摘要
目的:观察ERCP联合EST序贯应用一贯煎加减治疗肝外胆管结石术后肝阴亏虚型患者的临床疗效。方法:选择符合标准的2019年1月—2021年12月因诊断为肝外胆管结石就诊于安徽中医药大学第一附属医院普外科的60例患者,并按随机数字表法分为观察组和对照组,每组各30例,对照组予以ERCP联合EST治疗,术后常规予西药治疗;观察组在对照组的基础上,予一贯煎加减口服。观察对比2组患者治疗后的疗效及鼻胆管引流量、胆汁细菌培养结果;炎性指标、肝功能指标、血清胆汁生化指标改善程度及术后复发率。结果:2组患者无临床疗效差异(P>0.05)。治疗前2组患者的炎性指标、肝功能指标及血清胆汁生化指标比较无差异(P>0.05),治疗后2组患者各项指标均改善,观察组改善程度显著优于对照组(P<0.05)。观察组术后第5、7天鼻胆管引流量分别为(336.50±91.06)mL和(456.23±110.02)mL,与对照组比较有统计学意义(P<0.05)。治疗后对照组细菌培养阴性率63.33%,观察组86.67%,比较有统计学意义(P<0.05)。观察组术后结石复发率(6.67%)与对照组(26.67%)比较有统计学意义(P<0.05)。结论:ERCP、EST联合一贯煎加减治疗能够提高手术成功率,起到抑制术后胆道炎症、加快肝功能恢复、调节胆汁成分、防治术后结石复发的作用。
Objective:To observe the clinical efficacy of ERCP combined with EST and sequential application of modified Yiguanjian in the treatment of patients with liver yin deficiency after surgery for extrahepatic bile duct stones.Methods:60 patients who met the criteria and were diagnosed with extrahepatic bile duct stones in the General Surgery Department of the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from January 2019 to December 2021 were selected and divided into observation group and observation group according to the random number table method.There were 30 cases in each group in the control group.The control group was treated with ERCP combined with EST,and was routinely treated with western medicine after surgery.The observation group was treated with modified orally administered Yiguanjian on the basis of the control group.Observe and compare the posttreatment efficacy,nasobiliary drainage volume,and bile bacterial culture results of the 2 groups of patients;the degree of improvement in inflammatory indicators,liver function indicators,serum bile biochemical indicators,and postoperative recurrence rate.Results:There was no difference in clinical efficacy between the 2 groups of patients(P>0.05).There was no difference in inflammatory indicators,liver function indicators and serum bile biochemical indicators between the two groups of patients before treatment(P>0.05).After treatment,all indicators of the patients in the two groups were improved,and the improvement degree of the observation group was significantly better than that of the control group(P<0.05).The nasobiliary drainage volume of the observation group on the 5th and 7th days after surgery was(336.50±91.06)mL and(456.23±110.02)mL respectively,which was statistically significant compared with the control group(P<0.05).After treatment,the negative bacterial culture rate in the control group was 63.33%and that in the observation group was 86.67%,which was statistically significant(P<0.05).The postoperative stone recurrence rate in the observation group(6.67%)was statistically significant compared with the control group(26.67%)(P<0.05).Conclusion:ERCP,EST combined with Yiguanjian modified treatment can improve the success rate of surgery,inhibit postoperative biliary inflammation,accelerate liver function recovery,regulate bile composition,and prevent and treat postoperative stone recurrence.
作者
汪玲虎
张琦
于庆生
齐伟
梁久银
刘海韦
舒亚倩
WANG Linghu;ZHANG Qi;YU Qingsheng;QI Wei;LIANG Jiuyin;LIU Haiwei;SHU Yaqian(The First Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230031,China;Institute of Chinese Traditional Surgery,Anhui Academy of Chinese Medicine,Anhui Hefei 230031,China)
出处
《中医药临床杂志》
2023年第10期2024-2029,共6页
Clinical Journal of Traditional Chinese Medicine
基金
十二五国家临床重点专科建设项目(财社[2013]239号)
安徽省高校优秀青年人才支持计划项目(gxyq2019035)。
