疏肝利胆汤联合胆总管切开取石术治疗老年胆囊合并胆总管结石效果观察
摘要
目的探究疏肝利胆汤联合胆总管切开取石术治疗老年胆囊结石合并胆总管结石患者的临床效果及对肝功能及胆汁成分、生活质量的影响。方法选取96例老年胆囊结石合并胆总管结石患者作为研究对象,随机分为观察组和对照组各48例。对照组患者采取胆囊切除联合胆总管切开取石及T管引流方法治疗,观察组患者在对照组基础上术后口服疏肝利胆汤。比较2组患者治疗效果以及肝功能指标、胆汁成分。结果治疗后观察组治疗有效率为91. 7%,明显高于对照组的77. 1%(P <0. 05);观察组血清谷草转氨酶(AST)、谷丙转氨酶(ALT)、总胆红素(TBil)、谷氨酰转肽酶(GGT)水平明显低于对照组(P均<0. 05);观察组胆汁引流量明显多于对照组(P <0. 05),胆汁中TBil、非结合胆红素(UCB)、胆固醇(CHO)、Ca2+水平均明显低于对照组(P均<0. 05),胆汁酸(TBA)、磷脂(PL)水平均明显高于对照组(P均<0. 05);观察组ZPS评分明显低于对照组(P <0. 05),KPS评分明显高于对照组(P <0. 05)。结论疏肝利胆汤能够调节胆汁成分,改善肝功能指标,提高患者生活质量,联合胆总管切开取石术能够明显提高老年胆囊结石合并胆总管结石治疗效果,值得在临床中推广应用。
引文
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[2]黄品谚,丁佑铭,汪斌,等.腹腔镜胆道镜治疗胆囊结石合并胆总管结石两种术式的疗效比较[J].临床外科杂志,2016,24(5):369-371
[3]唐梓涵.疏肝利胆汤治疗慢性胆囊炎49例观察[J].实用中医药杂志,2016,32(4):325
[4]中国慢性胆囊炎、胆囊结石内科诊疗共识意见(2014年,上海)[J].胃肠病学,2015,20(05):292-296
[5] Appleby RN,Nolan JD,Johnston I M,et al. Novel associations of bile acid diarrhoea with fatty liver disease and gallstones:a cohort retrospective analysis[J]. Bmj Open Gastroenterology,2017,4(1):e000178
[6] Asai Y,Yamada T,Tsukita S,et al. Activation of the Hypoxia Inducible Factor 1αSubunit Pathway in Steatotic Liver Contributes to Formation of Cholesterol Gallstones[J]. Gastroenterology,2017,152(6):1521-1535
[7]郝文立,王帅.胆囊结石与高脂血症及中医体质的相关性研究[J].重庆医学,2016,45(19):2632-2634
[8]张科军,倪园明.自拟利胆排石汤辅助胆道镜取石术治疗慢性胆囊炎合并胆结石的临床观察[J].中国中医药科技,2016,23(2):206-207
[9]张洁靖,李汉智.利胆排石汤保守治疗慢性胆囊炎的临床分析[J].中国实验方剂学杂志,2016,22(7):187-190
[10]Fang BJ,Shen JY,Hua Z,et al. Albiflorin Granule significantly decreased the cholesterol gallstone formation by the regulation of insulin transduction signal[J]. Asian Pacific Journal of Tropical Medicine,2016,9(9):856-860
[11]Xie Y,Chen Z,Su R,et al. Preparation and Optimization of Amorphous Ursodeoxycholic Acid Nano-suspensions by Nanoprecipitation based on Acid-base Neutralization for Enhanced Dissolution[J].Current Drug Delivery,2017,14(4):483
[12]Portincasa P,Wang DQ. Effect of Inhibition of Intestinal Cholesterol Absorption on the Prevention of Cholesterol Gallstone Formation[J]. Medicinal Chemistry,2017,13(5):421