金茵利胆口服液辅助治疗急性梗阻性化脓性胆管炎38例临床观察

Clinical observation on 38 cases of Jinyin Lidan Koufuye (金茵利胆口服液) in adjuvant treatment of acute obstructive suppurative cholangitis

目的观察金茵利胆口服液辅助治疗急性梗阻性化脓性胆管炎(AOSC)的临床疗效。方法将76例AOSC患者按照随机数字表法分为治疗组和对照组,各38例。对照组行经内镜逆行胰胆管造影(ERCP)取石术,同时给予西医常规治疗;治疗组在对照组治疗方法的基础上口服或经鼻胃管注入金茵利胆口服液,比较2组术前、术后第1天、术后第3天血清总胆红素(TBIL)、结合胆红素(DBIL)、C反应蛋白(CRP)的含量和丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)的活性及2组患者的首次排气时间。结果术后第1天、第3天2组血清ALT、AST活性及TBIL、DBIL、CRP含量均明显降低,与同组术前比较差异有统计学意义(P<0.05或P<0.01),且治疗组术后第3天对各项指标的改善作用均明显优于对照组(P<0.05);术后第3天2组血清ALT、AST活性及TBIL、DBIL、CRP含量均明显降低,与同组术后第1天比较差异有统计学意义(P<0.05)。治疗组术后首次排气时间为(12.50±2.25) h,对照组为(18.25±2.75) h,2组比较差异有统计学意义(P<0.05)。结论在ERCP取石术及西医常规治疗的基础上联合金茵利胆口服液可明显改善AOSC患者的肝功能,降低血清CRP含量,缩短术后首次排气时间,值得临床推广运用。

Objective To observe the clinical efficacy of Jinyin Lidan Koufuye(金茵利胆口服液)in adjuvant treatment of acute obstructive suppurative cholangitis(AOSC).Methods Seventy-six cases of AOSC were divided into control group and treatment group according to random number table method,with 38 cases in each.The control group was given endoscopic retrograde cholangio-pancreatography(ERCP)lithotomy therapy as well as routine Western treatment.The treatment group was given Jinyin Lidan Koufuye by mouth or by nasogastric tube injection on the basis of the control group.The levels of serum total bilirubin(TBIL),direct bilirubin(DBIL),C-reactive protein(CRP)and activity of alanine aminotransferase(ALT)and aspartate aminotransferase(AST),together with initial exhaust time of the patients in the two groups before surgery and on the 1st,3rd day after surgery were compared.Results On the 1st,3rdday after surgery,the serum ALT and AST activity and the levels of TBIL,DBIL and CRP in patients all decreased significantly,and the difference was statistically significant compared with the same group before surgery(P<0.05 or P<0.01),moreover,the improvement of various indicators in the treatment group on the 3rdday after surgery was superior to that in the control group(P<0.05).On the 3rdday after surgery,the serum ALT and AST activity and the levels of TBIL,DBIL and CRP all significantly decreased in the two groups,and there was statistically significant difference compared with those of the same group on the 1st day after surgery(P<0.05).The initial exhaust time after surgery of the treatment group was(12.50±2.25)h,that of the control group was(18.25±2.75)h,and there was statistically significant difference between the two groups(P<0.05).Conclusion It can significantly improve the liver function of patients of AOSC,decrease the serum levels of CRP and shorten the initial exhaust time after surgery to combine Jinyin Lidan Koufuye on the basis of ERCP lithotomy and routine Western treatment,which deserves clinical promotion and application.