消石利胆胶囊联合优思弗治疗慢性胆囊炎、胆囊结石的临床疗效观察

发布时间：2018-11-14 15:12

【摘要】：目的:以胆舒胶囊治疗作对照,探讨消石利胆胶囊联合熊去氧胆酸胶囊(优思弗)治疗慢性胆囊炎、胆囊结石的临床疗效。方法:观察2014年9月至2016年12月期间来吉林大学第二医院肝胆胰内科就诊的经腹部彩超确诊的慢性胆囊炎患者82例。随机分为3组,单用胆舒胶囊组即对照1组27例,口服胆舒胶囊每次2粒,日3次;单用消石利胆胶囊组即对照2组28例,给予消石利胆胶囊每次3粒,日3次口服;消石利胆胶囊联合熊去氧胆酸胶囊(优思弗)组即实验1组27例,给予消石利胆胶囊每次3粒,日3次口服,加用熊去氧胆酸胶囊750mg,日1次口服。经腹部彩超确诊的慢性胆囊炎胆结石患者115例。随机分为4组,单用优思弗组即对照3组25例,给予优思弗750mg,日1次口服;单用消石利胆胶囊组即对照4组30例,给予消石利胆胶囊每次3粒,日3次口服;胆舒胶囊联合优思弗组即对照5组29例,给予胆舒胶囊每次2粒,日3次口服,加用优思弗750mg,日1次口服;消石利胆胶囊联合熊去氧胆酸胶囊组即实验2组31例,给予消石利胆胶囊每次3粒,日3次口服加用熊去氧胆酸胶囊750mg,日1次口服。慢性胆囊炎组疗程为4周,慢性胆囊炎胆结石组疗程为12周。治疗后2周时检查并记录慢性胆囊炎组患者右上腹痛、口苦、后背部疼痛、胆囊区压痛、进食后腹胀消化不良等一般症状改善情况。治疗后4周时检查并记录慢性胆囊炎胆结石患者右上腹痛、口苦、后背部疼痛、胆囊区压痛、进食后腹胀消化不良等一般症状改善情况。慢性胆囊炎胆结石组分别于治疗后4周、12周时记录患者胆囊结石的溶石情况。结果:1、慢性胆囊炎患者在治疗2周时,实验组患者在右上腹痛、胆囊区压痛、口苦、后背部疼痛、进食后腹胀消化不良等方面改善情况明显优于对照组,差异有统计学意义(P0.05);治疗前后症状积分(均值)下降实验组明显优于对照组(P0.01);组内比较治疗前后症状积分(均值)下降有明显差异(P0.01)。2、慢性胆囊炎胆结石患者治疗4周时,实验组患者在右上腹痛、胆囊区压痛、口苦、进食后腹胀消化不良等症状改善方面明显优于对照组,差异有统计学意义(P0.05);在后背部疼痛改善上实验组2明显优于对照组3及对照组4,差异有统计学意义(P0.05);实验组2略高于对照组5,但差异无统计学意义(P0.05);治疗前后症状积分(均值)下降实验组明显优于对照组(P0.01);组内比较治疗前后症状积分(均值)下降有明显差异(P0.01)。3、慢性胆囊炎胆结石患者在4周溶石治疗实验组有效率为45.2%,对照组3、对照组4及对照组5的有效率分别是16.0%、13.3%、20.7%;12周时,实验组有效率为87.1%,对照组3、对照组4及对照组5的有效率分别是56.0%、53.3%、62.1%;实验组患者的溶石治疗效果与对照组相比有明显差异(P0.05)。结论:消石利胆胶囊联合优思弗治疗单纯慢性胆囊炎患者,在改善一般临床症状上明显优于单一药物治疗组,在有效治疗疗程上联合治疗组与单一用药组比较明显缩短;消石利胆胶囊联合优思弗治疗慢性胆囊炎胆结石患者,不仅在改善患者临床症状方面,尤其是长疗程12周时,溶石治疗效果更为显著,明显优于对照组,联合治疗值得临床上推广应用。
[Abstract]:Objective: To control the treatment of chronic cholecystitis and cholecystolithiasis in the treatment of chronic cholecystitis and cholecystolithiasis. Methods: 82 cases of chronic cholecystitis diagnosed by abdominal color Doppler ultrasound from the second hospital of Jilin University from September 2014 to December 2016 were observed. The two groups were randomly divided into 3 groups, the single-use cholecuroshu capsule group (27 cases in control group 1), the oral cholecuroshu capsule 2 granules each time, and the day 3 times; the single-use anti-stone choleretic capsule group, i.e., the control group 2, 28 cases, and the anti-calculus and choleretic capsule was given three capsules each time, and the three times of the day were taken orally; Xiaoshi Lidan capsule combined with ursodeoxycholic acid capsule (Youthf), one of the 27 patients in the experimental group, was given three capsules at a time of 3 times per day, and was orally taken with a bear desoxycholic acid capsule (750mg, day 1). 115 patients with chronic cholecystitis and cholelithiasis diagnosed by abdominal color ultrasound. The four groups were randomly divided into 4 groups, 25 cases of control group and 25 cases of control group. The capsules were orally administered once every 2 capsules, daily for 3 times, and with the above-mentioned two groups. The combined bear desoxycholic acid capsule group (31 cases of the experimental group 2) was administered by the combination of the Xiao Shi Lidan capsule combined with the Ursodeoxycholic acid capsule group, which was orally administered with the Ursodeoxycholic acid capsule on the day of 3 times and the day was once orally taken. The treatment course of the chronic cholecystitis group was 4 weeks, and the treatment course of the chronic cholecystitis group was 12 weeks. After 2 weeks of treatment, the patients with chronic cholecystitis were examined and recorded with general symptoms such as abdominal pain, bitter taste, back pain, tenderness in the gallbladder, and abdominal distension and indigestion after eating. After 4 weeks of treatment, the patients with chronic cholecystitis and cholelithiasis were examined and recorded with the general symptoms such as abdominal pain, bitter taste, back pain, tenderness in the gallbladder, abdominal distension and indigestion after eating. The gallstone formation in patients with chronic cholecystitis was recorded at 4 and 12 weeks after treatment. Results: 1. When the patients with chronic cholecystitis were treated for 2 weeks, the patients in the experimental group had abdominal pain in the right, the pain in the gallbladder area, the pain of the mouth, the pain of the back and the back, and the abdominal distension and indigestion after eating. The difference was statistically significant (P <0.05). The integral (mean) of the symptoms before and after treatment was significantly better than that in the control group (P0.01), and there was a significant difference in the reduction of the symptom score (mean) before and after the treatment in the group (P0.01). In the treatment of the patients with chronic cholecystitis and cholelithiasis for 4 weeks, the patients in the experimental group had the abdominal pain in the right, the pain in the gallbladder area, and the bitter taste. There was a significant difference between the control group and the control group (P <0.05), and the experimental group 2 was slightly higher than that in the control group (P <0.05). However, there was no significant difference in the difference between the treatment group and the control group (P 0.01), and the difference of the symptom score (mean value) in the treatment group was significantly different from that in the control group (P0.01). The effective rate of the patients with chronic cholecystitis and cholelithiasis was 40.2% in the experimental group, the control group 3, the control group 4 and the control group 5 were respectively 16. 0%, 13. 3%, 20. 7%, 12 weeks, the effective rate of the experimental group was 87.1%, and the control group 3, The effective rate of the control group 4 and the control group 5 was 56. 0%, 53. 3%, and 62.1%, respectively. The treatment effect of the treatment group in the experimental group was significantly different from that of the control group (P0.05). Conclusion: The treatment of simple chronic cholecystitis with the combination of Xiao-Shi Lidan capsule and high-optimal method is superior to the single-drug treatment group in the improvement of the general clinical symptoms, and the combination of the combination therapy group and the single-use group is obviously shortened in the effective treatment course; In the treatment of patients with chronic cholecystitis and cholelithiasis, the patients with chronic cholecystitis and cholelithiasis are treated with Xiaoshi Lidan Capsule, especially in the 12-week long course of treatment, which is better than that of the control group, and the combination therapy is worthy of clinical popularization and application.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R575.6

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