调胆合剂B对家兔胆囊切除术后胆汁分泌及成份的影响的实验研究
摘要
目的:通过观察调胆合剂B对家兔胆囊切除术后胆汁分泌量的影响,研究其利胆作用而形成对胆道的机械冲洗,以稀释局部炎症介质浓度,促进胆囊切除术后胆道系统功能的恢复正常。
材料与方法:取家兔24只,雌雄不拘,体重2.5kg左右,禁食不禁水12h,上腹部术区备皮,称重后随机分成3组,即空白组,无菌蒸馏水对照组及调胆合剂B组3个剂量组。家兔用3%戊巴比妥钠(30mg/kg)经耳缘静脉注射麻醉,将兔仰卧固定在兔板手术台上,上腹部术区常规消毒,取上腹部正中切口,逐层切开进腹,止血确切,显露胃,十二指肠,胆囊和胆总管,结扎胆囊管后切除胆囊,然后纵行切开胆总管(切口长约0.3cm),在胆总管内,向其近端放置一引流管,将胆总管切口缝合并固定胆总管,引流管用于胆汁引流,引流管下接一引流袋,为准确测量家兔胆汁流量,将胆总管切口远端结扎,于关腹前经家兔口腔下胃管至十二指肠内,查无活动性出血及胆汁漏出,逐层关腹,术毕。待家兔苏醒后,经胃管分别注入无菌蒸馏水和调胆合剂B各15ml,并同时开始计时,每6小时计量一次并同时再次用上述计量及方法给药,共4次。观察并记录空白组,无菌蒸馏水对照组及调胆合剂B组,3组家兔胆汁流量和胆汁成分的变化情况。
结果:
1.家兔胆囊切除术模型成功制备,通过胃管十二指肠灌药更容易控制实验的进行。
2.调胆合剂B组较对照组胆汁分泌量显著增加,P＜0.01。
3.调胆合剂B组较对照组胆红素的含量无明显变化,P＞0.05。
4.调胆合剂B组较对照组胆汁中胆汁酸、胆固醇及磷脂的平均浓度变化无显著差异,与蒸馏水组比P＞0.05,与对照组比P＞0.05。
结论:
1.调胆合剂B能促进家兔胆囊切除术后胆汁的分泌。
2.调胆合剂B对家兔胆汁主要成份及浓度无影响。
Purpose: Adjusts gallbladder mixture B through the observation after thedomestic rabbit gallbladder excision method the bile secretion's influence, studies its advantage gallbladder function to form to biliary duct's machinery flushing, dilutes the partial inflammation medium density, after promoting the gallbladder excision method, biliary system function restoration.
Material and method: Takes domestic rabbit 24, female and male does notarrest, about body weight 2. 5kg, fasts to be unable to restrain water 12h, the epigastrium technique area prepares the skin, after the weighing, divides into 3 groups stochastically, namely the blank group, the aseptic distilled water control group and adjusts the gallbladder mixture B group of 3 monitoring teams. The domestic rabbit (30mg/kg) anaesthetizes with 3% pentobarbitol sodium, lies supine the rabbit fixes on the rabbit board surgery table, the epigastrium technique area convention disinfection, is accepted after passing an examination center the abdomen the margin, the cascade cuts open the abdomen, the hematischesis truly, exposes the stomach, the duodenum, the gallbladder and the choledoch, after tying up the ductus cysticus, excises the gallbladder, then the vertical line cuts open the choledoch (long margin approximately 0.5cm), in the choledoch, lays aside a drainage tube to its near-end, the drainage tube uses in the bile drainage, under the drainage tube meets a drainage bag, for the correct measurement domestic rabbit bile current capacity, the choledoch margin far-end ligation, Before Guanfu after the domestic rabbit oral cavity under the stomach tube to the duodenum, looks up the non-activity hemorrhage and The bile, the cascade turns off the abdomen, the technique finishes. After treating the domestic rabbit regains consciousness, after the stomach tube separately pours into the aseptic distilled water and adjusts gallbladder mixture B each 15ml, simultaneously and starts to time, Every 6 hours measure one time and simultaneously once more use the above measurement and the method give the medicine, altogether 4 times. Observes and records the blank group, the aseptic distilled water control group and adjusts the gallbladder mixture B group, 3 group of domestic rabbit bile current capacity and bile ingredient change situation.
Results:
1. The domestic rabbit gallbladder excision method model success preparation, fills medicine easier control experiment's advance through the stomach tube duodenum.
2. Adjusts the gallbladder mixture B group to compare the control group bile secretion obviously to increase, P<0.01.
3. Adjusts the gallbladder mixture B group to compare the control group bilirubinthe content to change not obviously, P>0.05.
4. Adjusts the gallbladder mixture B group to compare in the control group bile the bile acid, the cholesterol and the phospho-lipin average density change not remarkable difference, Compares P>0. 05 with the distilled water group, compares P>0. 05 with the control group.
Conclusion:
1. After adjusting gallbladder mixture B can promote the domestic rabbit gallbladder excision method, bile secretion.
2. Adjusts gallbladder mixture B does not have the influence to the domestic rabbit bile essential component and the density.
材料与方法:取家兔24只,雌雄不拘,体重2.5kg左右,禁食不禁水12h,上腹部术区备皮,称重后随机分成3组,即空白组,无菌蒸馏水对照组及调胆合剂B组3个剂量组。家兔用3%戊巴比妥钠(30mg/kg)经耳缘静脉注射麻醉,将兔仰卧固定在兔板手术台上,上腹部术区常规消毒,取上腹部正中切口,逐层切开进腹,止血确切,显露胃,十二指肠,胆囊和胆总管,结扎胆囊管后切除胆囊,然后纵行切开胆总管(切口长约0.3cm),在胆总管内,向其近端放置一引流管,将胆总管切口缝合并固定胆总管,引流管用于胆汁引流,引流管下接一引流袋,为准确测量家兔胆汁流量,将胆总管切口远端结扎,于关腹前经家兔口腔下胃管至十二指肠内,查无活动性出血及胆汁漏出,逐层关腹,术毕。待家兔苏醒后,经胃管分别注入无菌蒸馏水和调胆合剂B各15ml,并同时开始计时,每6小时计量一次并同时再次用上述计量及方法给药,共4次。观察并记录空白组,无菌蒸馏水对照组及调胆合剂B组,3组家兔胆汁流量和胆汁成分的变化情况。
结果:
1.家兔胆囊切除术模型成功制备,通过胃管十二指肠灌药更容易控制实验的进行。
2.调胆合剂B组较对照组胆汁分泌量显著增加,P＜0.01。
3.调胆合剂B组较对照组胆红素的含量无明显变化,P＞0.05。
4.调胆合剂B组较对照组胆汁中胆汁酸、胆固醇及磷脂的平均浓度变化无显著差异,与蒸馏水组比P＞0.05,与对照组比P＞0.05。
结论:
1.调胆合剂B能促进家兔胆囊切除术后胆汁的分泌。
2.调胆合剂B对家兔胆汁主要成份及浓度无影响。
Purpose: Adjusts gallbladder mixture B through the observation after thedomestic rabbit gallbladder excision method the bile secretion's influence, studies its advantage gallbladder function to form to biliary duct's machinery flushing, dilutes the partial inflammation medium density, after promoting the gallbladder excision method, biliary system function restoration.
Material and method: Takes domestic rabbit 24, female and male does notarrest, about body weight 2. 5kg, fasts to be unable to restrain water 12h, the epigastrium technique area prepares the skin, after the weighing, divides into 3 groups stochastically, namely the blank group, the aseptic distilled water control group and adjusts the gallbladder mixture B group of 3 monitoring teams. The domestic rabbit (30mg/kg) anaesthetizes with 3% pentobarbitol sodium, lies supine the rabbit fixes on the rabbit board surgery table, the epigastrium technique area convention disinfection, is accepted after passing an examination center the abdomen the margin, the cascade cuts open the abdomen, the hematischesis truly, exposes the stomach, the duodenum, the gallbladder and the choledoch, after tying up the ductus cysticus, excises the gallbladder, then the vertical line cuts open the choledoch (long margin approximately 0.5cm), in the choledoch, lays aside a drainage tube to its near-end, the drainage tube uses in the bile drainage, under the drainage tube meets a drainage bag, for the correct measurement domestic rabbit bile current capacity, the choledoch margin far-end ligation, Before Guanfu after the domestic rabbit oral cavity under the stomach tube to the duodenum, looks up the non-activity hemorrhage and The bile, the cascade turns off the abdomen, the technique finishes. After treating the domestic rabbit regains consciousness, after the stomach tube separately pours into the aseptic distilled water and adjusts gallbladder mixture B each 15ml, simultaneously and starts to time, Every 6 hours measure one time and simultaneously once more use the above measurement and the method give the medicine, altogether 4 times. Observes and records the blank group, the aseptic distilled water control group and adjusts the gallbladder mixture B group, 3 group of domestic rabbit bile current capacity and bile ingredient change situation.
Results:
1. The domestic rabbit gallbladder excision method model success preparation, fills medicine easier control experiment's advance through the stomach tube duodenum.
2. Adjusts the gallbladder mixture B group to compare the control group bile secretion obviously to increase, P<0.01.
3. Adjusts the gallbladder mixture B group to compare the control group bilirubinthe content to change not obviously, P>0.05.
4. Adjusts the gallbladder mixture B group to compare in the control group bile the bile acid, the cholesterol and the phospho-lipin average density change not remarkable difference, Compares P>0. 05 with the distilled water group, compares P>0. 05 with the control group.
Conclusion:
1. After adjusting gallbladder mixture B can promote the domestic rabbit gallbladder excision method, bile secretion.
2. Adjusts gallbladder mixture B does not have the influence to the domestic rabbit bile essential component and the density.
引文
[1]黄志强.个世纪以来肝、胆、胰外科的发展.中华外科杂志.2001,9(1):9-15
[2]黄志强.微创外科及外科微创化在本世纪外科的发展.腹部外科,2004,17(2):71-73
[3]Shamiyeh A,wayand W.Current status of laparoscopic therapy of cholecystolithiasis and common bile duet stones.Dig Dis,2005,23(2):119-126.
[4]金庆丰编著.胆道疾病.上海:上海科学技术出版社.1979,183.
[5]DC薛比斯顿主编.曾宪九译.克氏外科学.北京:人民卫生出版社.1983,1439.
[6]张静,袁作彪,高炬,等.养肝柔肝法逆转豚鼠成石胆汁致石性的实验研究[J].中西医结合学报,2003,1(4):289-291.
[7]朱培庭,张静,章学林,等.升清胶囊对豚鼠胆石病相关基因的影响[J].中西医结合学报,2005,3(3):207-209.
[8]方盛泉,倪红梅,朱生梁.胆囊切除术后胆道动力障碍辨证分型与胆总管直径相关性初步研究.上海中医药大学学报.2006,20(1):33-34
[9]方盛泉,朱生梁,倪红梅.疏肝利胆和胃法治疗胆囊切除术后胆道动力障碍45例.上海中医药杂志.2005,39(3):22-23
[10]许斌,武焕文,朴明姬.中药制剂对胆道手术后患者胆汁分泌的影响.辽宁中医杂志,2005,32(4):324-325
[11]陈孝平,陈汉主编.肝胆外科学.北京:人民卫生出版社.2005:6
[12]蔡逊,卢绮萍.腹腔镜与开腹胆囊切除术后胃肠动力恢复临床研究.西南国防医药.2006;16(3):253-255
[13]田伏洲,张丙印,黄太熔,等.肝胆管结石患者胆道口括约肌功能的观察[J].中华外科杂志,1989;27(3):144
[14]贾秀云,于之英.利胆通瘀法治疗胆囊切除后综合征31例[J].江苏中医.1996,17(8):13-14
[15]聂丹丽,崔大江,刘润霞.祛瘀胆通汤治疗胆囊切除后综合征44例[J].河南中医.1998,22(1):47
[16]徐青霞.清胆通瘀汤治疗胆道术后综合征126例疗效观察[J].中国民间疗法.1996,2(1):35-36
[17]马子密,傅延龄.历代本草药性汇解.第一版.北京:中国医药科技出版社,2002
[18]Feldmm M,Scharschmidt BF,Sleisenger MH.Sleisenger and foroltran' s gastrointesinal and liver disease(6th Edition,Volumel )[M].Philadelphia:Harcourt publisher Limited.2001,980-981
[19]王绍明,李力.胆囊切除术后胆道动力障碍的辨证治疗.成都中医药大学学报.2000,23(3):16-19
[20]Sheman S.Troiano FP.Hawes RH,et al.Frequency of abnormal sphincter of Oddi manometry compared with clinical suspincion of sphincter of Oddi dysfunction [J].Am J Gastroenteorol,1991,86(8):586
[21]黄志强主编.现代疆部外科学[M].长沙:湖南科学技术出版社.1997,39
[22]魏经国,张劲松,孟庆江等.胰胆管十二指肠X线解剖与胆源性腹痛.中华消化内镜杂志.1998,15:15-18
[23]魏经国,王耀程,孟庆江.胆管Boyden括约肌在胆汁排出中的作用及影响因素.中国临床解剖学杂志.2000,18:248-251
[24]Yokohata K,Tanaka M.Cyclic motility of the sphincter of Oddi.J Hepatobil Pancreat Surg.2000,7:178-182
[25]Hogan WJ,Geenen JE,Biliary dyskinesia.Endoscopy.1998,30:179-183
[26]徐福可,杨为民.胆囊切除术后胆道内动力改变的探讨.华夏医药.2003,3:21-23
[27]Chen YK,Foliente RL,Santoro MJ,Walter MH,Collen MJ.Endoscopic sphincterotomy-induced pancreatitis:increased risk associated with nondilated bile duets and sphincter of Oddi dysfunction.Am J Gastroenterol.1994,9:327-333
[28]Geenen JE,Hogan WJ,Dodds WJ,et al.The eficacy ofendoscopic sphinctemtomy after cholecystectomy in patientswith sphincter of Oddi dysfunction.N Ensl J Med.1989,320:82-85
[29]Rosenblaft ML,Catalano MF,Alcocer E,Geenen JE.Comparison of sphincter of Oddi manometry,fatty meal sonography,and hepatobiliary scintigraphy in the diagnosis of sphincter of Oddi dysfunction.Gashointes Endosc.2001,54:697-704
[30]Di Francesco V,Brunori MP,Rigo L,Toouli J,ingelini G,Frulloni L,Bovo P,Filippini M,Vaona B,Talamini G,Cavallini G.Comparison of ultrasound-secretin test and sphincter of Oddi manometry in patients with recurrent acute pancreatitis.Dig Dis Sci.1999,44:336-340
[31]Fazel A,Li SC,Burton FR.Octreotide relaxes the hypertensive sphincter of Oddi:pathophysiological and therapeutic implications.Am]Gastroenterol.2002,97:612-616
[32]Koslutani T,Kodama T,Sato H,Takaaki J,Imamura Y,Kato K,Wakabayashi N,Tokita K,Mitsufuji S.A synthetic prostaglandin El analog,alprostadil alfadex,relaxes sphincter of Oddi in humans.Dig Dis Sci.2002,47:152-156
[33]Di Francesco V,Mariani A,Angelini G,Masci E,Frulloni L,Talamini G,Passaretti S,Testoni P,Cavallini G.Effects of gabexate mesilate,a protease inhibitor,on human sphincter of Oddi motility.Dig Dis Sci.2002,47:741-745
[34]Lee SK,Kim MH,Kim HJ,Seo DS,Yoo KS,Joo YH,Min YI,Kim JH,Min BI.Electroacupuncture may relax the sphincter of Oddi in humans.Gastrointest Endosc.2001,53:211-216
[35]吴金祥,张俊平.清肝利胆汤治疗胆囊炎合并胆石症86例[J].河南中医学院学报,2005,20(6):41.
[36]曹建西,侯智亮,彭红光.生大黄配合抗生素治疗急性重症胆管炎24例[J].中医杂志,2004,45(2):1272128.
[37]胡家石,吴咸中.内镜鼻胆管引流2清解灵治疗急性重型胆管炎的临床观察[J].中西医结合杂志,1989,9(3):1442147.
[38]张静,章学林,高炬,等.清热通下中药对胆管炎大鼠肠屏障保护和炎症反应调控的研究[J].中西医结合学报,2005,3(3):
[39]印会河主编.中医基础理论[M].上海:上海科学技术出版社.1983,52
[40]邓明飞,段绍斌.胆道术后综合征的辨病辨证治疗.新疆中医.2004,22(5):34-35
[41]胡德泉,汪玮.胆囊切除后综合征的中医治疗.实用中西医结合临床.2002,2(3):31-32
[42]金平,周腊梅,胡世芬.加味柴胡疏肝散治疗胆囊术后胆道动力障碍42例.Chin J Integr Trad West Med Dig.October 2002 Vol 10.No.5
[43]杜庆文.中西医结合治疗胆囊术后综合症67例分析.chinese Journal of the Practical Chinese with Modem Medicine 2006 VOL.(19) No.21:2548
[44]就聂丹丽,崔大江,刘润霞.祛瘀胆通汤治疗胆囊切除后综合征44例.河南中医.1998,18(1):47
[45]余德刚,赵礼金,蔡治方等.中西医结合治疗胆囊切除术后综合征56例.现代中西医结合杂志.2006,15(1):61-62
[46]崔闽鲁.疏和饮治疗胆囊术后综合征30例.福建中医学院学报.2005,15(5):11-12
[47]天津市南开医院,遵义医学院主编.新急腹症学[M].北京:人民卫生出版社,1978.4162423.211-213.
[48]Walsh TN,Kussell RC.Cholecystectomy and gallbladder c onserration[J].Br J Surg.1997,79(1):44
[1]陈孝平,陈汉主编.肝胆外科学.北京:人民卫生出版社.2005:6
[2]黄志强主编.现代疆部外科学[M].长沙:湖南科学技术出版社.1997:39
[3]田伏洲,张丙印,黄太熔,等.肝胆管结石患者胆道口括约肌功能的观察[J].中华外科杂志,1989;27(3):144
[4]Meshkinpour H,Mollot M.Sphincter of Oddi dysfunction and unexplained abdominal pain:clinical and mesometric study[J].Dig Dis Sei.1992:37(4):257
[5]Evans PR,Dowsert JF,Bak YT.Et al.Abnormal sphincter of Oddi response to cholecystckimin in postcholecy tectomy syndrome patients witb irritable bowel syndrome[J].Dig Dis Sei.1995:40(9):1149
[6]Wilson P,Jamieson JR,Hinder RA,et al.Pathologic duodengastric reflex associated with penisistence of symptom after cholecystectomy [J].Surgery.1995;117(6):421
[7]高学敏主编.中药学.北京:中国中医药出版社.2004
[8]马清钧,王淑玲.临床实用中药学.南昌:江西科学技术出版社,2002.3
[2]黄志强.微创外科及外科微创化在本世纪外科的发展.腹部外科,2004,17(2):71-73
[3]Shamiyeh A,wayand W.Current status of laparoscopic therapy of cholecystolithiasis and common bile duet stones.Dig Dis,2005,23(2):119-126.
[4]金庆丰编著.胆道疾病.上海:上海科学技术出版社.1979,183.
[5]DC薛比斯顿主编.曾宪九译.克氏外科学.北京:人民卫生出版社.1983,1439.
[6]张静,袁作彪,高炬,等.养肝柔肝法逆转豚鼠成石胆汁致石性的实验研究[J].中西医结合学报,2003,1(4):289-291.
[7]朱培庭,张静,章学林,等.升清胶囊对豚鼠胆石病相关基因的影响[J].中西医结合学报,2005,3(3):207-209.
[8]方盛泉,倪红梅,朱生梁.胆囊切除术后胆道动力障碍辨证分型与胆总管直径相关性初步研究.上海中医药大学学报.2006,20(1):33-34
[9]方盛泉,朱生梁,倪红梅.疏肝利胆和胃法治疗胆囊切除术后胆道动力障碍45例.上海中医药杂志.2005,39(3):22-23
[10]许斌,武焕文,朴明姬.中药制剂对胆道手术后患者胆汁分泌的影响.辽宁中医杂志,2005,32(4):324-325
[11]陈孝平,陈汉主编.肝胆外科学.北京:人民卫生出版社.2005:6
[12]蔡逊,卢绮萍.腹腔镜与开腹胆囊切除术后胃肠动力恢复临床研究.西南国防医药.2006;16(3):253-255
[13]田伏洲,张丙印,黄太熔,等.肝胆管结石患者胆道口括约肌功能的观察[J].中华外科杂志,1989;27(3):144
[14]贾秀云,于之英.利胆通瘀法治疗胆囊切除后综合征31例[J].江苏中医.1996,17(8):13-14
[15]聂丹丽,崔大江,刘润霞.祛瘀胆通汤治疗胆囊切除后综合征44例[J].河南中医.1998,22(1):47
[16]徐青霞.清胆通瘀汤治疗胆道术后综合征126例疗效观察[J].中国民间疗法.1996,2(1):35-36
[17]马子密,傅延龄.历代本草药性汇解.第一版.北京:中国医药科技出版社,2002
[18]Feldmm M,Scharschmidt BF,Sleisenger MH.Sleisenger and foroltran' s gastrointesinal and liver disease(6th Edition,Volumel )[M].Philadelphia:Harcourt publisher Limited.2001,980-981
[19]王绍明,李力.胆囊切除术后胆道动力障碍的辨证治疗.成都中医药大学学报.2000,23(3):16-19
[20]Sheman S.Troiano FP.Hawes RH,et al.Frequency of abnormal sphincter of Oddi manometry compared with clinical suspincion of sphincter of Oddi dysfunction [J].Am J Gastroenteorol,1991,86(8):586
[21]黄志强主编.现代疆部外科学[M].长沙:湖南科学技术出版社.1997,39
[22]魏经国,张劲松,孟庆江等.胰胆管十二指肠X线解剖与胆源性腹痛.中华消化内镜杂志.1998,15:15-18
[23]魏经国,王耀程,孟庆江.胆管Boyden括约肌在胆汁排出中的作用及影响因素.中国临床解剖学杂志.2000,18:248-251
[24]Yokohata K,Tanaka M.Cyclic motility of the sphincter of Oddi.J Hepatobil Pancreat Surg.2000,7:178-182
[25]Hogan WJ,Geenen JE,Biliary dyskinesia.Endoscopy.1998,30:179-183
[26]徐福可,杨为民.胆囊切除术后胆道内动力改变的探讨.华夏医药.2003,3:21-23
[27]Chen YK,Foliente RL,Santoro MJ,Walter MH,Collen MJ.Endoscopic sphincterotomy-induced pancreatitis:increased risk associated with nondilated bile duets and sphincter of Oddi dysfunction.Am J Gastroenterol.1994,9:327-333
[28]Geenen JE,Hogan WJ,Dodds WJ,et al.The eficacy ofendoscopic sphinctemtomy after cholecystectomy in patientswith sphincter of Oddi dysfunction.N Ensl J Med.1989,320:82-85
[29]Rosenblaft ML,Catalano MF,Alcocer E,Geenen JE.Comparison of sphincter of Oddi manometry,fatty meal sonography,and hepatobiliary scintigraphy in the diagnosis of sphincter of Oddi dysfunction.Gashointes Endosc.2001,54:697-704
[30]Di Francesco V,Brunori MP,Rigo L,Toouli J,ingelini G,Frulloni L,Bovo P,Filippini M,Vaona B,Talamini G,Cavallini G.Comparison of ultrasound-secretin test and sphincter of Oddi manometry in patients with recurrent acute pancreatitis.Dig Dis Sci.1999,44:336-340
[31]Fazel A,Li SC,Burton FR.Octreotide relaxes the hypertensive sphincter of Oddi:pathophysiological and therapeutic implications.Am]Gastroenterol.2002,97:612-616
[32]Koslutani T,Kodama T,Sato H,Takaaki J,Imamura Y,Kato K,Wakabayashi N,Tokita K,Mitsufuji S.A synthetic prostaglandin El analog,alprostadil alfadex,relaxes sphincter of Oddi in humans.Dig Dis Sci.2002,47:152-156
[33]Di Francesco V,Mariani A,Angelini G,Masci E,Frulloni L,Talamini G,Passaretti S,Testoni P,Cavallini G.Effects of gabexate mesilate,a protease inhibitor,on human sphincter of Oddi motility.Dig Dis Sci.2002,47:741-745
[34]Lee SK,Kim MH,Kim HJ,Seo DS,Yoo KS,Joo YH,Min YI,Kim JH,Min BI.Electroacupuncture may relax the sphincter of Oddi in humans.Gastrointest Endosc.2001,53:211-216
[35]吴金祥,张俊平.清肝利胆汤治疗胆囊炎合并胆石症86例[J].河南中医学院学报,2005,20(6):41.
[36]曹建西,侯智亮,彭红光.生大黄配合抗生素治疗急性重症胆管炎24例[J].中医杂志,2004,45(2):1272128.
[37]胡家石,吴咸中.内镜鼻胆管引流2清解灵治疗急性重型胆管炎的临床观察[J].中西医结合杂志,1989,9(3):1442147.
[38]张静,章学林,高炬,等.清热通下中药对胆管炎大鼠肠屏障保护和炎症反应调控的研究[J].中西医结合学报,2005,3(3):
[39]印会河主编.中医基础理论[M].上海:上海科学技术出版社.1983,52
[40]邓明飞,段绍斌.胆道术后综合征的辨病辨证治疗.新疆中医.2004,22(5):34-35
[41]胡德泉,汪玮.胆囊切除后综合征的中医治疗.实用中西医结合临床.2002,2(3):31-32
[42]金平,周腊梅,胡世芬.加味柴胡疏肝散治疗胆囊术后胆道动力障碍42例.Chin J Integr Trad West Med Dig.October 2002 Vol 10.No.5
[43]杜庆文.中西医结合治疗胆囊术后综合症67例分析.chinese Journal of the Practical Chinese with Modem Medicine 2006 VOL.(19) No.21:2548
[44]就聂丹丽,崔大江,刘润霞.祛瘀胆通汤治疗胆囊切除后综合征44例.河南中医.1998,18(1):47
[45]余德刚,赵礼金,蔡治方等.中西医结合治疗胆囊切除术后综合征56例.现代中西医结合杂志.2006,15(1):61-62
[46]崔闽鲁.疏和饮治疗胆囊术后综合征30例.福建中医学院学报.2005,15(5):11-12
[47]天津市南开医院,遵义医学院主编.新急腹症学[M].北京:人民卫生出版社,1978.4162423.211-213.
[48]Walsh TN,Kussell RC.Cholecystectomy and gallbladder c onserration[J].Br J Surg.1997,79(1):44
[1]陈孝平,陈汉主编.肝胆外科学.北京:人民卫生出版社.2005:6
[2]黄志强主编.现代疆部外科学[M].长沙:湖南科学技术出版社.1997:39
[3]田伏洲,张丙印,黄太熔,等.肝胆管结石患者胆道口括约肌功能的观察[J].中华外科杂志,1989;27(3):144
[4]Meshkinpour H,Mollot M.Sphincter of Oddi dysfunction and unexplained abdominal pain:clinical and mesometric study[J].Dig Dis Sei.1992:37(4):257
[5]Evans PR,Dowsert JF,Bak YT.Et al.Abnormal sphincter of Oddi response to cholecystckimin in postcholecy tectomy syndrome patients witb irritable bowel syndrome[J].Dig Dis Sei.1995:40(9):1149
[6]Wilson P,Jamieson JR,Hinder RA,et al.Pathologic duodengastric reflex associated with penisistence of symptom after cholecystectomy [J].Surgery.1995;117(6):421
[7]高学敏主编.中药学.北京:中国中医药出版社.2004
[8]马清钧,王淑玲.临床实用中药学.南昌:江西科学技术出版社,2002.3