摘要
目的:探讨大黄灵仙方对腹腔镜下胆总管切开取石术疗效的影响。方法:将67例胆总管结石患者随机分为治疗组34例和对照组33例。两组患者均行腹腔镜下胆总管切开取石术,术后除常规治疗外,治疗组加服大黄灵仙方汤剂。观察两组患者T管胆汁引流量、术后禁食与肛门排气时间及并发症发生情况;比较两组患者排石率、总有效率及术后复发率。结果 :总有效率治疗组为97.05%(33/34),高于对照组的81.82%(27/33)(P=0.041);术后第4天治疗组患者T管引流量为(374.20±90.80)mL,多于对照组的(326.86±68.40)mL(P=0.019);排石率治疗组为80.00%(8/10),高于对照组的33.33%(3/9)(P=0.04);复发率治疗组为3.13%(1/32),低于对照组的22.22%(6/27)(P=0.024);谷丙转氨酶、谷草转氨酶、总胆红素、碱性磷酸酶、γ-谷氨酰转移酶治疗组分别为(55.20±18.63)U/L、(51.32±15.12)U/L、(23.34±9.73)μmol/L、(103.87±40.84)U/L、(56.82±19.38)U/L,分别低于对照组的(67.89±20.65)U/L(P=0.010)、(60.72±17.8)U/L(P=0.023)、(28.66±10.50)μmol/L(P=0.035)、(129.22±49.23)U/L(P=0.025)、(63.13±21.47)U/L(P=0.211);术后肛门排气时间、禁食时间及住院时间治疗组均短于对照组(P<0.05);并发症发生率两组比较差异无统计学意义(P=0.261)。结论:大黄灵仙方具有促进腹腔镜下胆总管切开取石术患者胆汁排泄、减轻胆管炎症水肿、减少胆道感染几率、改善肝细胞代谢、促进胃肠功能恢复、防治结石复发等作用。
Objective:To discuss the influence of Dahuang Lingxian prescription on clinical efficacy of laparoscopic choledochotomy lithotomy.Methods:All 67 patients were randomized into 34 cases of the treatment group and 33 cases of the control group.The patients in both groups performed laparoscopic choledochotomy lithotomy,besides postoperative routine therapy,the treatment group was treated with Dahuang Lingxian decoction.To observe the T-duct bile drainage flow rate,postoperative fasting and anal exhaust time and the incidence of the complications between both groups;to compare stone discharge rate,total effective rate and the recurrence rate after the surgery between both groups.Results:Total effective rate of the treatment group was 97.05%(33/34),higher than 81.82%(27/33)of the control group(P=0.041);the patients'T-duct bile drainage volume was(374.20±90.80)mL in the treatment group the forth day after the surgery,higher than(326.86±68.40)mL in the control group(P=0.019);stone discharge rate of the treatment group was 80.00%(8/10),higher than 33.33%(3/9)of the control group(P=0.04);the recurrence rate of the treatment group was 3.13%(1/32),lower than 22.22%(6/27)of the control group(P=0.024);the concentrations of ALT,AST,TBIL and ALPγ-glutamyl transferase(γ-GT)of the treatment group were(55.20±18.63)U/L,(51.32±15.12)U/L,(23.34±9.73)μmol/L and(103.87±40.84)U/L,(56.82±19.38)U/L respectively,lower than(67.89±20.65)U/L(P=0.010),(60.72±17.8)U/L(P=0.023),(28.66±10.50)μmol/L(P=0.035),and(129.22±49.23)U/L(P=0.025),(63.13±21.47)U/L(P=0.211);postoperative anal exhaust time fasting time and hospital stay of the treatment group were shorter than these of the control group(P<0.05);the difference had no statistical meaning in the incidence of the complications between both groups(P=0.261).Conclusion:Dahuang Lingxian prescription could promote bile excretion,relieve the edema and inflammation of bile duct,reduce the odds of biliary infection,improve the metabolism of liver cells,promote the recovery of gastrointesti
作者
吕震
唐乾利
卓臣义
葛斌
俞渊
王兵
冯时
许彦
LYU Zhen;TANG Qianli;ZHUO Chenyi;GE Bin;YU Yuan;WANG Bing;FENG Shi;XU Yan(Traditional Chinese Medical Hospital of Zhuji,Zhuji 311800,China;Youjiang Medical University for Nationalites/Guangxi Clinical Medical Research Center for Hepatobiliary Diseases,Baise 533000,China;the First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530023,China)
出处
《西部中医药》
2023年第5期90-93,共4页
Western Journal of Traditional Chinese Medicine
基金
国家自然科学基金(81860851)
广西科学研究与技术开发计划项目(重点研发计划)(桂科AB17195071)
广西自然科学基金(2018GXNSFDA281017)。
关键词
胆总管结石
腹腔镜
大黄灵仙方
临床疗效
choledocholithiasis
laparoscope
Dahuang Lingxian prescription
clinical effects
