苗药金茵化石颗粒联合化学药治疗慢性结石性胆囊炎的临床观察

发布时间：2018-03-28 19:08

本文选题：金茵化石颗粒　切入点：化学药　出处：《中国药房》2017年35期

【摘要】：目的:探讨苗药金茵化石颗粒联合化学药治疗慢性结石性胆囊炎的临床疗效及安全性。方法:选取2014年1月-2016年1月我院收治的慢性结石性胆囊炎120例,按随机数字表法分为对照组和观察组,各60例。对照组患者餐前给予硫酸镁注射液10 m L,tid;餐后口服阿莫西林片0.5 g,tid+消旋山莨菪碱片10 mg,tid+复方胆通片1片,tid。观察组患者在对照组基础上给予苗药金茵化石颗粒15 g,tid。两组患者均连续治疗4周。观察两组患者临床疗效及上腹疼痛、恶心厌油腻、结石改善情况,并比较两组患者治疗前后的胆囊壁厚度,白细胞介素2(IL-2)、IL-15水平和胆固醇7α羟化酶(CYP7A1)、二磷酸葡萄糖醛酸基转移酶(B-UGT)m RNA及蛋白表达水平,记录两组患者不良反应发生情况。结果:观察组患者的临床总有效率为96.67%,显著高于对照组的88.33%,差异有统计学意义(P0.05)。治疗后1 d、1周,观察组患者上腹疼痛改善率分别为63.33%、81.67%,显著高于对照组的36.67%、50.00%,差异均有统计学意义(P0.05);两组患者治疗后2~4周的上腹疼痛改善率以及治疗后恶心厌油腻改善率比较,差异均无统计学意义(P0.05)。观察组患者的结石排净率为33.33%,显著高于对照组的11.67%,差异有统计学意义(P0.05)。治疗前,两组患者胆囊壁厚度,IL-2、IL-15水平和CYP7A1、B-UCT m RNA及蛋白表达水平比较,差异均无统计学意义(P0.05);治疗后,两组患者胆囊壁厚度和IL-2、IL-15水平均显著降低,CYP7A1、B-UCT m RNA及蛋白表达水平均显著升高,且观察组显著优于对照组,差异均有统计学意义(P0.05)。两组患者不良反应发生率比较,差异无统计学意义(P0.05)。结论:苗药金茵化石颗粒联合化学药治疗慢性结石性胆囊炎疗效显著,能有效改善患者右上腹疼痛和恶心厌油腻症状,降低IL-2、IL-15水平,上调CYP7A1、B-UCT m RNA及其蛋白表达,且安全性较高。
[Abstract]:Objective: to investigate the clinical efficacy and safety of Jinyin fossil granules combined with chemical drugs in the treatment of chronic calculous cholecystitis. Methods: 120 cases of chronic calculous cholecystitis treated in our hospital from January 2014 to January 2016 were selected. According to the random digital table method, they were divided into control group and observation group. 60 patients in each group were treated with magnesium sulfate injection 10 mL / L before meal and 10 mg / kg anisodamine tablet 10 mg / kg of anisodamine tablet after meal respectively. The patients in the observation group were given the fossil of Jinyin vaccine on the basis of the control group, while the patients in the observation group were given the tablet of Amoxicillin 0.5 g / L after meal and 1 tablet of compound Dantong tablet (10 mg / g) of Anisodamine tablets. The patients in both groups were treated continuously for 4 weeks. The clinical curative effect and upper abdominal pain were observed in both groups. After treatment, the thickness of gallbladder wall, the level of IL-15 and the expression levels of cholesterol 7 伪 -hydroxylase CYP7A1C, glucuronyltransferase B-UGTM RNA and protein before and after treatment were compared between the two groups. Results: the total effective rate of the patients in the observation group was 96.67, which was significantly higher than that in the control group (88.33), and the difference was statistically significant (P 0.05). The improvement rate of upper abdominal pain in the observation group was 63.33 and 81.67 respectively, which was significantly higher than that in the control group (36.67 and 50.005), and the difference was statistically significant (P 0.05), and the improvement rate of upper abdominal pain and nausea and anaerobic greasy after 24 weeks treatment were compared between the two groups. There was no significant difference between the two groups (P 0.05). The stone excretion rate in the observation group was 33.33, which was significantly higher than that in the control group (11.67%). The difference was statistically significant (P 0.05). Before treatment, the level of IL-2 IL-15 and the expression of CYP7A1 B-UCT m RNA and protein were compared between the two groups. After treatment, the thickness of gallbladder wall and the level of IL-15 decreased significantly, and the expression of CYP7A1B-UCT m RNA and protein in the observation group were significantly higher than that in the control group. There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion: the therapeutic effect of Jinyin fossil granules combined with chemical drugs on chronic calculous cholecystitis is significant. It can effectively improve the right upper abdominal pain and nausea, reduce the level of IL-15, and up-regulate the expression of CYP7A1 B-UCT m RNA and its protein.
【作者单位】：黔南布依族苗族自治州中医医院普外科;黔南民族师范学院贵州省高校民族药用植物资源开发工程研究中心;
【基金】：贵州省中医药管理局中医药、民族医药科学技术研究课题(No.QYZZ2015084) 贵州省普通高等学校民族药用植物资源开发工程研究中心建设项目(No.黔教合KY字[2014]227号)
【分类号】：R575.61

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