A study on relationship of nitric oxide,oxidation,peroxidation,lipoperoxidation with chronic cholecystitis

AIM:To study relationship of injury induced by nitric oxide, oxidation, peroxidation,lipoperoxidation with chronic cholecystitis.METHODS:The values of plasma nitric oxide (P-NO), plasma vitamin C (P-VC), plasma vitamin E (P-VE), plasma beta-carotene (P-beta-CAR), plasma lipoperoxides (P-LPO), erythrocyte superoxide dismutase (E-SOD), erythrocyte catalase (E-CAT), erythrocyte glutathione peroxidase (E-GSH-Px) activities and erythrocyte lipoperoxides (E-LPO) level in 77 patients with chronic cholecystitis and 80 healthy control subjects were determined, differences of the above average values between the patient group and the control group and differences of the average values between preoperative and postoperative patients were analyzed and compared, linear regression and correlation of the disease course with the above determination values as well as the stepwise regression and correlation of the course with the values were analyzed.RESULTS:Compared with the control group, the average values of P-NO, P-LPO, E-LPO were significantly increased (P【0.01), and of P-VC, P-VE, P-beta-CAR, E-SOD, E-CAT and E-GSH-Px decreased (P 【0.01) in the patient group. The analysis of the linear regression and correlation showed that with prolonging of the course, the values of P-NO, P-LPO and E-LPO in the patients were gradually ascended and the values of P-VC,P-VE, P-beta-CAR, E-SOD, E-CAT and E-GSH-Px descended (P【0.01). The analysis of the stepwise regression and correlation indicated that the correlation of the course with P-NO, P-VE and P-beta-CAR values was the closest. Compared with the preoperative patients, the average values of P-NO, P-LPO and E-LPO were significantly decreased (P 【0.01) and the average values of P-VC, E-SOD, E-CAT and E-GSH-Px in postoperative patients increased (P 【0.01) in postoperative patients. But there was no significant difference in the average values of P-VE, P-beta-CAR preoperative and postoperative patients.CONCLUSION:Chronic cholecystitis could induce the increase of nitric oxide, oxidation, peroxidation and lipoperoxidation.

H pylori are associated with chronic cholecystitis

AIM： To study whether H pylon are associated with chronic cholecystitis. METHODS： The subjects were divided into three groups： H pylori-infected cholecystitis group, H pylorinegative cholecystitis group and control group. Pathologic changes of the gallbladder were observed by optic and electronic microscopes and the levels of interleukin-1, 6 and 8 （IL-1, 6 and 8） were detected by radioimmunoassay. RESULTS： Histological evidence of chronic cholecystitis including degeneration, necrosis, inflammatory cell infiltration, were found in the region where H pylori colonized. Levels of IL-1, 6 and 8 in gallbladder mucosa homogenates were significantly higher in H py/oriinfected cholecystitis group than those in Hpylorinegative cholecystitis group and control group. CONCLUSION： H pylon infection may be related to cholecystitis.

Oxidative Stress before and after Operation in Patients with Chronic Cholecystitis Containing Gallstone

To study the relationship of oxidative, antioxidative constituents and antioxidases in blood with chronic cholecystitis containing gallstone, levels of lipoperoxides (LPO), nitric oxide (NO), vitamin C(VC), vitamin E (VE) and β carotene (β CAR) in plasma as well as level of LPO, activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH Px) in erythrocytes were investigated by spectrophotometric assay in 107 patients with this condition (PCg) and 100 healthy volunteers (HVs). Compared with HVs group, the average value of LPO and NO in plasma and that of LPO in erythrocytes of PCg group were significantly increased ( P <0.0001), while that of VC, VE and β CAR in plasma and the average activities of SOD, CAT and GSH Px in erythrocytes were significantly decreased ( P <0.0001). Linear regression and correlation analysis for 107 preoperative PCg showed that the value of LPO and NO in plasma and that of LPO in erythrocytes of PCg gradually increased ( P <0.0001), representing a significant linear positive correlation. The value of VC, VE and β CAR in plasma and that of SOD, CAT and GSH Px in erythrocytes of PCg gradually decreased ( P <0.0001), representing a significant linear negative correlation. Stepwise regression and correlation analysis for 107 preoperative PCg suggested that the closest correlation was observed between the course of disease and the value of NO and VC in plasma and that of SOD, GSH Px and LPO in erythrocytes, r =0.7306, F =32.1408, P <0.0001. Compared with the preoperative PCg group, the average value of LPO and NO in plasma and that of LPO in erythrocytes of the postoperative PCg group were significantly decreased ( P <0.0001). Furthermore, the average value of VC in plasma and that of SOD, CAT and GSH Px in erythrocytes of the postoperative PCg group were significantly increased ( P <0.0001), whereas no significant difference was found between their average value of VE and β CAR in plasma. These findings suggested that oxidative stress was an aggravating pathological condition in PCg group. Therefore, we recommend that in treating PCg, antioxidants such as VC, VE, β CAR should be given in order to alleviate their potential oxidative damages.

Individualized nomogram improves diagnostic accuracy of stage Ⅰ-Ⅱ gallbladder cancer in chronic cholecystitis patients with gallbladder wall thickening

BACKGROUND： Early diagnosis of gallbladder cancer（GBC） can remarkably improve the prognosis of patients. This study aimed to develop a nomogram for individualized diagnosis of stage Ⅰ-Ⅱ GBC in chronic cholecystitis patients with gallbladder wall thickening.METHODS： The nomogram was developed using logistic regression analyses based on a retrospective cohort consisting of 89 consecutive patients with stage Ⅰ-Ⅱ GBC and 1240 patients with gallbladder wall thickening treated at one biliary surgery center in Shanghai between January 2009 and December 2011. The accuracy of the nomogram was validated by discrimination, calibration and a prospective cohort treated at another center between January 2012 and December 2014（n=928）.RESULTS： Factors included in the nomogram were advanced age, hazardous alcohol consumption, long-standing diagnosed gallstones, atrophic gallbladder, gallbladder wall calcification, intraluminal polypoid lesion, higher wall thickness ratio and mucosal line disruption. The nomogram had concordance indices of 0.889 and 0.856 for the two cohorts, respectively. Internal and external calibration curves fitted well. The area under the receiver-operating characteristic curves of the nomogram was higher than that of multidetector row computed tomography in diagnosis of stage Ⅰ-Ⅱ GBC（P〈0.001）.CONCLUSION： The proposed nomogram improves individualized diagnosis of stage Ⅰ-Ⅱ GBC in chronic cholecystitis patients with gallbladder wall thickening, especially for those the imaging features alone do not allow to confirm the diagnosis.

CLINICAL OBSERVATION OF THE THERAPEUTICAL EFFECT OF 32 CASES OF ACUTE AND CHRONIC CHOLECYSTITIS WITH EYE ACUPUNCTURE

32 cases of patients with acute and chronic cholecystitis were treated with eyeacupuncture.The eye points used were Liver Region,Gallbladder Region and Middle Jiao Region.Reinforcing or reducing technique were applied under different conditions,The cure rate was 25％,the markedly effective rate was 31.25％,the effective rate was 28.21％and the ineffective rate was15.6％.The total effective rate was 84.37％.

A scanning electron microscope study on the gallbladder mucosa in chronic cholecystitis

Three kinds of chronic cholecystifis were investigated with SEM.The results showed thatin the mild chronic cholecystitis,pathological changes represented mainly the collapse on the surfaceof the mucosa and the separation of the columnar cells;while in the moderate ones,erosivechanges on the surface of the epithelium were revealed and in the severe chronic cholecystitis,patchy desquamation of the columnar cells occurred as a result,the lamina propria and thefibro-connective tissue under lamina propria were exposed.In all the three types of the cholecysfitis,mucoid droplets and cholesterol crystals could be seen on the surface of the epithelium.Differentnumbers of lymphocytes were found in the lamina propria.

H pylori exist in the gallbladder mucosa of patients with chronic cholecystitis

AIM:To study whether H pylori locate in the gallbladder mucosa of patients with chronic cholecystitis.METHODS:Using Warthy-Starry(W-S)silver stain and immunohistochemistry stain with anti-H pylori antibodies,we screened paraffin specimens in 524 cases of cholecystitis.H pylori urease gene A(HPUA)and H pylori urease gene B(HPUB)were analyzed by polymerase chain reaction(PCR)in the fresh tissue specimens from 81 cases of cholecystitis.RESULTS:H pylori-like bacteria were found in 13.55% of the gallbladders of the cholecystitis patients using W-S stain.Meanwhile,bacteria positive for H pylori antibodies were also found in 7.1% of the gallbladders of patients with cholecystitis by immunohistochemistry.Of 81 gallbladders,11 were positive for both HPUA and HPUB,4 were positive for HPUA only and 7 were positive for HPUB only.CONCLUSION:H pylori exist in the gallbladders of patients with chronic cholecystitis.

Mechanism of Shugan Lidan decoction in treating chronic calculous cholecystitis

Chronic calculous cholecystitis is a common clinical medical disease,which is classified as"hypochondriac pain"in traditional Chinese medicine(TCM).It is caused by liver failure and stagnation of liver qi.Therefore,the method of Soothing the liver and promoting bile flow is often used for regulating and harmonizing qi and blood.This paper discusses its mechanism of action,and points out that Shugan Lidan decoction has great effect on the treatment of chronic calculous cholecystitis,especially in the early treatment of the disease and delaying the progress of the disease,which provides help for the clinical treatment of chronic calculous cholecystitis.

自拟利胆经验方治疗慢性胆囊炎临床观察

目的观察孙晓生教授自拟利胆1号方治疗慢性胆囊炎的临床疗效和安全性。方法选取108例慢性胆囊炎患者为研究对象,利用随机数字表法分为2组,各54例。对照组采取常规西医治疗,观察组加用自拟利胆1号方治疗,4周后对比2组临床疗效。结果治疗前2组患者的中医症状积分、肝胆功能指标、免疫指标、炎性细胞因子相比,组间差异无统计学意义(P>0.05),治疗4周后均较治疗前改善且观察组改善效果优于对照组(P<0.05);观察组不良反应发生率与对照组相比,差异无统计学意义(P>0.05)。结论自拟利胆1号方对慢性胆囊炎有效,不良反应发生率低,使用前景广阔。

经胆囊后三角解剖入路腹腔镜手术治疗胆囊结石伴慢性胆囊炎的临床效果观察

目的 探讨治疗胆囊结石伴慢性胆囊炎患者时采用经胆囊后三角解剖入路腹腔镜手术的临床效果。方法 112例胆囊结石伴慢性胆囊炎患者,采用随机数字表法分为对照组和观察组,每组56例。对照组采用常规胆囊三角入路腹腔镜手术治疗,观察组采用经胆囊后三角解剖入路腹腔镜手术治疗。对比两组的围术期指标,手术前后白细胞计数(WBC)、C反应蛋白(CRP)水平。结果 观察组术中出血量(27.50±7.35)ml少于对照组的(42.15±5.69)ml,肠功能恢复时间(20.42±4.17)h、住院时间(5.53±1.18)d、手术时间(24.39±3.13)min短于对照组的(31.53±3.25)h、(7.58±2.52)d、(38.63±2.41)min,差异有统计学意义(P<0.05)。术后3 d,观察组的WBC(8.39±0.37)×10^(9)/L与CRP(8.20±0.37)mg/L均低于对照组的(10.58±0.41)×10^(9)/L、(12.31±0.35)mg/L,差异有统计学意义(P<0.05)。结论 针对胆囊结石伴慢性胆囊炎患者,治疗时可以考虑经胆囊后三角解剖入路腹腔镜手术,其术中出血量少,肠功能恢复速度较快,住院时间短,且能降低对患者的损伤,应用价值较高,值得进一步推广。

蒙医药辨证治疗慢性胆囊炎的临床疗效观察

目的:探讨蒙医药辨证治疗慢性胆囊炎的临床疗效观察。方法:选取60例慢性胆囊炎患者,均为我院2022年1月—2022月12月收入,按随机数字表法分组。对照组30例患者使用中成药常规治疗,研究组30例患者使用蒙医药辨证治疗,将两组患者治疗前后蒙医证候评分进行比较。结果:研究组患者治疗后效果评分低于对照组患者,P<0.05。结论:使用蒙医药辨证治疗慢性胆囊炎治疗效果显著,可以有效改善患者症状,能够从整体上调整患者的身体状态,以达到真正的治本之效。

从厥阴病机论乌梅丸现代临床证治思路

从厥阴病寒热错杂,阴阳失和的病机入手,探析乌梅丸收敛气血,调和阴阳的作用及其临床应用范围。结合现代药理学研究及古今医家经验,总结出乌梅丸在治疗糖尿病性胃轻瘫、胃食管反流病、慢性顽固性腹泻、慢性胆囊炎、顽固性失眠和溃疡性结肠炎上所取得的显著疗效,为经方临床应用提供思路。

残余胆固醇与慢性胆囊炎相关性研究

目的探讨残余胆固醇(RC)与慢性胆囊炎之间的相关性。方法回顾性选择2024年1—5月在某三甲医院健康管理中心进行健康体检的19587名体检者为研究对象,通过超声检查结果评估慢性胆囊炎,分为慢性胆囊炎组(2816例)和非慢性胆囊炎组(16771例),采用Spearman秩相关分析探讨RC与慢性胆囊炎发病的其他危险因素的相关性,采用二元Logistic回归分析(向前法)探讨RC是否为慢性胆囊炎的独立危险因素。结果Spearman秩相关分析显示,残余胆固醇与收缩压、舒张压、体重指数、空腹血糖、淋巴细胞百分比、总胆固醇、甘油三酯、甘油三酯、白/球蛋白、总胆红素、尿酸、肌酐呈正相关(rs=0.078、0.111、0.114、0.102、0.019、0.247、0.440、0.133、0.024、0.074、0.093,P<0.05);与中性粒细胞百分比、高密度脂蛋白、低密度脂蛋白、总胆红素、白蛋白、球蛋白、尿素氮负相关(rs=-0.017、-0.258、-0.059、-0.192、-0.052、-0.177、-0.043,P<0.05);与脉压差、血小板无相关关系(rs=0.009、-0.010,P>0.05)。二元Logistic回归分析显示,年龄(OR=1.035,95%CI=1.031~1.038)、婚否(OR=1.942,95%CI=1.357~2.780)、肥胖(OR=1.145,95%CI=1.012~1.295)、残余胆固醇(OR=1.116,95%CI=1.025~1.216)、血脂异常(OR=1.090,95%CI=1.001~1.187)、肌酐(OR=1.003,95%CI=1.001~1.005)是慢性胆囊炎发病的独立危险因素(P<0.05)。结论慢性胆囊炎的发生与RC有关,RC是慢性胆囊炎发病的独立危险因素。

腹腔镜胆囊切除术治疗慢性胆囊炎患者预防应用抗菌药物合理性分析

目的了解腹腔镜胆囊切除术(LC)治疗胆石症引起的慢性胆囊炎患者围手术期预防应用抗菌药物的合理性。方法回顾性选取我院2022年1月至2023年1月收治的166例行LC治疗的胆石症引起的慢性胆囊炎患者作为研究对象,调查其围术期预防性应用抗菌药物情况,并分析抗菌药物在品种选择、用药疗程、给药时机等方面的合理性。结果品种选择:166例患者应用的抗菌药物品种较多:头孢替安152例(91.6%)、依诺沙星5例(3.0%)、头孢哌酮钠舒巴坦钠4例(2.4%)、头孢他啶2例(1.2%)、左氧氟沙星氯化钠1例(0.6%)。除3例为二联用药外,163例(98.2%)均为单一用药,且91.6%单用注射用盐酸头孢替安。用药时机:除2例为术前0.5~1 h用药外,164例(98.8%)患者均为术后用药,无术中用药。用药疗程:术后用药时长以<24 h为主(159例,95.8%),2例(1.2%)用药时长为24~48 h,5例(3.0%)用药时长为48~72 h,1例(0.6%)用药时长≥72 h。合理性评价:166例患者在联合用药(164例,98.8%)、给药途径(166例,100%)、用法用量(166例,100%)及用药疗程(159例,95.8%)的合理性较高,给药时机的合理性最低(2例,1.2%),用药指征合理性偏低,为74.1%(123例),药物选择方面的合理性为89.1%(148例),整体用药合理率为79.86%(928例)。25例(15.1%)患者发生消化道相关症状的近期并发症,包括腹痛腹胀(8例,4.8%)、腹泻(10例,6.0%)、恶心呕吐(7例,4.2%)。有并发症与无并发症患者在用药指征、药物选择、给药时机、联合用药、给药途径、用法用量、用药疗程方面的用药合理性对比,差异均无统计学意义(P>0.05)。结论我院胆石症引起的慢性胆囊炎患者在LC围术期预防性应用抗菌药物总体较为合理,但仍然存在用药时机不当、无适应证用药、抗菌药物选用不合理等问题。

姜德友教授治疗慢性胆囊炎经验

慢性胆囊炎是胆囊持续的、反复发作的慢性炎症过程,是临床常见病、多发病。中医学认为慢性胆囊炎属于“胆胀”“胃脘痛”“胁痛”“黄疸”等范畴,主要表现为反复的右上腹疼痛不适或有嗳气、腹胀、恶心等消化系统症状,查体可有右上腹部压痛。姜德友教授提出本病核心病机为腑不通降。临证治疗时,姜德友教授善从胆胃论治,治疗上强调治病求本、标本兼顾,提倡明辨寒热、气滞、瘀血、结石之侧重,通降腑气与驱邪共施。此外,姜德友教授以中医临床优势思维、经方思维为指导,活用经方,用药精当,又注重三因制宜,将黑龙江地区气候、饮食特点与患者体质相结合,并强调专病专药,且善用角药,疗效显著,值得学习借鉴。

胆石片联合头孢唑林钠治疗慢性胆囊炎的临床效果观察

目的 观察胆石片联合头孢唑林钠治疗慢性胆囊炎的临床效果。方法 90例慢性胆囊炎患者作为研究主体,按患者入院时间不同将其分成常规组(2020年1月~2021年6月入院)、实验组(2021年7月~2022年12月入院),每组45例。常规组接受头孢唑林钠单一静脉滴注治疗,实验组在常规组基础上联合胆石片治疗。比较两组患者治疗前后的临床症状评分(恶心呕吐、厌油腻、胆区疼痛、纳呆腹胀)、MC Gill疼痛评分[视觉模拟评分法(VAS)、疼痛分级指数(PRI)、疼痛强度(PPI)]、炎性反应指标[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]、肝胆功能指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)]、临床治疗效果。结果 治疗后,常规组恶心呕吐(2.40±0.15)分、厌油腻(1.45±0.13)分、胆区疼痛(2.77±0.18)分、纳呆腹胀(1.94±0.07)分;实验组恶心呕吐(1.20±0.07)分、厌油腻(0.52±0.10)分、胆区疼痛(1.13±0.11)分、纳呆腹胀(0.63±0.04)分。实验组恶心呕吐、厌油腻、胆区疼痛、纳呆腹胀的评分低于常规组(P<0.05)。治疗后,常规组VAS评分(3.30±0.40)分、PRI评分(1.14±0.10)分、PPI评分(2.66±0.14)分;实验组VAS评分(1.12±0.30)分、PRI评分(0.43±0.07)分、PPI评分(1.15±0.08)分。实验组VAS评分、PRI评分、PPI评分低于常规组(P<0.05)。治疗后,常规组IL-6(65.45±4.85)ng/L、TNF-α(42.25±1.60)ng/L、hs-CRP(24.18±3.39)mg/L;实验组IL-6(36.77±3.06)ng/L、TNF-α(31.07±0.40)ng/L、hs-CRP(12.00±1.60)mg/L。治疗后实验组炎性反应指标低于对照组(P<0.05)。治疗后,常规组ALT(60.26±8.02)U/L、AST(65.25±7.36)U/L、TBIL(32.43±6.07)μmol/L;实验组ALT(31.97±4.85)U/L、AST(46.78±5.96)U/L、TBIL(22.01±4.38)μmol/L。治疗后实验组肝胆功能指标低于对照组(P<0.05)。实验组总有效率97.78%高于对照组的86.67%(P<0.05)。结论 慢性胆囊炎患者经胆石片联合头孢唑林钠治疗效果良好,可改善临床症状,建议普及应用。

经胆囊后三角解剖入路行腹腔镜胆囊切除术对慢性胆囊炎合并胆结石患者免疫功能及应激反应的影响

目的研究经胆囊后三角解剖入路行腹腔镜胆囊切除术对慢性胆囊炎合并胆结石患者免疫功能及应激反应的影响。方法选取2020年1月至2023年1月我院收治的180例慢性胆囊炎合并胆结石患者作为研究对象,按照随机数字表法将其分为对照组(n=90)和观察组(n=90)。两组均行腹腔镜胆囊切除术,对照组经胆囊三角解剖入路,观察组经胆囊后三角解剖入路。比较两组的围术期指标、氧化应激因子水平、免疫功能指标以及术后并发症发生情况。结果观察组的手术时间、住院时间及肠功能恢复时间短于对照组,术中出血量少于对照组,差异具有统计学意义(P<0.05)。治疗24 h后,观察组的丙二醛(MDA)、3-硝基酪氨酸(3-NT)水平低于对照组,超氧化物歧化酶(SOD)、谷胱甘肽(GSH)水平高于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)高于对照组,CD8^(+)低于对照组,差异具有统计学意义(P<0.05)。观察组的术后并发症总发生率为2.22%,低于对照组的10.00%,差异具有统计学意义(P<0.05)。结论经胆囊后三角解剖入路行腹腔镜胆囊切除术治疗慢性胆囊炎合并胆结石患者的效果显著,可缩短手术时间、术后肠道功能恢复时间以及住院时间,减少术中出血量,减轻氧化应激反应,改善免疫功能,且术后并发症风险较低。

健康体检人群慢性胆囊炎与血脂水平、体重指数及空腹血糖的关系研究

目的了解某三甲医院不同年龄组健康体检人群慢性胆囊炎发生现况,分析慢性胆囊炎与血脂水平、体重指数、空腹血糖的相关性。方法从2023年1—5月在某三甲医院进行健康体检的对象中选取18岁以上,有完整的一般资料,各项生化指标齐全的29350名为研究人群。超声检测是否存在慢性胆囊炎,使用t检验和χ^(2)检验分析慢性胆囊炎与血脂、BMI、空腹血糖的关系。结果成人健康体检人群TC值为(5.13±1.03)mmol/L,TG值为(1.62±1.36)mmol/L,HDL-C值为(1.63±0.38)mmol/L,LDL-C值为(2.97±0.84)mmol/L,BMI值为(24.15±3.29)kg/m^(2),GLU值为(5.43±1.25)mmol/L。健康体检人群中慢性胆囊炎发病率为15.4%(4516/29350例)。18~29岁、30~39岁、40~49岁、50~59岁、≥60岁各年龄组慢性胆囊炎发病率差异有统计学意义(发病率分别为3.6%、8.4%、15.1%、20%、24.4%,χ^(2)=2150.318,P<0.05),≥60岁人群中发病率最高为24.4%(1183/4834例)。TC、TG、LDL-C增高组慢性胆囊炎发病率均大于正常组,HDL-C正常组慢性胆囊炎发病率大于降低组,TC、TG、LDL-C各水平差异有统计学意义(χ^(2)分别为33.176、33.965、17.070,P<0.05),HDL-C正常组慢性胆囊炎发病率与降低组之间差异无统计学意义(χ^(2)为2.12,P>0.05)。超重患者慢性胆囊炎发病率最高,为17.9%(1960/10948例),各组别之间差异有统计学意义(χ^(2)=132.292,P<0.05)。GLU升高组慢性胆囊炎发病率发病率最高为21.6%(849/3929例),各组别之间差异有统计学意义(χ^(2)=134.914,P<0.05)。各年龄组中:18~29岁,BMI各组别间差异有统计学意义(t值为2.767,P<0.05),其余指标各组别间差异均无统计学意义;30~39岁,TC、TG、HDL-C、LDL-C、BMI、GLU,差异均有统计学意义(t值分别为1.986、2.188、-2.791、2.302、8.294、2.657,P<0.05);40~49岁,TC、TG、HDL-C、LDL-C、BMI、GLU水平比较,差异均有统计学意义(t值分别为3.433、3.205、-4.835、2.579、8.015、3.716,P<0.05);50~59岁,HDL-C、LDL-C、BMI、GLU水平比较,差异有统计学意义(t值分别为-9.731、4.965、8.454、4.700,P<0.05);≥60岁,TC、HDL-C、LDL-C、BMI、GLU水平比较,差异有统计学意义(t值分别为-2.827、-7.953、-3.277、6.048、2.520,P<0.05)。结论成人健康体检人群胆囊炎发病率高,发病率随年龄的增加而增高。各年龄组中,慢性胆囊炎发病均与体重指数有关。除18~29岁外,其余各年龄组慢性胆囊炎发病与空腹血糖、血脂均有相关性。

Effective Common Chinese Herbal Medicines Used in Treating Chronic Cholecystitis with Liver-Gallbladder Dampness-Heat Syndrome: A Review of Clinical Studies in the Past 10 Years

The objective of the study is to identify the effective common Chinese herbal medicines used in treating chronic cholecystitis with liver-gallbladder dampness-heat syndrome(CCLGDHS) through reviewing relevant clinical studies published in the past 10 years. Data were collected from Science Direct and Chinese National Knowledge Infrastructure. Data screening was carried out for the abstracts and full texts of the data. The top 15 Chinese herbal medicines with the highest occurring frequency were selected, statistically analyzed, and classified by their medicinal properties, actions, and indications according to the Chinese Pharmacopoeia 2015 edition. The top 15 effective common Chinese herbal medicines comprise Chai Hu, Huang Qin, Jin Qian Cao, Bai Shao, Yin Chen, Yu Jin, Chuan Lian Zi, Yan Hu Suo, Zhi Shi, Ban Xia, Bai Zhu, Pu Gong Ying, Gan Cao, Zhi Zi, and Qing Pi. The predominant natures were cold, cool, and warm. This combination can clear stagnant heat, warm Yang, and regulate Qi dynamics. In addition, bitter, pungent, and sweet were the predominant flavors. They can clear dampness-heat, regulate Qi dynamics to relieve cramps and pain, as well as tonify the deficiency. Along with entering the liver and gallbladder meridians, these herbal medicines also entered the spleen, stomach, and lung meridians to prevent potential disease transmission. The combinatorial medicinal actions of the effective common Chinese herbal medicine highlight the importance of the holistic concept of traditional Chinese medicine when treating CCLGDHS. In addition, the inclusion of activating blood to promote blood circulation, relieving cramps and alleviating pain, and tonifying the spleen and stomach represents a new finding in the treatment principle for CCLGDHS.

经胆囊后三角入路与前三角入路行腹腔镜胆囊切除术治疗胆囊结石合并慢性胆囊炎的效果对比

目的:分析经胆囊后三角入路与前三角入路行腹腔镜胆囊切除术(LC)治疗胆囊结石合并慢性胆囊炎的临床效果。方法:选取2020年6月—2023年1月在武山县第二人民医院就诊的105例胆囊结石合并慢性胆囊炎患者,按随机数表法将其分为对照组(n=52)与观察组(n=53)。对照组经胆囊前三角入路行LC,观察组经胆囊后三角入路行LC。术后随访3个月,对比两组手术相关指标、炎症因子水平、免疫功能及并发症。结果:观察组术中出血量少于对照组,手术时间、胃肠功能恢复时间、住院时间均短于对照组,差异有统计学意义(P<0.05)。术前,两组C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)、CD3^(+)、CD4^(+)、CD8^(+)相比,差异无统计学意义(P>0.05);术后1 d,两组CRP、TNF-α、PCT、CD8^(+)水平均升高,CD3^(+)、CD4^(+)水平均下降,且与对照组相比,观察组CRP、TNF-α、PCT,CD8^(+)水平更低,CD3^(+)、CD4^(+)水平更高,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:经胆囊后三角行LC治疗胆囊结石合并慢性胆囊炎患者的效果确切,能够减少出血量,缩短手术时间,减轻炎症反应,减少对机体免疫系统的损害,且并发症少。