中西医结合治疗老年急性梗阻性化脓性胆管炎临床观察
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摘要
目的:分析中西医结合治疗老年急性梗阻性化脓性胆管炎的效果。方法:98例老年急性梗阻性化脓性胆管炎患者,按随机数字表法分为两组:观察组和对照组。对照组49例患者给予常规西医治疗,观察组49例患者在对照组的基础上给予中医治疗。对比两组的血清丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、血清总胆红素、血清直接胆红素以及相关观察指标。结果:治疗后,观察组患者的血清丙氨酸氨基转移酶(44.08±15.70)U/L、天门冬氨酸氨基转移酶(39.65±11.30)U/L、血清总胆红素(26.08±7.23)μmol/L、血清直接胆红素(14.65±2.80)μmol/L以及腹膜炎发生率、肾功能衰竭发生率、肺部感染发生率、血淀粉酶升高率、死亡率较对照组患者的血清丙氨酸氨基转移酶(67.40±15.40)U/L、天门冬氨酸氨基转移酶(39.65±11.30)U/L、血清总胆红素(66.20±10.40)μmol/L、血清直接胆红素(32.23±7.50)μmol/L以及腹膜炎发生率、肾功能衰竭发生率、肺部感染发生率、血淀粉酶升高率、死亡率明显降低,差异具有统计学意义(P<0.05)。结论:老年急性梗阻性化脓性胆管炎中西医结合治疗的效果显著,能够有效降低患者天门冬氨酸氨基转移酶、血清总胆红素等相关指标水平,改善患者预后水平。
Objective: To analyze the effect of traditional Chinese medicine combined with Western medicine treatment of elderly patients with acute obstructive suppurative cholangitis. Methods: 98 cases of elderly patients with acute obstructive suppurative cholangitis were randomly divided into two groups: the observation group and the control group. Forty-nine patients of the control group were given conventional Western medicine treatment, and the other 49 patients of the observation group on the basis of the control group were given traditional Chinese medicine treatment. The serum alanine aminotransferase, aspartate aminotransferase, serum total bilirubin, serum direct bilirubin and the related observation indexes were compared between two groups. Results: After treatment, the observatin group's serum alanine amino transferase(44.08±15.70)U/L, aspartate aminotransferase(39.65±11.30)U/L, serum total bilirubin(26.08±7.23)mol/L, serum direct bilirubin(14.65±2.80)mol/L, peritonitis incidence, renal failure, the incidence of pulmonary infection, blood amylase and mortality rate were significantly decreased than those of the control group[serum alanine amino transferase(67.40±15.40)U/L, aspartate aminotransferase(39.65±11.30)U/L, serum total bilirubin(66.20±10.40)mol/L, serum direct bilirubin(32.23±7.50)mol/L, the incidence of peritonitis, renal failure, the incidence rate of pulmonary infection, blood amylase and mortality rate], and the difference was statistically significant(P<0.05). Conclusion: Traditional Chinese medicine combined with Western medicine treatment has significant effect on elderly patients with acute obstructive suppurative cholangitis and can effectively reduce the patients' aspartate aminotransferase, serum total bilirubin levels and other related indicators and improve the prognosis of patients.
Objective: To analyze the effect of traditional Chinese medicine combined with Western medicine treatment of elderly patients with acute obstructive suppurative cholangitis. Methods: 98 cases of elderly patients with acute obstructive suppurative cholangitis were randomly divided into two groups: the observation group and the control group. Forty-nine patients of the control group were given conventional Western medicine treatment, and the other 49 patients of the observation group on the basis of the control group were given traditional Chinese medicine treatment. The serum alanine aminotransferase, aspartate aminotransferase, serum total bilirubin, serum direct bilirubin and the related observation indexes were compared between two groups. Results: After treatment, the observatin group's serum alanine amino transferase(44.08±15.70)U/L, aspartate aminotransferase(39.65±11.30)U/L, serum total bilirubin(26.08±7.23)mol/L, serum direct bilirubin(14.65±2.80)mol/L, peritonitis incidence, renal failure, the incidence of pulmonary infection, blood amylase and mortality rate were significantly decreased than those of the control group[serum alanine amino transferase(67.40±15.40)U/L, aspartate aminotransferase(39.65±11.30)U/L, serum total bilirubin(66.20±10.40)mol/L, serum direct bilirubin(32.23±7.50)mol/L, the incidence of peritonitis, renal failure, the incidence rate of pulmonary infection, blood amylase and mortality rate], and the difference was statistically significant(P<0.05). Conclusion: Traditional Chinese medicine combined with Western medicine treatment has significant effect on elderly patients with acute obstructive suppurative cholangitis and can effectively reduce the patients' aspartate aminotransferase, serum total bilirubin levels and other related indicators and improve the prognosis of patients.
引文
[1] 李萱,张鸿涛,严豪杰.老年急性梗阻性化脓性胆管炎不同治疗方法的疗效比较[J].中国中西医结合外科杂志,2016,22(3):272-274.
[2] 苟维杰.急诊内镜介入治疗老年急性梗阻性化脓性胆管炎的临床疗效观察[J].河北医学,2015,21(8):1451-1454.
[3] 刘梦园,孙明军.急诊内镜下逆行胰胆管造影术治疗急性梗阻性胆管炎及胆源性胰腺炎疗效分析[J].临床军医杂志,2017,45(5):504-507.
[4] 中国中西医结合学会消化系统疾病专业委员会.胆石症中西医结合诊疗共识意见(2017年)[J].中国中西医结合消化杂志,2018,26(2):132-138.
[5] 李军亮,刘利波,李力军.外科手术与急诊内镜手术治疗急性梗阻性化脓性胆管炎(AOSC)患者的效果分析[J].肝胆外科杂志,2017,25(3):214-217.
[6] Gotthardt DN,Weiss KH,Rupp C,et al. Bacteriobilia and fungibilia are associated with outcome in patients with endoscopic treatment of biliary complications after liver transplantation[J].Endoscopy,2013,45(11):890-896.
[7] 宋勇,黄亚川,秦高平.个体化治疗老年急性梗阻性化脓性胆管炎患者的临床研究[J].首都医科大学学报,2015,36(3):449-453.
[8] Nesvaderani M,Eslick GD,Cox MR. Acute pancreatitis:update on management[J]. Med J Aust,2015,202(8):420-423.
[9] 都海明,陈宝龙,张立南,等.急性胆管炎患者血清PCT、SAA和CRP指标检测结果分析[J].西南国防医药,2017,27(8):791-793.
[10] 颜海帆,李东,王国平,等.急性梗阻化脓性胆管炎的内镜治疗及细菌感染对预后的影响[J].中华医院感染学杂志,2017,27(10):2275-2278.
[11] 许建听.三镜联合常规手术治疗急性梗阻性化脓性胆管炎的疗效分析[J].浙江临床医学,2017,19(4):644-645.
[12] 王正峰,周文策,张辉,等.急性梗阻性化脓性胆管炎急诊内镜治疗方法的研究[J].中华消化内镜杂志,2017,34(4):259-261.
[13] Voigtl?nder T,Leuchs E,Vonberg RP,et al. Microbiological analysis of bile and its impact in critically ill patients with secondary sclerosing cholangitis[J]. Journal of Infection,2015,70(5):483-490.
[14] 薛宁,林一帆,王利平,等.内镜介入术后配合扶正逐瘀联合清热解毒中药治疗急性梗阻性化脓性胆管炎继发全身炎症反应的研究[J].现代中西医结合杂志,2016,25(13):1378-1381.
[15] 李军尧,刘利波,李力军.外科手术与急诊内镜手术治疗急性梗阻性化脓性胆管炎(AOSC)患者的效果分析[J].肝胆外科杂志,2017,25(3):214-217.
[16] 周渠新,朱剑南,金凯,等.急性梗阻性化脓性胆管炎合并感染性休克患者的临床特征及治疗后相关指标变化[J].中华医院感染学杂志,2018,28(1):88-91.
[17] 王鹏利,王建华,张家墉,等.大柴胡汤联合PTCD治疗老年急性重症胆管炎临床观察[J].陕西中医,2016,37(10):1338-1339.
[18] 吴熙,陈高,陈泽.消炎利胆汤治疗急性梗阻性化脓性胆管炎的疗效及对肝功能和炎症因子的影响[J].中医药信息,2018,35(1):98-101.
[19] 李有成,严文有,李鹏.疏肝化瘀通络汤治疗原发性硬化性胆管炎48例疗效观察[J].西部中医药,2015,28(1):66-68.
[20] 谢毅,张超.精氨酸联合加味大柴胡汤对急性胆管炎大鼠肝脏功能的保护作用[J].郑州大学学报(医学版),2015,50(5):706-709.
[2] 苟维杰.急诊内镜介入治疗老年急性梗阻性化脓性胆管炎的临床疗效观察[J].河北医学,2015,21(8):1451-1454.
[3] 刘梦园,孙明军.急诊内镜下逆行胰胆管造影术治疗急性梗阻性胆管炎及胆源性胰腺炎疗效分析[J].临床军医杂志,2017,45(5):504-507.
[4] 中国中西医结合学会消化系统疾病专业委员会.胆石症中西医结合诊疗共识意见(2017年)[J].中国中西医结合消化杂志,2018,26(2):132-138.
[5] 李军亮,刘利波,李力军.外科手术与急诊内镜手术治疗急性梗阻性化脓性胆管炎(AOSC)患者的效果分析[J].肝胆外科杂志,2017,25(3):214-217.
[6] Gotthardt DN,Weiss KH,Rupp C,et al. Bacteriobilia and fungibilia are associated with outcome in patients with endoscopic treatment of biliary complications after liver transplantation[J].Endoscopy,2013,45(11):890-896.
[7] 宋勇,黄亚川,秦高平.个体化治疗老年急性梗阻性化脓性胆管炎患者的临床研究[J].首都医科大学学报,2015,36(3):449-453.
[8] Nesvaderani M,Eslick GD,Cox MR. Acute pancreatitis:update on management[J]. Med J Aust,2015,202(8):420-423.
[9] 都海明,陈宝龙,张立南,等.急性胆管炎患者血清PCT、SAA和CRP指标检测结果分析[J].西南国防医药,2017,27(8):791-793.
[10] 颜海帆,李东,王国平,等.急性梗阻化脓性胆管炎的内镜治疗及细菌感染对预后的影响[J].中华医院感染学杂志,2017,27(10):2275-2278.
[11] 许建听.三镜联合常规手术治疗急性梗阻性化脓性胆管炎的疗效分析[J].浙江临床医学,2017,19(4):644-645.
[12] 王正峰,周文策,张辉,等.急性梗阻性化脓性胆管炎急诊内镜治疗方法的研究[J].中华消化内镜杂志,2017,34(4):259-261.
[13] Voigtl?nder T,Leuchs E,Vonberg RP,et al. Microbiological analysis of bile and its impact in critically ill patients with secondary sclerosing cholangitis[J]. Journal of Infection,2015,70(5):483-490.
[14] 薛宁,林一帆,王利平,等.内镜介入术后配合扶正逐瘀联合清热解毒中药治疗急性梗阻性化脓性胆管炎继发全身炎症反应的研究[J].现代中西医结合杂志,2016,25(13):1378-1381.
[15] 李军尧,刘利波,李力军.外科手术与急诊内镜手术治疗急性梗阻性化脓性胆管炎(AOSC)患者的效果分析[J].肝胆外科杂志,2017,25(3):214-217.
[16] 周渠新,朱剑南,金凯,等.急性梗阻性化脓性胆管炎合并感染性休克患者的临床特征及治疗后相关指标变化[J].中华医院感染学杂志,2018,28(1):88-91.
[17] 王鹏利,王建华,张家墉,等.大柴胡汤联合PTCD治疗老年急性重症胆管炎临床观察[J].陕西中医,2016,37(10):1338-1339.
[18] 吴熙,陈高,陈泽.消炎利胆汤治疗急性梗阻性化脓性胆管炎的疗效及对肝功能和炎症因子的影响[J].中医药信息,2018,35(1):98-101.
[19] 李有成,严文有,李鹏.疏肝化瘀通络汤治疗原发性硬化性胆管炎48例疗效观察[J].西部中医药,2015,28(1):66-68.
[20] 谢毅,张超.精氨酸联合加味大柴胡汤对急性胆管炎大鼠肝脏功能的保护作用[J].郑州大学学报(医学版),2015,50(5):706-709.