摘要: |
目的:探讨自拟疏肝利胆汤对胆囊切除术后综合征( PCS)患者胆总管、奥狄氏括约肌( SO)测压水平的影响。方法:选取 2020年 3月—2021年 4月本院收治的 48例 PCS患者,采用随机单双编号法将患者分为观察组和对照组,每组 24例。对照组采用常规西医治疗,观察组在对照组的基础上添加自拟疏肝利胆汤,两组均持续治疗 2周。观察两组患者的临床疗效,分别于治疗前后评估两组患者的中医证候积分;采用内镜检测胆总管压力及 SO基础压、蠕动频率以及逆向蠕动波;抽取患者清晨空腹静脉血,检测患者的肝功能 [谷丙转氨酶(ALT)、谷草转氨酶(AST)]和相关炎性因子 [白细胞介素 -4(IL-6)、肿瘤因子 -α(TNF-α)]水平;记录两组患者治疗期间的不良反应发生情况。结果:观察组总有效率为 87.50%,高于对照组的 62.50%,差异有统计学意义( P<0.05);治疗后,观察组食欲减退、腹痛腹胀、腹泻、恶心嗳气证候积分均明显低于对照组( P<0.05);观察组的胆总管内压、 SO基础压、蠕动频率、逆向蠕动波明显低于对照组( P<0.05);观察组的 ALT、 AST、IL-6、TNF-α水平明显低于对照组( P<0.05)。两组患者均无明显头晕、皮疹、胸闷等不良反应发生。结论:自拟疏肝利胆汤方辅助临床西医治疗 PCS患者可明显降低胆管及 SO压力,改善肝功能,降低炎症反应程度,提高临床疗效。 |
关键词: 胆囊切除术后综合征 疏肝利胆汤 胆总管 奥狄氏括约肌 |
DOI:10.3969/j.issn.1007-6948.2022.04.011 |
投稿时间:2021-10-21 |
基金项目: |
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Effects of Self-made Shugan Lidan Decoction on Common Bile Ducts and Sphincter of Oddi Pressure in Patients with Post-cholecystectomy Syndrome |
ZHANG Rui-qian |
Hepatopancreatobiliary Surgery, Lishui City Center Hospital, Lishui Zhejiang 323000, China |
Abstract: |
Objective To explore the effects of self-made Shugan Lidan Decoction on common bile ducts and sphincter of oddi (SO) pressure in patients with post-cholecystectomy syndrome (PCS). Methods A total of 48 patients with PCS admitted to the hospital were enrolled between March 2020 and April 2021. The patients were divided into observation group and control group by random single and double labeling method, 24 cases in each group. The control group was treated with routine western medicine, while the observation group was additionally treated with self-made Shugan Lidan Decoction. Both groups were continuously treated for 2 weeks. The clinical curative effect in both groups were observed. Before and after treatment, scores of TCM syndromes were assessed. The pressure of common bile ducts, basal pressure of SO, peristaltic frequency and reverse peristaltic waves were examined by endoscopy. The fasting venous blood in the morning was collected to detect liver function [alanine aminotrans (ALT), aspartate transaminase (AST)] and related inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)]. The occurrence of adverse reactions during treatment in both groups were recorded. Results The total response rate of the observation group was higher than that of the control group (87.50% vs 62.50%, P<0.05). After treatment, scores of TCM syndromes (loss of |
Key words: Post-cholecystectomy syndrome Shugan Lidan Decoction common bile duct sphincter of oddi |