疏肝二金汤治疗慢性胆囊炎肝胆气滞证的临床疗效观察

发布时间：2018-05-02 07:49

本文选题：疏肝二金汤 + 慢性胆囊炎　；参考：《湖南中医药大学》2016年硕士论文

【摘要】：目的:探讨疏肝二金汤治疗慢性胆囊炎肝胆气滞证的临床疗效和安全性,以及其对胆囊收缩功能的影响。方法:将符合纳入标准的60例慢性胆囊炎肝胆气滞证患者,采用随机数字表法分为两组,治疗组和对照组各30例。分别予以疏肝二金汤、胆石利通片治疗30天,观察患者在治疗前后临床症状及超声检查下胆囊大小、形态等变化,并通过脂餐试验测定胆囊排空指数,观察胆囊收缩功能变化情况。结果:1.临床疗效评定:治疗后,治疗组和对照组的总有效率分别为93.33%、66.67%,两组比较有统计学意义(P0.05)。两组治疗前后综合症状积分和积分差值比较有统计学意义(P0.05)。对治疗前后两个主症的积分情况进行比较时,治疗组均有统计学意义(P0.05);对照组第一个主症(右胁胀痛或隐痛)治疗前后比较有统计学意义(P0.05),而第二个主症(疼痛因情志变化而加重或减轻)治疗前后比较无统计学意义(P0.05)。2.超声检查疗效评定:两组治疗前后超声检查提示治疗组的有效率为93.33%,明显高于对照组(68.75%),两者比较有统计学意义(P0.05)。治疗后两组患者的胆囊排空指数分别较前比较,均有统计学意义(P0.05);两组治疗前后GBEF差值比较有统计学意义(P0.05)。治疗后两组患者的胆囊收缩功能分别较前比较,均有统计学意义(P0.05)。治疗后两组患者胆囊收缩功能之间比较无统计学意义(P0.05)。结论:疏肝二金汤治疗可改善慢性胆囊炎肝胆气滞证患者总的临床症状,提高总有效率,且在改善主症方面有优势。也可改善该病患者超声检查下胆囊的壁厚、毛糙度及透声性等,并增强胆囊收缩功能,提示疏肝二金汤可能能够通过促进胆囊的收缩,加大胆囊排空率,达到利胆作用。
[Abstract]:Objective: to investigate the clinical efficacy and safety of Shugan Erjin decoction in treating chronic cholecystitis with stagnation of liver-gallbladder qi and its effect on gallbladder contraction. Methods: sixty cases of chronic cholecystitis with liver and gallbladder qi stagnation were divided into two groups by random number table, 30 cases in treatment group and 30 cases in control group. The patients were treated with Shugan Erjin decoction and cholestasis Litong tablet for 30 days. The changes of gallbladder size and shape were observed before and after treatment, and the gallbladder emptying index was measured by fat meal test. The changes of gallbladder contraction function were observed. The result is 1: 1. Evaluation of clinical efficacy: after treatment, the total effective rates of the treatment group and the control group were 93.33 and 66.67, respectively. The two groups had statistical significance (P 0.05). Before and after treatment, there were significant differences in the score and the difference between the two groups (P 0.05). When comparing the scores of the two main symptoms before and after treatment, In the treatment group, there was significant difference between the first main symptom (right flank pain or latent pain) before and after treatment, but the second main symptom (the pain was aggravated or alleviated due to the change of emotion) had no statistical significance before and after treatment. Evaluation of the curative effect of ultrasonic examination: the effective rate of the treatment group was 93.33, which was significantly higher than that of the control group (68.75g / kg) before and after treatment, and the comparison between the two groups was statistically significant (P 0.05). After treatment, the gallbladder emptying index of the two groups was significantly higher than that of the former, and the difference of GBEF between the two groups before and after treatment was statistically significant (P 0.05). After treatment, the gallbladder contraction function of the two groups was significantly higher than that of the former group (P 0.05). There was no significant difference in gallbladder systolic function between the two groups after treatment (P 0.05). Conclusion: Shugan Erjin decoction can improve the total clinical symptoms of chronic cholecystitis patients with stagnation of liver-gallbladder qi, improve the total effective rate, and have an advantage in improving the main symptoms of chronic cholecystitis. It can also improve the wall thickness, roughness and sound permeability of gallbladder under ultrasonic examination, and enhance the contraction function of gallbladder. It suggests that Shugan Erjin decoction can promote the contraction of gallbladder, increase the rate of gallbladder emptying, and achieve the effect of choledochism.
【学位授予单位】：湖南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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