| 摘要: |
| 目的:观察茵陈利胆汤联合经皮经肝胆管穿刺引流术(PTCD)治疗胆管癌合并梗阻性黄疸的临床疗效。方法:选择2018年10月—2020年10月在海军军医大学第三附属医院中西医结合科住院的胆管癌合并梗阻性黄疸患者72例，根据患者年龄、病程及胆红素水平配对分为对照组与治疗组各36例，两组患者充分行PTCD术解除梗阻，同时根据病情予保肝、抗感染、补充电解质等对症治疗，治疗组在上述基础上加用茵陈利胆汤中药煎剂，治疗14 d，观察并比较两组患者治疗前后中医临床症状积分、肝功能指标、体能状态卡氏评分(KPS)。结果:治疗14 d后，两组患者黄染、纳差、乏力临床症状积分及总胆红素(TBIL)、谷丙转氨酶(ALT)差异有统计学意义(P<0.05)，治疗组明显优于对照组。两组患者治疗后KPS均较治疗前好转，治疗组改善优于对照组，差异有统计学意义(P<0.05)。治疗组总有效率为88.9%，高于对照组75.0%，差异有统计学意义(P<0.05)。结论:茵陈利胆汤联合PTCD不仅能促进患者胆汁排泄，恢复肝功能，而且有改善患者纳差、乏力等作用。 |
| 关键词: 茵陈利胆汤 经皮经肝胆管穿刺引流术 胆管癌 梗阻性黄疸 临床疗效 |
| DOI：10.3969/j.issn.1007-6948.2021.05.006 |
| 投稿时间：2020-12-18 |
| 基金项目:上海市卫生局课题(20114179)；上海市卫生和计划生育委员会中医药科研课题(2018JQ002)；上海市嘉定区卫生健康委员会中医药科研课题(2020-KY-ZYY-01) |
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| Clinical Research of Yinchen Lidan Decoction Combined with PTCD in the Treatment of Cholangiocarcinoma with Obstructive Jaundice |
| XIA Zhen-wei,ZHANG Jing,GUO Tao |
| Department of Integrated Traditional Chinese and Western Medicine, The Third Affiliated Hospital of Chinese PLA Naval Military Medical University, Shanghai 201805, China |
| Abstract: |
| Objective The purpose of this study is to investigate the clinical efficacy of Yinchen Lidan Decoction combined with percutaneous transhepatic cholangial drainage (PTCD) in the treatment of cholangiocarcinoma with obstructive jaundice. Methods 72 cases of cholangiocarcinoma with obstructive jaundice from October 2018 to October 2020 were selected. According to the patient’s age, course of disease and bilirubin level, they were paired into control group and treatment group, which with 36 cases in each group.All patients underwent full PTCD to relieve the obstruction. At the same time, symptomatic treatments such as liver protection, anti-infection and electrolyte supplementation were given according to the condition. The treatment group was treated with Yinchen Lidan Decoction on the above basis for 14 days. Results After 14 days of treatment, the treatment group was significantly better than the control group in terms of yellowing, anorexia, fatigue, total bilirubin (TBIL), alanine aminotransferase (ALT), which KPS scores (P<0.05). The total effective rate of the treatment group is 88.9%, which is better than that of the control group of 75%. There was a difference in clinical efficacy between the two groups (P<0.05). Conclusion Yinchen Lidan Decoction combined with PTCD can not only promote bile excretion and restore liver function, but also improve patients’anorexia and fatigue. |
| Key words: Yinchen Lidan Decoction percutaneous transhepatic cholangial drainage cholangiocarcinoma obstructive jaundice clinical efficacy |
