利胆活血通腑方对加速原发性肝癌肝部分切除患者恢复的临床研究

发布时间：2018-11-11 00:23

【摘要】：通过对采用中西医结合方法治疗的原发性肝癌肝切除围手术期病人恢复情况进行临床研究,运用利胆活血通腑汤观察中医药在加速原发性肝癌肝切除手术病人康复中的作用,客观评价并探讨中医药在肝脏外科加速康复中的意义等。方法:选择2016年2月至2017年1月因原发性肝癌入住南通市第三人民医院肝胆外科行肝切除的患者40例作为观察研究对象,随机分为A、B两组(观察组、对照组),每组20例;两组均采用常规护肝治疗,A组在此基础上加用中药利胆活血通腑方,比较两组术前、术后第1、3、5、7天临床症状及ALT、AST、TBIL等肝功能指标以及肿瘤坏死.-因子α等变化情况,并综合评估比较临床症状和平均住院日等。结果:本次实验满足入组条件病人40例中,符合标准并全程顺利接受研究方法、资料收集完整者34例,其中,观察组19例,对照组15例。两组患者在术前各项评判指标无明显差异,术后第七天观察组ALT35.53±21.99U/L,AST20.32±6.75U/L对照组ALT80.87±63.10 U/L,AST60.53 ±31.67 U/L(P0.05),术后第五天观察组 TNF-α 8.26±1.56 pg/ml,TBIL 10.31 ±2.79 umol/L,对照组 TNF-α 10.88±1.83 pg/ml,TBIL 16.33 ±4.97 umol/L(P0.05)。各项临床症状变化指标相比也均具有统计学差异(p0.05)。平均住院日观察组为12.84±1.74天,对照组为15.67±1.76天(P0.01),有显著统计学差异。结论:在肝脏部分切除患者围手术期使用利胆活血通腑方治疗缺血再灌注损伤后,患者平均住院日降低,观察各项指标观察组较对照组均有明显改善,患者术后临床症状反应情况也较对照组好。表明原发性肝癌肝切除围手术期病人采用中西医结合治疗方法,以利胆活血通腑为主法,使用利胆活血通腑方可有效降低部分炎症介质水平、减轻肝脏缺血再灌注损伤等,加速肝脏功能修复,促进患者快速康复。
[Abstract]:Through the clinical study on the recovery of patients with primary liver cancer treated by combination of traditional Chinese and western medicine during the perioperative period of hepatectomy, the role of traditional Chinese medicine in accelerating the rehabilitation of patients undergoing hepatectomy for primary liver cancer was observed by using Lidan Huoxue Tong Fu decoction. Objective evaluation and explore the significance of TCM in the accelerated rehabilitation of liver surgery. Methods: from February 2016 to January 2017, 40 patients admitted to the third people's Hospital of Nantong City for hepatectomy were randomly divided into two groups (observation group, control group) with 20 cases in each group. Both groups were treated with routine liver protection therapy. Group A was treated with traditional Chinese medicine Lidan Huoxue Tong Fu recipe on this basis. The clinical symptoms and ALT,AST, were compared between the two groups before and after operation. Liver function indexes such as TBIL and tumor necrosis.-factor 伪 were evaluated and compared with clinical symptoms and average hospitalization days. Results: among the 40 patients who met the condition of entering the group, they met the standard and accepted the study method successfully. The data were collected completely in 34 cases, including 19 cases in the observation group and 15 cases in the control group. On the seventh day after operation, ALT35.53 卤21.99U / L AST 20.32 卤6.75U/L control group ALT80.87 卤63.10 U / L AST 60.53 卤31.67 UL / L (P0.05). On the fifth day after operation, TNF- 伪 in the observation group was 8.26 卤1.56 pg/ml,TBIL 10.31 卤2.79 umol/L, control group, TNF- 伪 10.88 卤1.83 pg/ml,TBIL 16.33 卤4.97 umol/L (P0.05). The changes of clinical symptoms were also statistically different (p 0.05). The average hospitalization days were 12.84 卤1.74 days in the observation group and 15.67 卤1.76 days in the control group (P0.01). Conclusion: after the treatment of ischemia-reperfusion injury with Lidan Huoxue Tong Fu prescription in the perioperative period of partial hepatectomy patients, the average hospitalization time of the patients decreased, and the observed indexes in the observation group were significantly improved than those in the control group. The clinical symptoms and reactions of the patients after operation were also better than those of the control group. The results showed that patients with primary liver cancer were treated with integrated traditional Chinese and western medicine in perioperative period of hepatectomy. The main method was to facilitate the treatment of gallbladder and blood circulation, and the use of Lidan Huoxue Tong Fu decoction to effectively reduce the level of inflammatory mediators and alleviate the hepatic ischemia-reperfusion injury, and so on. Accelerate the repair of liver function and promote the rapid recovery of patients.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.7

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