摘要
目的:分析化裁柴胡桂枝干姜汤治疗胆囊切除术后腹泻胆热脾寒证的治疗效果。方法:选取2021年1月—2022年1月于南京市中西医结合医院脾胃病科、普外科门诊及住院就诊,且诊断为胆囊切除术后腹泻胆热脾寒证患者72例,采用随机数字表法分为观察组36例和对照组36例,分别给予化裁柴胡桂枝干姜汤、复方阿嗪米特肠溶片口服治疗,疗程皆为8周。对比分析两组治疗效果、两组治疗前后中医证候积分、胆囊收缩素(cholecystokinin, CCK)、血管活性肠肽(vasoactinei intrestinal peptide, VIP)、胃泌素(gastrin, GAS)水平的变化情况以及两组治疗后复发情况,并记录不良反应。结果:观察组近期治疗总有效率为91.67%(33/36),显著高于对照组的69.44%(25/36)(P<0.05);治疗结束3个月后随访,观察组复发率为5.56%(2/36),明显低于对照组的22.22%(8/36)(P<0.05);两组治疗后中医证候积分均显著低于治疗前(P<0.05),CCK、VIP、GAS水平均显著改善(P<0.05),观察组治疗后各项指标改善情况均优于对照组(P<0.05);两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:化裁柴胡桂枝干姜汤治疗胆囊切除术后腹泻胆热脾寒证的临床疗效显著,可有效缓解症状,下调CCK、VIP、GAS水平,对降低远期复发率具有重要价值。
Objective:To analyze the therapeutic effect of modified Chaihu Guizhi Ganjiang Decoction in treatment of post-cholecystectomy diarrhea of Gallbladder-heat and Spleen-cold syndrome.Methods:72 patients with post-cholecystectomy diarrhea of Gallbladder-heat and Spleen-cold syndrome were randomly divided into the observation group and the control group,with 36 cases in each group.The observation group was treated with modified Chaihu Guizhi Ganjiang Decoction and the control group was treated with Compound Azintamide Enteric-Coated Tablet,respectively.The course of treatment was 8 weeks.The therapeutic effects was compared between the two groups.The TCM symptoms score,the levels of cholecystokinin(CCK),vasoactive intestinal peptide(VIP)and gastrin(GAS)were compared and analyzed before and after the treatment in the two groups.The recurrence of adverse reactions was recorded in the two groups.Results:The total effective rate of the observation group was 91.67%(33/36),which was significantly higher than 69.44%(25/36)of the control group(P<0.05).During 3 months of follow-up,the recurrence rate of the observation group was 5.56%(2/36),which was significantly lower than 22.22%(8/36)of the control group(P<0.05).The TCM symptoms score was significantly lower after the treatment than that before the treatment in the two groups(P<0.05);the levels of CCK,VIP and GAS were significantly improved after the treatment in the two groups(P<0.05);the improvement of each index was more significant in the observation group than that in the control group(P<0.05).There was no statistical difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Modified Chaihu Guizhi Ganjiang Decoction has a significant clinical effect in treatment of post-cholecystectomy diarrhea of Gallbladder-heat and Spleen-cold syndrome,which can effectively relieve symptoms,down-regulate levels of CCK,VIP and GAS,and is of great significance in reducing long-term recurrence rate.
作者
李思宇
刘万里
黄玉珍
吴昊
LI Siyu;LIU Wanli;HUANG Yuzhen;WU Hao(Nanjing University of Chinese Medicine,Nanjing 210023,China;Nanjing Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Nanjing University of Chinese Medicine,Nanjing 210014,China)
出处
《中医药学报》
CAS
2023年第5期73-78,共6页
Acta Chinese Medicine and Pharmacology
基金
2020年度南京市卫生科技发展专项资金(YKK20161)。
关键词
胆囊切除术后腹泻
柴胡桂枝干姜汤
胆热脾寒证
胆囊收缩素
血管活性肠肽
胃泌素
Post-cholecystectomy diarrhea
Chaihu Guizhi Ganjiang Decoction
Gallbladder-heat and Spleen-cold syndrome
Cholecystokinin
Vasoactive intestinal peptide
Gastrin
