小剂量胆宁片保护腹腔镜联合胆道镜保胆取石术(LRCL)后胆囊功能机制分析

Low-dose Danning Tablets protect gallbladder function after laparoscopic combined choledochoscopy lithotripsy by reducing oxidative stress in the body

目的探讨小剂量胆宁片在腹腔镜联合胆道保胆取石术(laparoscopic combined choledochoscopy lithotripsy,LRCL)后对胆囊功能影响。方法将108例接受LRCL的胆囊结石患者随机分为两组,每组54例,分别接受小剂量胆宁片治疗(观察组)和安慰剂治疗(对照组)。治疗3个月后检测患者血清中一氧化氮(NO)、丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽(GSH)的变化,第12个月和第24个月检测胆囊功能包括胆囊结石复发率、胆囊收缩率、胆囊壁厚度和血浆胆囊收缩素(cholecystokinin,CCK)水平。结果治疗后3个月,观察组MDA的表达量低于对照组,SOD、GSH的表达量高于对照组,NO则没有差异;术前、术后第12个月和第24个月胆囊功能情况,观察组第12个月与24个月的胆囊收缩率和CCK的水平大于对照组(P<0.05),胆囊壁厚度都小于对照组(P<0.05),胆结石复发率低于对照组。结论在患者进行LRCL后,经过口服小剂量的胆宁片治疗,可降低术后机体的氧化应激水平,胆囊的功能和结石的复发率都有改善,能够在术后预防胆囊结石的复发,提高患者术后健康指数。

Objective The purpose of this study is to examine the influence of low-dose Danning Tablets on gallbladder functionality post laparoscopic combined choledochoscopy lithotripsy(LRCL).Methods A total of 108 participants with gallbladder stones who underwent LRCL were randomly allocated into two groups,with 54 participants in each group.The observation group received treatment with low-dose Danning Tablets,while the control group received a placebo.Changes in serum levels of NO,MDA,SOD,and GSH were assessed after 3 months of treatment,and gallbladder function indicators,including stone recurrence rate,gallbladder contraction rate,gallbladder wall thickness,and plasma cholecystokinin(CCK)levels,were measured at the 12th and 24th months.Results After 3 months of treatment,the observation group exhibited significantly lower levels of MDA compared to the control group,while demonstrating significantly higher levels of SOD and GSH(P<0.05).However,there were no significant differences in NO levels between the two groups.At the 12th and 24th months,the observation group displayed significantly higher gallbladder contraction rates and CCK levels compared to the control group(P<0.05).In addition,the gallbladder wall thickness of the observation group was significantly lower than that of the control group(P<0.05).Furthermore,the recurrence rate of gallbladder stones was significantly lower in the observation group than in the control group.Conclusion In conclusion,oral administration of low-dose Danning Tablets post LRCL can effectively diminish postoperative oxidative stress levels and significantly enhance gallbladder function,thereby reducing the recurrence rate of gallbladder stones.It serves as an effective preventive measure for gallbladder stone recurrence and promotes improved postoperative health indices among patients.