利胆汤对腹腔镜下保胆取石术后胆囊功能的影响
发布时间：2018-08-21 20:49
【摘要】：目的:1、探讨利胆汤对腹腔镜下保胆取石术后胆囊功能及并发症的治疗效果;2、系统研究利胆汤对腹腔镜下保胆取石术后胆囊功能及术后并发症治疗的药理机理;3、为中医药在腹腔镜下保胆取石术后的临床应用提供依据;方法:选取2014年9月至2016年8月期间,在广州市中医医院收治的择期行腹腔镜下保胆取石术且符合入组标准患者60例。按患者入组的先后,采用随机数表法,分为空白组、对照组、治疗组,各20例。三组在术后常规治疗、护理、健康指导方面等相同,空白组不予溶石利胆类药物;对照组术后第一天开始予华沙利胆片,每次2粒,每日3次,连续服用6个月;治疗组术后第一天开始予利胆汤口服,早晚口服各一次,连续服用6个月。观察三组患者保胆取石术后一般状况,检测三组患者术后6个月胆囊壁厚度、胆囊收缩率测定、胆囊结石复发情况和术后并发症之间的差异。复查血、尿、粪常规、心、肝、肾功能检查,作为药物临床安全性评估指标,并对治疗前后数据进行统计学分析,从而作出临床疗效及安全性评价。结果:1、在术后6个月胆囊壁厚度方面,三组术前与术后6个月胆囊壁厚度比较,均明显降低,差异具有统计学意义(P0.05)。对照组与治疗组均低于空白组,且治疗组低于对照组,差异均有统计学意义(P0.05)。2、在术后6个月胆囊收缩率方面,对照组与治疗组均高于空白组,且治疗组高于对照组,差异均有统计学意义(P0.05)。3、术后6个月并发症上,腹泻发生率方面,治疗组低于对照组和空白组低,差异具有统计学意义(P0.05);纳差发生率方面,治疗组低于空白组,差异有统计学意义,然而对照组与治疗组之间差异无统计学意义(P0.05);三组在腹胀、腹痛方面,差异无统计学意义(P0.05)。4、三组在结石复发率上,差异无统计学意义(P0.05)。5、三组治疗前后安全指标比较无异常。结论:利胆汤对腹腔镜下保胆取石术后胆囊功能具有明显的良性调节作用,在改善胆囊收缩功能,降低胆囊厚度,减少术后腹泻并发症的发生,优于华沙利胆片,改善纳差方面与华沙利胆片效果相同。但对术后6个月内腹胀、腹痛、结石复发率方面无明显作用。利胆汤临床应用安全有效。
[Abstract]:Objective to investigate the therapeutic effect of Lidan decoction on gallbladder function and complications after laparoscopic cholelithiasis removal. To study systematically the pharmacological mechanism of Lidan decoction on gallbladder function and postoperative complications after laparoscopic cholelithiasis. The clinical application of traditional Chinese medicine (TCM) in laparoscopic cholecystectomy; Methods: from September 2014 to August 2016, 60 patients who were treated in Guangzhou traditional Chinese Medicine Hospital by laparoscopic cholelithiasis were selected. The patients were divided into three groups: blank group, control group and treatment group with 20 cases each. The three groups had the same routine treatment, nursing care and health guidance after operation, the blank group was not treated with litholytic and choledochic drugs, and the control group was given two tablets of Warsaw gallbladder three times a day for 6 months from the first day after operation. In the treatment group, Lidan decoction was given orally on the first day after operation and once in the morning and evening for 6 months. The general condition of the three groups after cholecystolithiasis was observed, and the difference of gallbladder wall thickness, gallbladder contraction rate, recurrence of gallstone and postoperative complications were detected 6 months after operation. Reexamination of blood, urine, fecal routine, heart, liver, kidney function, as a drug clinical safety evaluation index, and statistical analysis of data before and after treatment, so as to make clinical efficacy and safety evaluation. Results at 6 months after operation, the thickness of gallbladder wall in the three groups was significantly lower than that in the control group (P0.05). The control group and the treatment group were lower than the blank group, and the treatment group was lower than the control group, the difference was statistically significant (P0.05) .2.The gallbladder contraction rate of the control group and the treatment group were higher than that of the blank group at 6 months after operation, and the treatment group was higher than the control group. The incidence of diarrhea in treatment group was lower than that in control group and blank group, the difference was statistically significant (P0.05); the incidence of anorexia in treatment group was lower than that in blank group, and the incidence of anorexia in treatment group was lower than that in blank group. The difference was statistically significant, but there was no significant difference between the control group and the treatment group (P0.05); the three groups in abdominal distension, abdominal pain, the difference was not statistically significant (P0.05) .4, the three groups in the recurrence rate of stones, The difference was not statistically significant (P0.05). 5. There was no abnormal safety index before and after treatment in the three groups. Conclusion: Lidan decoction has obvious benign regulation effect on gallbladder function after laparoscopic cholecystectomy, which is superior to Warsaw gallbladder tablet in improving gallbladder contraction function, decreasing gallbladder thickness and reducing complications of postoperative diarrhea. The effect of improving anorexia was the same as that of Warsaw Lidan tablet. But there was no significant effect on abdominal distension, abdominal pain and recurrence rate of calculi within 6 months after operation. The clinical application of Lidan decoction is safe and effective.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R657.4
，
本文编号：2196311
[Abstract]:Objective to investigate the therapeutic effect of Lidan decoction on gallbladder function and complications after laparoscopic cholelithiasis removal. To study systematically the pharmacological mechanism of Lidan decoction on gallbladder function and postoperative complications after laparoscopic cholelithiasis. The clinical application of traditional Chinese medicine (TCM) in laparoscopic cholecystectomy; Methods: from September 2014 to August 2016, 60 patients who were treated in Guangzhou traditional Chinese Medicine Hospital by laparoscopic cholelithiasis were selected. The patients were divided into three groups: blank group, control group and treatment group with 20 cases each. The three groups had the same routine treatment, nursing care and health guidance after operation, the blank group was not treated with litholytic and choledochic drugs, and the control group was given two tablets of Warsaw gallbladder three times a day for 6 months from the first day after operation. In the treatment group, Lidan decoction was given orally on the first day after operation and once in the morning and evening for 6 months. The general condition of the three groups after cholecystolithiasis was observed, and the difference of gallbladder wall thickness, gallbladder contraction rate, recurrence of gallstone and postoperative complications were detected 6 months after operation. Reexamination of blood, urine, fecal routine, heart, liver, kidney function, as a drug clinical safety evaluation index, and statistical analysis of data before and after treatment, so as to make clinical efficacy and safety evaluation. Results at 6 months after operation, the thickness of gallbladder wall in the three groups was significantly lower than that in the control group (P0.05). The control group and the treatment group were lower than the blank group, and the treatment group was lower than the control group, the difference was statistically significant (P0.05) .2.The gallbladder contraction rate of the control group and the treatment group were higher than that of the blank group at 6 months after operation, and the treatment group was higher than the control group. The incidence of diarrhea in treatment group was lower than that in control group and blank group, the difference was statistically significant (P0.05); the incidence of anorexia in treatment group was lower than that in blank group, and the incidence of anorexia in treatment group was lower than that in blank group. The difference was statistically significant, but there was no significant difference between the control group and the treatment group (P0.05); the three groups in abdominal distension, abdominal pain, the difference was not statistically significant (P0.05) .4, the three groups in the recurrence rate of stones, The difference was not statistically significant (P0.05). 5. There was no abnormal safety index before and after treatment in the three groups. Conclusion: Lidan decoction has obvious benign regulation effect on gallbladder function after laparoscopic cholecystectomy, which is superior to Warsaw gallbladder tablet in improving gallbladder contraction function, decreasing gallbladder thickness and reducing complications of postoperative diarrhea. The effect of improving anorexia was the same as that of Warsaw Lidan tablet. But there was no significant effect on abdominal distension, abdominal pain and recurrence rate of calculi within 6 months after operation. The clinical application of Lidan decoction is safe and effective.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R657.4
，
本文编号：2196311
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