利胆健脾汤治疗慢性胆囊炎（肝郁脾虚型）的临床研究

发布时间：2018-06-04 06:46

本文选题：利胆健脾汤 + 慢性胆囊炎　；参考：《云南中医学院》2017年硕士论文

【摘要】：目的:本课题旨在对肝郁脾虚型慢性胆囊炎的临床研究,探讨利胆健脾汤治疗慢性胆囊炎(肝郁脾虚型)的临床疗效及安全性评估,进一步探寻中医药对慢性胆囊炎的治疗作用,为中医治疗慢性胆囊炎(肝郁脾虚型)提供新的方法。方法:临床选择符合纳入标准的慢性胆囊炎患者82例,随机分为治疗组和对照组各41例。治疗组给予口服利胆健脾汤(炒柴胡10g、党参30g、茯苓30g、杭白芍15g、炒白术15g、香橼15g、粉葛30g、金钱草15g、茵陈15g、炒鸡内金10g、甘草10g-药物来源均选用云南省中医医院的中药房提供的中药小包装,由云南省中医医院中药房煎药机统一代煎中药),日1剂,3次/日,每次150ml(一袋),饭后半小时温服。对照组予口服胆舒胶囊治疗(四川济生堂生产批号:国药准字Z20026078)治疗,3次/日,2粒(0.9g)/次,饭后半小时口服。两组均于治疗4周后进行临床疗效及安全性指标观察并记录。结果:治疗前两组患者在年龄、性别和病程分布及治疗前彩超情况上比较均无统计学差异(P0.05),具有可比性。1.治疗后治疗组疾病总有效率为92.5%,与对照组的总有效率70.0%比较差异有显著统计学意义(P0.01)。2.治疗组改善中医证候有效率为95.0%,与对照组有效率75.0%相比较差异有显著统计学意义(P0.01)。3.治疗前后各单个症状积分变化的比较:治疗组在改善倦怠乏力、情绪抑郁或烦躁易怒、腹胀、大便稀溏/便秘方面明显优于对照组(P0.01),在改善右胁胀满不适、嗳气叹息、食少纳呆症状方面优于对照组(P0.05),而在改善右胁疼痛、口苦、恶心/呕吐症状方面二者比较无明显差异(P0.05)。4.治疗组改善胆囊彩色B超声像的有效率为82.5%,与对照组改善胆囊彩色B超声像的有效率65.0%比较差异有统计学意义(P0.05)。5.试验期间两组患者在尿液分析、大便常规+潜血和心电图检查均未发现明显异常变化,均未出现明显不良反应和副作用;其中两组血常规、肝功、肾功组内比较差异无统计学意义(P0.05)。结论:利胆健脾汤具有改善慢性胆囊炎(肝郁脾虚型)的疗效。与对照组比较在改善中医证候及胆囊彩色B超声像方面疗效更佳;在改善倦怠乏力、情绪抑郁或烦躁易怒、大便稀溏/便秘、腹胀、右胁胀满不适、食少纳呆、嗳气叹息症状方面优于对照组。并且其安全性良好,可以将其作为治疗慢性胆囊炎(肝郁脾虚型)的用药选择及参考。
[Abstract]:Objective: to study the clinical effect and safety of Lidan Jianpi decoction in the treatment of chronic cholecystitis with liver stagnation and spleen deficiency. To explore the therapeutic effect of traditional Chinese medicine on chronic cholecystitis and provide a new method for the treatment of chronic cholecystitis. Methods: 82 patients with chronic cholecystitis were randomly divided into treatment group (n = 41) and control group (n = 41). The treatment group was given orally Lidan Jianpi decoction (fried Bupleurum 10g, Codonopsis lanceolata 30g, Poria cocos 30g, Hangzhou White Peony 15g, fried Atractylodes macrocephalae 15g, Citron 15g, Pueraria lobata 30g, Cynthia chinensis 15g, Yinchen 15g, Fried Chicken Neijin 10g, Licorice 10g- Drug Source of Yunnan traditional Chinese Medicine Hospital Small packaging of traditional Chinese medicine, The decoction machine of traditional Chinese medicine store of Yunnan traditional Chinese Medicine Hospital was used as the sole agent of traditional Chinese medicine, one dose per day, three times a day, 150 ml (one bag, half an hour after meal). The control group was treated with oral Danshu capsule (Sichuan Jishengtang production lot number: Z20026078). The clinical efficacy and safety indexes were observed and recorded 4 weeks after treatment in both groups. Results: there was no statistical difference between the two groups in age, sex, course of disease and color Doppler ultrasound before treatment (P 0.05). After treatment, the total effective rate of disease in the treatment group was 92.5%, which was significantly different from that in the control group (70.0%). The effective rate of improving TCM syndromes in the treatment group was 95.0%, which was significantly different from that of the control group (75.0%). Comparison of scores of individual symptoms before and after treatment: the treatment group was superior to the control group in improving burnout, depression or irritability, abdominal distension, loose stools / constipation, improving the right flank full of discomfort, belching and sighing. There was no significant difference between the two groups in improving the pain of right flank, bitter mouth and nausea / vomiting symptoms in the control group (P 0.05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05). The effective rate of improving the B-ultrasound image of gallbladder in the treatment group was 82.5, which was significantly higher than that in the control group (65.0%). During the trial, no abnormal changes were found in urine analysis, stool routine occult blood and electrocardiogram examination, and there were no obvious adverse reactions and side effects in both groups, including blood routine, liver function, liver function, There was no significant difference in renal function group (P 0.05). Conclusion: Lidan Jianpi decoction can improve chronic cholecystitis. Compared with the control group, it was more effective in improving TCM syndromes and cholecyst color B ultrasound images, and in improving burnout, depression or irritability, loose stool / constipation, abdominal distension, right flounder, full of discomfort, low food intake, etc. The symptoms of belching and sighing were better than that of the control group. And its safety is good, can be used as the treatment of chronic cholecystitis (liver stagnation and spleen deficiency type) drug choice and reference.
【学位授予单位】：云南中医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R259

【参考文献】