茵栀黄口服液联合PTCD治疗恶性胆道梗阻性黄疸临床观察

Clinical observation on Yinzhihuang Oral Liquid combined with PTCD in treatment of malignant biliary obstructive jaundice

目的 观察经皮肝穿刺胆道引流术(PTCD)术后第2天联合茵栀黄口服液治疗恶性胆道梗阻性黄疸(MBOJ)临床疗效。方法 将我院92例MBOJ患者随机分为研究组与对照组各46例。对照组接受PTCD治疗研究组在PTCD术后第2天服用菌桅黄口服液。评估两组减黄效果,PTCD留置时间、拔管率、平均生存期,并发症发生率;比较PTCD术前、术后14d两组总胆红素(TB)、直接胆红素(DB)、间接胆红素(IB)、谷丙转氨酶(ALT)、门冬氨酸氨基转移酶(GOT)、谷草转氨酶(AST)、糖类抗原199(CA199)、甲胎蛋白(AFP)含量;比较PTCD术前、术后14 d目黄等主要证候、畏寒发热等次要证候积分。结果 术后14 d,研究组减黄总有效率高于对照组(P<0.05)研究组PTCD留置时间短于对照组研究组拔管率、平均生存期均优于对照组(P<0.05);研究组并发症发生率低于对照组(P<0.05);两组TB、DB、IB、ALT、GOT、AST含量、目黄等主要证候、畏寒发热等次要证候积分均低于治疗前,研究组上述指标均低于对照组(P<0.05);两组CA199、AFP含量均低于治疗前(P<0.05)但两组CA199、AFP含量比较差异无统计学意义(P>0.05)。结论 PTCD术后第2天应用茵栀黄口服液可有效改善MBOJ的症状,明显缩短留置时间,提高拔管率,延长平均生存期,提高肝功能。

Objective To observe the clinical efficacy of percutaneous liver puncture biliary drainage(PTCD)combined with the application of Yinzhihuang Oral Liquid on the 2nd day after surgery on malignant biliary obstructive jaundice(MBOJ).Methods A total of 92 MBOJ patients were randomly divided into study group and control group,with 46 eases each.Control group was treated with PTCD,and study group was treated with Yinzhihuang Oral Liquid on the basis of control group.The effects of yellowing reduction,PTCD indwelling time,extubation rate,average survival and complication rate were evaluated between the two groups,and the contents of total bilirubin(TB),direct bilirubin(DB),indirect bilirubin(IB),alanine aminotransferase(ALT),aspartate aminotransferase(GOT),aspartate aminotransferase(AST),carbohydrate antigen 199(C A199)and alpha-fetoprotein(AFP),the scores of major syndromes such as yellow and secondary syndromes such as chills and fever were compared between the two groups before and 14 days after PTCD.Results On the 14th day after PTCD,the total effective rate of yellowing reduction in study group was higher than that in control group(P<0.05);the indwelling time of study group was shorter than that in control group,the extubation rate and average survival rate in study group were superior to those in control group(P<0.05),and the complication rate in study group was lower than that in control group(P<0.05);the scores of TB,DB,IB,ALT,GOT,AST,major syndromes such as yellow and secondary syndromes such as chills and fever in both groups were lower than those before treatment,and were lower in study group than those in control group(P<0.05);the contents of CA199 and AFP in both groups were lower than those before treatment(P<0.05),and there was no significant difference between the two groups(P>0.05).Conclusion The application of Yinzhihuang Oral Liquid on the 2nd day after PTCD effectively improves the symptoms of MBOJ,significantly shortens the indwelling time,increases the extubation rate,prolongs the average survival time,and improves liver function.