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疏肝利胆汤治疗老年患者腹腔镜下胆囊切除术后慢性腹泻的临床疗效
屈卫龙,丁晓雯,乔楠,林松
0
南京中医药大学附属南通医院普外科南通 226001
摘要:
目的 观察疏肝利胆汤治疗老年患者腹腔镜下胆囊切除术后慢性腹泻的临床疗效及对肠道菌群的影响。方法:纳入南通市中医院2022年1月—2022年12月南通市中医院普外科治疗的腹腔镜胆囊切除术后腹泻老年患者60例,根据随机数字表法分为治疗组和对照组,每组30例。对照组予以双歧杆菌三联活菌胶囊联合盐酸洛哌丁胺胶囊口服;治疗组在对照组基础上予以疏肝利胆汤口服,疗程3个月。观察并比较两组的中医疗效、临床症状积分(便次、腹痛、腹胀、恶心呕吐、食欲减退)、肠道菌群测定(双歧杆菌、嗜酸球菌、大肠埃希菌、肠球菌)、肠道分泌型免疫球蛋白A(sIgA)及血清D-乳酸、血清胃肠激素[血清胃泌素(GAS)、胆囊收缩素(CCK)、血管活性肠肽(VIP)、5-羟色胺(5-HT)、神经肽(NPY)]水平。结果:治疗组患者临床总有效率(96.66%)高于对照组(76.66%),差异有统计学意义(P<0.05);治疗组临床症状积分、肠道菌群测定、肠道sIgA及血清D-乳酸和血清胃肠激素均明显改善,且较对照组更明显,差异有统计学意义(P<0.05),两组均无不良事件发生。结论:疏肝利胆汤治疗老年患者腹腔镜下胆囊切除术后慢性腹泻患者,能有效改善临床症状,修复肠道免疫及黏膜屏障,调节肠道菌群,调节胃肠激素水平,安全且有效。
关键词:  胆囊切除术  腹泻  疏肝利胆汤  肠道菌群  临床研究
DOI:10.3969/j.issn.1007-6948.2023.05.002
基金项目:南通市社会民生科技计划项目(MSZ2022027)
Clinical effect of Shugan Lidan Decoction in the treatment of chronic diarrhea after laparoscopic cholecystectomy in elderly patients
QU Wei-long,DING Xiao-wen,QIAO Nan
Department of General Surgery, Nantong Hospital Affiliated to Nanjing University of Chinese Medicine, Nantong 226001, China
Abstract:
Objective To observe the clinical effect of Shugan Lidan Decoction on chronic diarrhea after laparoscopic cholecystectomy in elderly patients and its effect on intestinal flora. Methods A total of 60 elderly patients with diarrhea after laparoscopic cholecystectomy were included in the general surgery of Nantong hospital of Traditional Chinese Medicine from January 2022 to December 2022. They were divided into treatment group and control group according to random number table method, with 30 cases in each group. The control group was given bifidobacterium triple viable capsule combined with loperamide hydrochloride capsule orally. The treatment group was given Shugan Lidan Decoction on the basis of the control group for 3 months. The observation items include the determination of curative effect of traditional Chinese medicine, clinical symptom score (stool frequency, abdominal pain, abdominal distension, nausea and vomiting, anorexia), determination of intestinal flora (bifidobacteria, eosinophilus, Escherichia coli, enterococcus), intestinal sIgA and blood D-lactic acid, serum gastrointestinal hormones [serum gastrin (GAS), cholecystokinin (CCK), vasoactive intestinal peptide (VIP), 5-hydroxytryptamine (5-HT), neuropeptide (NPY)]. Results The clinical effective rate of patients in the treatment group was higher than that in the control group, and the difference was statistically significant (96.66% vs 76.66%, P<0.05). The clinical symptom score, intestinal flora determination, intestinal sIgA and blood D-lactic acid and serum gastrointestinal hormones in the treatment group were significantly improved, and the difference was statistically significant (P<0.05), and there were no adverse events in the two groups. Conclusion Shugan Lidan decoction can effectively improve clinical symptoms, repair intestinal immunity and mucosal barrier, regulate intestinal flora and regulate gastrointestinal hormone levels in elderly patients with chronic diarrhea after laparoscopic cholecystectomy, which is safe and effective.
Key words:  Cholecystectomy  diarrhea  Shugan Lidan Decoction  intestinal flora  clinical research

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