茵陈蒿汤联合PTCD对老年急性梗阻性化脓性胆管炎治疗的临床研究

发布时间：2018-05-12 05:44

本文选题：茵陈蒿汤 + 急性梗阻性化脓性胆管炎　；参考：《浙江中医药大学》2016年硕士论文

【摘要】：目的探讨茵陈蒿汤联合经皮肝穿刺胆道引流术(PTCD)对老年急性梗阻性化脓性胆管炎治疗疗效。方法选取杭州市余杭区第二人民医院老年化脓性阻塞性胆管炎患者56例,按就诊顺序分对照组和研究组(各28例),两组均行经皮肝穿刺胆道引流术胆道引流,术后予以抗生素抗炎、甘草酸二胺针静脉滴注护肝治疗,研究组在对照组常规治疗的基础上胃管注入或者口服茵陈蒿汤,于治疗前和治疗后3天、5天、10天时间点,观察患者血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、血清总胆红素(TBIL).血清直接胆红素(DBIL)的含量、血常规白细胞计数、血CRP值,以及患者二次手术和总的住院时间的比较。结果两组治疗后血清ALT、AST、TBIL、DBIL的含量以及白细胞计数、血CRP值均明显低于治疗前(P0.05)；研究组治疗后血清ALT、AST、TBIL、 DBIL的含量以及二次手术和总住院时间明显低于对照组(P0.05)。研究组治疗后血白细胞计数、血CRP值与对照组相比无统计学差别(P0.05)。结论PTCD是有效治疗老年急性梗阻性化脓性胆管炎的有效治疗手段；茵陈蒿汤具有较好地清热利湿退黄功效,适用于肝胆湿热型急性梗阻性化脓性胆管炎的治疗；茵陈蒿汤联合经皮肝穿刺胆道引流术能更好的治疗老年急性梗阻性化脓性胆管炎,更快的降低老年急性梗阻性化脓性胆管炎患者血清ALT、AST、TBIL、DBIL含量,缩短患者住院时间。
[Abstract]:Objective to investigate the therapeutic effect of Yinchenhao decoction combined with percutaneous transhepatic biliary drainage (PTCD) on acute obstructive suppurative cholangitis in the elderly. Methods Fifty-six elderly patients with suppurative obstructive cholangitis in the second people's Hospital of Yuhang District of Hangzhou City were divided into two groups: control group (n = 28) and study group (n = 28). The two groups were treated with percutaneous transhepatic biliary drainage. After operation, antibiotics were given to resist inflammation, glycyrrhizin diamine was injected intravenously to protect liver, and the study group was treated by gastric tube injection or oral Yinchenhao decoction on the basis of routine treatment in the control group. Before treatment and 3 days after treatment, there were 10 days after treatment. Serum alanine aminotransferase (alt), aspartate aminotransferase (AST) and serum total bilirubin (Tbilirubin) were observed. The content of serum direct bilirubin (DBIL), white blood cell count (WBC), blood CRP, and the time of secondary operation and total hospital stay were compared. Results after treatment, the levels of serum alt ASTIL, white blood cell count and CRP in the two groups were significantly lower than those in the control group (P 0.05), and the levels of serum alt ASTIL, DBIL and the duration of secondary operation and total hospital stay in the study group were significantly lower than those in the control group (P 0.05). There was no significant difference in white blood cell count and CRP between the study group and the control group (P 0.05). Conclusion PTCD is an effective treatment for acute obstructive suppurative cholangitis in the elderly, Yinchenhao decoction has the effect of clearing away heat and dampness and removing yellow, and is suitable for the treatment of acute obstructive suppurative cholangitis of liver and gallbladder dampness heat type. Yinchenhao decoction combined with percutaneous transhepatic choledochodrainage can better treat acute obstructive suppurative cholangitis in the elderly, reduce serum alt AST TILBILDBIL content of aged patients with acute obstructive suppurative cholangitis more quickly, and shorten the hospitalization time of the elderly patients with acute obstructive suppurative cholangitis.
【学位授予单位】：浙江中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R657.45

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