芍药甘草汤早期干预急性胆管炎的疗效分析

发布时间：2018-06-27 19:26

本文选题：芍甘汤 + 胆总管结石　；参考：《大连医科大学》2013年硕士论文

【摘要】：目的：Oddi括约肌运动功能障碍在现在已经广泛为医学者所了解。而胆总管结石引起的急性胆管炎作为临床常见病，大量报道证实急性胆管炎的发生、发展与Oddi括约肌痉挛密切相关：急性胆管炎可以引发或伴随SO痉挛；而SO痉挛又可以加重急性胆管炎。SOD包括SO功能紊乱和狭窄, SO痉挛属于SOD功能紊乱范畴。我们的前期试验证实，芍甘汤的主要成分芍药甙可以舒张Oddi括约肌，从而缓解Oddi括约肌痉挛。本实验以胆总管结石引起的急性胆管炎患者为研究对象，观察早期应用芍甘汤对胆总管结石引起的急性胆管炎的疗效。方法：采用单盲随机对照临床试验方法，选择胆总管结石引起的急性胆管炎患者为研究对象，在非手术治疗阶段各种基本处置相同的条件下，治疗组41例入院即给予芍甘汤治疗，以应用生理盐水作为对照组。观察两组患者非手术治疗阶段后，发病48小时内疼痛缓解率、体温降低率、白细胞降低率、手术率。同时观察治疗组发病距应用芍甘汤0-12小时、12-24小时、24小时以上三组的疼痛缓解率。结果：比较治疗组与对照组在发病48小时内的疼痛缓解率、体温降低率、白细胞降低率、手术率，治疗组均不同于对照组，且经统计学分析具有统计学差异。同时发现，给药时间距发病时间越短，疼痛缓解率越高。结论：对于胆总管结石引起的急性胆管炎患者早期行芍甘汤干预治疗，能够明显缓解患者腹痛症状，减轻痛苦，降低体温及白细胞计数，减少了急诊手术率。距急性胆管炎发病时间越短，，芍甘汤对缓解Oddi括约肌痉挛效果越明显，防止了急性胆管炎的进展，尤其对于减轻疼痛效果明显，减少了患者的痛苦。
[Abstract]:Objective: dysmotility of oddi sphincter is now widely known in medicine. Acute cholangitis caused by choledocholithiasis is a common clinical disease. A large number of reports confirm that the occurrence of acute cholangitis is closely related to spasm of sphincter of oddi: acute cholangitis can cause or accompany so spasm; So spasticity can aggravate acute cholangitis. SOD includes so dysfunction and stenosis, so spasm belongs to SOD functional disorder category. Our previous experiments confirmed that paeoniflorin, the main component of Shaogan decoction, can relax sphincter of oddi and relieve spasm of oddi. In this study, acute cholangitis caused by choledocholithiasis was studied to observe the effect of early application of Shaogan decoction on acute cholangitis caused by choledocholithiasis. Methods: a single blind randomized controlled clinical trial was conducted to select the patients with acute cholangitis caused by choledocholithiasis. The treatment group (41 cases) was treated with Shaogan decoction immediately after admission, and the control group was treated with normal saline. The pain relief rate, hypothermia rate, leukopenia rate and operation rate were observed in 48 hours after non-operative treatment. At the same time, the pain relief rate of the treatment group was observed after the treatment group was treated with Shaogan decoction for 0-12 hours and 12-24 hours and more than 24 hours. Results: the pain relief rate, hypothermia rate, leukopenia rate and operation rate in the treatment group and the control group were all different from those in the control group within 48 hours after the onset of the disease, and there was statistical difference between the treatment group and the control group. At the same time, it was found that the shorter the time of administration, the higher the pain relief rate. Conclusion: early intervention therapy of Shaogan decoction for patients with acute cholangitis caused by choledocholithiasis can obviously relieve abdominal pain, alleviate pain, decrease body temperature and white blood cell count, and reduce the rate of emergency operation. The shorter the onset time of acute cholangitis, the more obvious the effect of Shaogan decoction on relieving sphincter spasm of oddi, which prevented the progression of acute cholangitis, especially in alleviating the pain and reducing the pain of the patients.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R657.4

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