胆清胶囊联合熊去氧胆酸胶囊治疗保胆取石术后结石复发的临床效果
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摘要
目的探讨胆清胶囊联合熊去氧胆酸胶囊治疗保胆取石术后结石复发的临床效果。方法选取2014年4月～2016年4月南京中医药大学附属南京市中西医结合医院收治的行内镜下微创保胆取石术的患者69例为研究对象。根据随机数字表法将患者分为对照组(n=34)和研究组(n=35)。对照组患者给予熊去氧胆酸胶囊治疗,研究组在此基础上联合胆清胶囊治疗。比较两组患者治疗2个月后的临床效果,比较两组患者治疗前后胆囊指标,观察两组患者治疗期间不良反应发生情况,随访2年,观察其复发情况。结果研究组患者总有效率高于对照组,差异有统计学意义(P <0.05)。两组患者治疗后胆囊壁厚度较治疗前降低,且研究组低于对照组(P <0.05);胆囊收缩率较治疗前升高,且研究组高于对照组(P <0.05)。研究组患者治疗后2年复发率明显低于对照组,差异有统计学意义(P <0.05)。两组患者不良反应发生率比较,差异无统计学意义(P> 0.05)。结论胆清胶囊联合熊去氧胆酸胶囊治疗保胆取石术后结石复发效果确切,安全性佳,可有效降低胆囊结石复发,改善胆囊功能,具有一定的临床应用价值。
Objective To investigate the clinical effect of Danqing Capsules combined with Ursodeoxycholic Acid Capules in the treatment of stone recurrence after gallbladder preserving lithotomy. Methods Sixty-nine patients who underwent endoscopic minimally invasive gallbladder preserving lithotomy in Nanjing Integrated Chinese and Western Medicine Affiliated to Nanjing University of Chinese Medicine from April 2014 to April 2016 were selected as the research subjects. The patients were divided into control group(n = 34) and study group(n = 35) according to the random number table method. The patients in the control group were treated with Ursodeoxycholic Acid Capules, and the study group was treated with Ursodeoxycholic Acid Capules and Danqing Capsules. The patients′ clinical efficacy in the two groups after 2 months of treatment was compared, the patients′ gallbladder index in the two groups before and after treatment was compared, the patients′ adverse reactions in the two groups during the treatment were observed. After two years of follow-up, the recurrence was observed. Results The total effective rate of patients in the study group was higher than that of control group, there was a significant difference between the two groups(P < 0.05). After treatment the thickness of the gallbladder wall in the two groups was lower than that before treatment, and the study group was lower than the control group(P < 0.05), the gallbladder contraction rate was higher than that before treatment, and the study group was higher than the control group(P < 0.05). The recurrence rate after treatment for 2 years of study group was lower than that of control group, the difference was statistically significant(P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P > 0.05). Conclusion Danqing Capsules combined with Ursodeoxycholic Acid Capules in the treatment of gallstone recurrence after cholecystolithiasis is effective and safe, it can effectively reduce the recurrence of gallstones and improve the function of gallbladder, and it has certain clinical value.
Objective To investigate the clinical effect of Danqing Capsules combined with Ursodeoxycholic Acid Capules in the treatment of stone recurrence after gallbladder preserving lithotomy. Methods Sixty-nine patients who underwent endoscopic minimally invasive gallbladder preserving lithotomy in Nanjing Integrated Chinese and Western Medicine Affiliated to Nanjing University of Chinese Medicine from April 2014 to April 2016 were selected as the research subjects. The patients were divided into control group(n = 34) and study group(n = 35) according to the random number table method. The patients in the control group were treated with Ursodeoxycholic Acid Capules, and the study group was treated with Ursodeoxycholic Acid Capules and Danqing Capsules. The patients′ clinical efficacy in the two groups after 2 months of treatment was compared, the patients′ gallbladder index in the two groups before and after treatment was compared, the patients′ adverse reactions in the two groups during the treatment were observed. After two years of follow-up, the recurrence was observed. Results The total effective rate of patients in the study group was higher than that of control group, there was a significant difference between the two groups(P < 0.05). After treatment the thickness of the gallbladder wall in the two groups was lower than that before treatment, and the study group was lower than the control group(P < 0.05), the gallbladder contraction rate was higher than that before treatment, and the study group was higher than the control group(P < 0.05). The recurrence rate after treatment for 2 years of study group was lower than that of control group, the difference was statistically significant(P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P > 0.05). Conclusion Danqing Capsules combined with Ursodeoxycholic Acid Capules in the treatment of gallstone recurrence after cholecystolithiasis is effective and safe, it can effectively reduce the recurrence of gallstones and improve the function of gallbladder, and it has certain clinical value.
引文
[1]Lamberts MP,Den Oudsten BL,Gerritsen JJ,et al.Prospective multicentre cohort study of patient-reported outcomes after cholecystectomy for uncomplicated symptomatic cholecystolithiasis[J].Br J Surg,2015,102(11):1402-1409.
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[3]冉江林,张绍茂,文强,等.腹腔镜下逆行全胆囊切除术与次全胆囊切除术治疗复杂胆管病变的效果比较[J].临床肝胆病杂志,2016,32(4):750-753.
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[10]罗梦笔,唐岩.肝胆结石片在抑制胆囊结石体外震波碎石后的结石复发中的临床效果观察[J].中国生化药物杂志,2017,37(8):66-67,70.
[11]Matayoshi N,Sato N,Okimoto T,et al.A Review of 7Cases of Laparoscopic Cholecystectomy for Pediatric Cholecystolithiasis[J].J UOEH,2017,39(3):223-227.
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[13]高野.120例胆囊切除术术式选择评价及其疗效对比[J]中国当代医药,2016,23(15):26-28.
[14]柳利.腹腔镜胆囊切除术与开腹手术治疗胆结石的临床效果[J].中国现代医生,2018,56(1):43-45.
[15]Wang T,Chen T,Zou S,et al.Ultrasound-guided double-tract percutaneous cholecystostomy combined with a choledochoscope for performing cholecystolithotomies in high-risk surgical patients[J].Surg Endosc,2014,28(7):2236-2242.
[16]程刚,田平,王照红,等.双镜联合保胆取石术治疗胆囊结石的临床分析[J].中国现代医生,2017,55(21):46-48.
[17]丁根华.腹腔镜联合肾镜保胆取石治疗胆囊结石的临床效果观察[J].中国当代医药,2016,23(16):38-40.
[18]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.
[19]李炜.胆囊结石合并肝外胆管结石术后超声的临床价值[J].中国医药导刊,2016,18(1):11-12.
[20]谢江,周明忠,蒙谦,等.消石利胆胶囊与熊去氧胆酸胶囊治疗慢性胆固醇性结石性胆囊炎的疗效比较[J].中国药房,2016,27(35):4965-4967.
[21]梅丹,顾宏刚,马恩伟,等.清胆胶囊配合双镜联合治疗老年胆囊结石伴急性胆管炎[J].长春中医药大学学报,2016,32(4):783-785.
[22]赵亮,史业东,邢飞,等.胆清胶囊联合熊去氧胆酸胶囊治疗胆囊结石的疗效观察[J].现代药物与临床,2017,32(12):2451-2455.
[23]Zhan T,Wei X,Chen ZQ,et al.A systematic review of RCTs and quasi-RCTs on traditional Chinese patent medicines for treatment of chronic hepatitis B[J].J Tradit Chin Med,2011,31(4):288-296.
[24]蒋欢欢,张霞,闫玉洁,等.大黄利胆胶囊预防微创保胆取石术后胆囊结石复发的疗效[J].医药导报,2016,35(11):1201-1204.
[2]刘永茂,李之令,刘江伟,等.微创保胆术后胆囊结石、息肉复发相关因素分析[J].山东医药,2017,57(23):94-96.
[3]冉江林,张绍茂,文强,等.腹腔镜下逆行全胆囊切除术与次全胆囊切除术治疗复杂胆管病变的效果比较[J].临床肝胆病杂志,2016,32(4):750-753.
[4]谢芝海,陈汉兵.内镜微创保胆取石术的应用现状与展望[J].中国基层医药,2017,24(8):1270-1274.
[5]Zha Y,Zhou ZZ,Chen XR,et al.Gallbladder-preserving cholelithotomy in laparoscopic and flexible choledochoscopic era:a report of 316 cases[J].Surg Laparosc Endosc Percutan Tech,2013,23(2):167-170.
[6]盛国涛,李双喜,莫小华,等.内镜微创保胆取石的临床研究与进展[J].肝胆外科杂志,2015,23(6):478-480.
[7]Cheung AC,Gulamhusein AF,Juran BD,et al.External validation of the United Kingdom-primary biliary cholangitis risk scores of patients with primary biliary cholangitis treated with ursodeoxycholic acid[J].Hepatol Commun,2018,2(6):676-682.
[8]王翠蓉.胆清胶囊微生物限度检查方法及验证[J].中国药业,2008,17(8):39-40.
[9]姬静,崔岩,李锐,等.肝外胆管结石的超声诊断和误诊分析[J].中国实验诊断学,2002,6(6):427.
[10]罗梦笔,唐岩.肝胆结石片在抑制胆囊结石体外震波碎石后的结石复发中的临床效果观察[J].中国生化药物杂志,2017,37(8):66-67,70.
[11]Matayoshi N,Sato N,Okimoto T,et al.A Review of 7Cases of Laparoscopic Cholecystectomy for Pediatric Cholecystolithiasis[J].J UOEH,2017,39(3):223-227.
[12]Dughayli M,Shimunov S,Johnson S,et al.Single-site robotic cholecystectomy:comparison of clinical outcome and the learning curves in relation to surgeon experience in a community teaching hospital[J].BMC Surg,2018,18(1):39.
[13]高野.120例胆囊切除术术式选择评价及其疗效对比[J]中国当代医药,2016,23(15):26-28.
[14]柳利.腹腔镜胆囊切除术与开腹手术治疗胆结石的临床效果[J].中国现代医生,2018,56(1):43-45.
[15]Wang T,Chen T,Zou S,et al.Ultrasound-guided double-tract percutaneous cholecystostomy combined with a choledochoscope for performing cholecystolithotomies in high-risk surgical patients[J].Surg Endosc,2014,28(7):2236-2242.
[16]程刚,田平,王照红,等.双镜联合保胆取石术治疗胆囊结石的临床分析[J].中国现代医生,2017,55(21):46-48.
[17]丁根华.腹腔镜联合肾镜保胆取石治疗胆囊结石的临床效果观察[J].中国当代医药,2016,23(16):38-40.
[18]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.
[19]李炜.胆囊结石合并肝外胆管结石术后超声的临床价值[J].中国医药导刊,2016,18(1):11-12.
[20]谢江,周明忠,蒙谦,等.消石利胆胶囊与熊去氧胆酸胶囊治疗慢性胆固醇性结石性胆囊炎的疗效比较[J].中国药房,2016,27(35):4965-4967.
[21]梅丹,顾宏刚,马恩伟,等.清胆胶囊配合双镜联合治疗老年胆囊结石伴急性胆管炎[J].长春中医药大学学报,2016,32(4):783-785.
[22]赵亮,史业东,邢飞,等.胆清胶囊联合熊去氧胆酸胶囊治疗胆囊结石的疗效观察[J].现代药物与临床,2017,32(12):2451-2455.
[23]Zhan T,Wei X,Chen ZQ,et al.A systematic review of RCTs and quasi-RCTs on traditional Chinese patent medicines for treatment of chronic hepatitis B[J].J Tradit Chin Med,2011,31(4):288-296.
[24]蒋欢欢,张霞,闫玉洁,等.大黄利胆胶囊预防微创保胆取石术后胆囊结石复发的疗效[J].医药导报,2016,35(11):1201-1204.