| 引用本文:蔡芸芸，曹铁留，沈婕，胡南华，喻丹，孙杰，何胜利.“胆脾同治”法调节恶性梗阻性黄疸患者术后肠黏膜屏障功能的临床研究[J].世界中医药,2018,(02):. |
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| “胆脾同治”法调节恶性梗阻性黄疸患者术后肠黏膜屏障功能的临床研究 |
| Clinical Study of the Protective Effect of “Combination Treatment of Gallbladder and Spleen” on Gastrointestinal Mucosa Barrier Function in Patients with Malignant Obstructive Jaundice |
| 投稿时间：2017-03-01 |
| DOI：10.3969/j.issn.1673-7202.2018.02.016 |
| 中文关键词: 胆脾同治 肠黏膜屏障功能 恶性梗阻性黄疸 |
| English Keywords:“Combination treatment of the gallbladder and spleen” method Gastrointestinal mucosa barrier function Malignant obstructive jaundice |
| 基金项目:上海市闵行区卫生局基金项目(2013MH26) |
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| 中文摘要: |
| 目的:观察“胆脾同治”法方药对恶性梗阻性黄疸患者肠黏膜屏障功能的调节保护作用。方法:选取2011年3月至2015年3月在复旦大学附属肿瘤医院闵行分院住院行PTCD外引流的MOJ患者60例,应用完全随机对照的方法,分为常规对照组和“胆脾同治”治疗观察组,对照组采用常规保肝、预防出血、和抗感染的支持治疗;“胆脾同治”治疗观察组在对照组的基础上加用先贤张锡纯“胆脾同治”方,治疗7 d后通过检测治疗前后尿液中LAC/MAN的比例、血清中内毒素水平、D-乳酸和二胺氧化酶(DAO)的变化,观察“胆脾同治”法对患者肠黏膜屏障功能的改善情况。结果:治疗7 d后,所有患者的尿液中LAC/MAN含量、静脉血中的内毒素、D-乳酸和DAO含量较治疗前都有所降低(P<0.05),与对照组比较较,观察组尿液中LAC/MAN比值,静脉血中内毒素以及D-乳酸和DAO水平都有明显下降［对照组分别为(0.176±0.038)、(32.47±11.68)pg/mL、(7.27±2.35)Mm/L,(2.39±0.53)Ku/L］;［观察组分别为(0.126±0.029)、(19.79±6.59)pg/mL、(4.31±1.25)Mm/L、(1.68±0.35)Ku/L］,差异有统计学意义(P<0.05)。结论:“胆脾同治”法对改善恶性梗阻性黄疸患者肠黏膜屏障功能具有明显的保护作用。 |
| English Summary: |
| To observe the protective effect of “combination treatment of the gallbladder and spleen” on gastrointestinal mucosa barrier function in patients with malignant obstructive jaundice.Methods:A total of 60 patients with malignant obstructive jaundice who underwent PTCD treatment were randomly divided into control group and study group.Control group was provided with the supporting treatment such asprotection of the liver, prevention of hemorrhage and anti-infectious methods.The study group received the additional combination treatment of the gallbladder and spleen according to the theories of Zhang Xichun.The effect of such treatment on the gastrointestinal mucosa barrier function in the patients was evaluated by the measurements of some factors.The LAC/MAN in the urine, the levels of endotoxin, D-acid and DAO in the blood were measured.Results:Compared with control group, the LAC/MAN in the urine, endotoxixn, Dlactic acid and DAO levels in the blood decreased significantly in the study group after 7 days treatment (P<0.05) ［the control group was respectively (0.176±0.038), (32.47±11.68)pg/mL, (7.27±2.35)Mm/L, (2.39±0.53)Ku/L］; ［the study group was (0.216±0.029), (19.79±6.59)pg/mL, (4.31±1.25)Mm/L, (1.68±0.35)Ku/L］.A statistically significant difference can be seen between the two groups (P<0.05).Conclusion:“The combination treatment of the gallbladder and spleen” has pronounced effects in the protection of gastrointestinal mucosa barrier in the patients with malignant obstructive jaundice. |
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