| 引用本文:高瑛，石坤和，顾渊，唐晓丹.胆石症术后联合中药制剂对患者血清总胆汁酸及预后情况的影响[J].世界中医药,2017,(02):. |
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| 胆石症术后联合中药制剂对患者血清总胆汁酸及预后情况的影响 |
| Effect of Integrative Chinese and Western Medicine on Serum Total Bile Acid and Prognosis in Patients with Gallstone |
| 投稿时间：2017-01-20 |
| DOI：10.3969/j.issn.1673-7202.2017.02.029 |
| 中文关键词: 胆石症 中药制剂 血清总胆汁酸 |
| English Keywords:Gallstone disease Traditional Chinese medicine Serum total bile acid |
| 基金项目:国家自然科学基金项目(编号：81102601)——疏肝化瘀法预防胆固醇结石形成作用机制的分子生物学研究 |
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| 中文摘要: |
| 目的：考察胆石症患者术后联用中药制剂小柴胡汤对其血清总胆汁酸的影响及患者预后情况。方法：选择2014至2015年上海市中医院收治的148例胆石症患者作为研究对象，中医辨证症候均为肝郁气滞型。按随机数表法将患者分2组，每组74例。患者均经外科手术取石。术后观察组联用中药制剂小柴胡汤，对照组仅接受术后常规药物治疗。疗程2个月。术前（1～3 d）、治疗后（术后第1、2个月末）分别检测肝功能相关指标（ALT、AsT、TBiL）和血清总胆汁酸浓度。考察治疗效果（指标：临床总有效率）和患者预后（指标：复发率）。结果：治疗后患者胁腹痛等不适症状均减轻或消除，肝郁、气滞症候得到明显改善；2个组临床总有效率比较的差异有统计学意义(P<0.05)。术后第1个月末、第2个月末，患者肝功能指标、血清TBA浓度均较其术前显著降低；其中观察组在治疗后(P<0.05)、每一时点(P<0.05)与对照组在如上指标比较的差异均有统计学意义(P<0.05)。持续随访患者，随诊率93.92%（139/148），复发率2.16%。结论：胆石症患者术后联用小柴胡汤可调节血清总胆汁酸浓度从而抑制胆石形成，对于预防胆石症、降低复发率有积极的临床意义。 |
| English Summary: |
| To observe the effect of traditional Chinese medicine decoction combined with western medicine on serum total bile acid in patients with gallstone disease and the prognosis.Methods:To collect 148 cases of cholelithiasis patients of liver Qi stagnation syndrome in the central Hospital of Shanghai.The patients were then randomly divided into 2 groups,each group of 74 cases.All patients were treated by surgery.After the operation,the observation group was treated with traditional Chinese medicine Xiao Chai Hu decoction,and the control group received postoperative routine medical treatment.The course of treatment was 2 months.Liver function (ALT,AsT,TBiL) and total bile acid were detected before(1-3 days) and after treatment(the first and 2 months after treatment )respectively.To observe the therapeutic effect (the index of total effective rate) and the prognosis of patients (the index of recurrence rate).Results:After treatment,the symptoms including hypochondriac pain or abdominal pain were relieved or eliminated,and syndrome of liver depression qi stagnation was improved.The difference in total clinical efficiency between 2 group was statistically significant (P<0.05).After first and the second month,liver function,serum TBA concentrations in all patients were significantly lower than their preoperative levels.In the observation group,the difference in above indexes after treatment (P<0.05) and at each point (P<0.05) compared with the control group were all statistically significant (P<0.05).The follow-up rate was 93.92% (139/148),and the recurrence rate was 2.16%.Conclusion:Combined use of Xiao Chai Hu decoction with western medicine in patients with gallstone can regulate the concentration of total bile acid in serum to inhibit the formation of gallstones,which has a positive clinical significance for preventing gallstone and reducing recurrence rate. |
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