| 摘要: |
| 目的:探讨柴芩四君子汤对胆囊切除术后患者粪胆汁酸代谢的影响。方法:选取2017年10月—2019年9月在天津市南开医院诊断为胆囊结石并行胆囊切除术患者43例，采用随机数字表法分为胆囊切除术后对照组22例、柴芩四君子汤组21例，柴芩四君子汤组为胆囊切除术后第1天开始口服柴芩四君子汤，每天1剂，早晚分服，连服14 d。分别留取患者术前1 d、术后7 d和14 d粪便，采用液相色谱质谱法(LC-MS)测定胆酸(CA)、鹅脱氧胆酸(CDCA)、脱氧胆酸(DCA)、石胆酸(LCA)和熊去氧胆酸(UDCA)等5种粪胆汁酸含量，并计算初级胆汁酸(PBA)、次级胆汁酸(SBA)和总胆汁酸(TBA)含量。结果:与对照组比较，柴芩四君子汤组术前1 d粪CA、CDCA、DCA、LCA、UDCA、PBA、SBA和TBA含量差异均无统计学意义。术后14 d粪CA含量升高(P=0.007)，CA/TBA、CDCA/TBA均升高(均P<0.05)，DCA、LCA含量、DCA/TBA、LCA/TBA均降低(均P<0.05)；PBA含量、PBA/TBA均升高(均P<0.05)；SBA含量、SBA/TBA均降低(均P<0.05)，TBA差异无统计学意义。结论:柴芩四君子汤可以调节CA、DCA、LCA、PBA、SBA含量及各胆汁酸相对含量。粪PBA含量增加以CA含量增加为特征。SBA含量降低以DCA、LCA含量降低为特征。 |
| 关键词: 柴芩四君子汤 胆囊切除 粪胆汁酸 液相色谱质谱法 |
| DOI：10.3969/j.issn.1007-6948.2022.04.020 |
| 投稿时间：2022-04-19 |
| 基金项目: |
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| Effects of Chaiqin Sijunzi Decoction on Fecal Bile Acid Metabolism in Patients after Cholecystectomy |
| ZHAO Yuan-chen，CUI Nai-qiang，GUAN Xin |
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| Abstract: |
| Objective To investigate the effect of Chaiqin Sijunzi Decoction on fecal bile acid metabolism in patients after cholecystectomy. Methods A total of 43 patients with cholecystolithiasis who underwent cholecystectomy in Tianjin Nankai Hospital from October 2017 to September 2019 were selected, and they were randomly divided into the control group of 22 cases and the Chaiqin Sijunzi Decoction group of 21 cases by random number table method. The Chaiqin Sijunzi Decoction group started to take Chaiqin Sijunzi Decoction orally on the 1st day after operation, one dose a day, which divided into morning and evening for 14 days. The feces of the patients were collected on the 1st day before, the 7 th and 14 th day after cholecystectomy respectively. The liquid chromatography-mass spectrometry (LC-MS) was used to determine the content of cholic acid (CA) and chenodeoxycholic acid (CDCA), deoxycholic acid (DCA), lithocholic acid (LCA) and ursodeoxycholic acid (UDCA) in the feces, as well as to calculate the primary bile acid (PBA), secondary bile acid (SBA) and total bile acid (TBA) content. Results Compared with the control group, there was no significant difference in the content of CA, CDCA, DCA, LCA, UDCA, PBA, SBA and TBA in the feces on the 1st day before surgery in the Chaiqin Sijunzi Decoction group. The content of fecal CA increased (P=0.007), CA/TBA and CDCA/TBA were increased (P=0.001, P=0.027); LCA content, DCA/TBA, LCA/TBA were decreased (P<0.05); PBA content and PBA/TBA were increased (P<0.05); SBA content and SBA/TBA were decreased (P<0.05), and there was no significant difference in TBA on the 14 th day after surgery. Conclusion Chaiqin Sijunzi Decoction could regulate the content of CA, DCA, LCA, PBA,SBA and the relative content of each bile acid. The increase in fecal PBA content was characterized by an increase in CA content. The decrease of SBA content is characterized by the decrease of DCA and LCA content. |
| Key words: Chaiqin Sijunzi decoction cholecystectomy fecal bile acid liquid chromatography- mass spectrometry |
