinical Effect of Lidan Tuihuang Decoction(利胆退黄汤)on Jaundice and Liver Function Improvement after Obstructive Jaundice(Liver-Gallbladder Damp-Heat Syndrome)

目的 观察利胆退黄汤对梗阻性黄疸(肝胆湿热证)术后退黄、改善肝功能的临床疗效。方法 选取2022年6月—2023年1月医院收治的梗阻性黄疸(肝胆湿热证)患者136例,均行腹腔镜胆囊切除术(laparoscopic cholecystectomy, LC)+腹腔镜胆总管探查术(laparoscopic common bile duct exploration, LCBDE)联合T管引流术,所有患者通过随机数表法分为两组,各68例,对照组术后常规抗感染及护肝治疗,研究组在对照组基础上服用利胆退黄汤治疗。比较两组术后肛门排气时间、黄疸消退时间和住院时间,术前及术后2周肝功能指标、炎症因子指标,中医症状积分,不良反应发生情况。结果 两组患者术后肛门排气时间和住院时间差异无统计学意义(P>0.05),研究组黄疸消退时间明显短于对照组(P<0.05)。术后2周,两组总胆红素(total bilirubin, TBIL)、直接胆红素(Direct Bilirubin, DBIL)、天冬氨酸转氨酶(aspartate transaminase, AST)、丙氨酸转移酶(alanine aminotransferase, ALT)水平显著降低,且研究组低于对照组(P<0.05)。术后2周,两组肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、C反应蛋白(C-reactive protein, CRP)、白介素-6(Interleukin-6,IL-6)水平显著降低,且研究组低于对照组(P<0.05)。研究组术后2周口苦咽干、恶心呕吐、舌苔症状积分均显著低于对照组(P<0.05)。两组均无严重不良反应发生。结论 利胆退黄汤对梗阻性黄疸(肝胆湿热证)术后患者临床疗效显著,能够退黄、改善肝功能,减轻机体炎症,促进患者,并且安全性可靠,值得推荐应用。

Objective To observe the clinical effect of Lidan Tuihuang Decoction(利胆退黄汤)on jaundice and liver function improvement after obstructive jaundice(liver-gallbladder damp-heat syndrome).Methods A total of 136 patients with obstruc-tive jaundice(liver-gallbladder damp-heat syndrome)admitted to the hospital from June 2022 to January 2023 were selected.All patients underwent laparoscopic cholecystectomy(LC)+laparoscopic common bile duct exploration(LCBDE)combined with T-tube drainage.All patients were divided into two groups by random number table method,68 cases in each group.The control group was treated with routine anti-infection and liver protection after operation,and the study group was treated with Lidan Tu-ihuang Decoction on the basis of the control group.The postoperative anal exhaust time,jaundice regression time and hospitaliza-tion time,liver function index,inflammatory factor index,TCM symptom score and adverse reactions were compared between the two groups.Results There was no significant difference in postoperative anal exhaust time or hospitalization time between the two groups(P>0.05).The jaundice regression time of the study group was significantly shorter than that of the control group(P<0.05).Two weeks after operation,the levels of total bilirubin(TBIL),direct bilirubin(DBIL),aspartate aminotransferase(AST)and alanine aminotransferase(ALT)in the two groups decreased significantly,and those in the study group were lower than the control group(P<0.05).At 2 weeks after operation,the levels of tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and interleukin-6(IL-6)in the two groups decreased significantly,and those in the study group were lower than the control group(P<0.05).The scores of bitter throat,nausea and vomiting and tongue coating in the study group were significantly lower than those in the control group at 2 weeks after operation(P<0.05).No serious adverse reactions occurred in both groups.Conclusion Lidan Tuihuang Decoction has a significant clinical effect on postoperative patients with obstructive jaundice(liver-gallbladder damp-heat syndrome).It can relieve jaundice,improve liver function,reduce body inflammation and pro-mote the recovery of the patients.It is safe and reliable and worthy of recommendation.