摘要
目的:探究加减大柴胡汤对胆总管结石湿热证患者热证候及肝功能的影响。方法:选取江苏省苏州市相城区第二人民医院2021年6月—2023年6月符合标准的118例胆总管结石湿热证患者作为研究对象。所有患者进行基础治疗:根据患者病情进行必要的抗感染、止痛、保肝治疗以及手术治疗。另外实施加减大柴胡汤治疗。观察加减大柴胡汤治疗前后的总有效率、中医症候积分、肝功能指标变化、炎性因子水平变化、并发症。结果:加减大柴胡汤治疗后总有效率(96.61%)高于治疗前(89.83%),经χ^(2)检验,差异有统计学意义(χ^(2)=4.291,P=0.038)。加减大柴胡汤治疗后的中医症候积分均低于治疗前,经t检验,差异有统计学意义(P<0.05)。加减大柴胡汤治疗后的肝功能指标丙氨酸转氨酶、天冬氨酸转氨酶、总胆红素、γ谷氨酰转移酶均低于治疗前,经t检验,差异有统计学意义(P<0.05)。加减大柴胡汤治疗后的白细胞介素-6、肿瘤坏死因子-ɑ低于治疗前,白细胞介素-10高于治疗前,差异显著,P<0.05。118例患者中急性胰腺炎2例,急性胆管炎3例,并发症总发生率为4.24%。结论:加减大柴胡汤能够显著改善胆总管结石湿热证患者的肝功能,减轻炎症反应,且并发症少,安全性高,能够提升治疗效果,促进患者康复。
Objective: To explore the effect of modified Dachaihu decoction on heat syndrome and liver function in patients with damp-heat syndrome of common bile duct stones. Methods: 118 patients with common bile duct stones and damp-heat syndrome who met the standards in our hospital from June 2021 to June 2023 were selected as the re-search subjects. All patients receive basic treatment: necessary anti-infection, analgesic, liver-protective treatment and surgical treatment according to the patient’s condition. In addition, modified and subtracted Dachaihu decoction treatment was implemented. Observe the total effective rate, TCM symptom scores, changes in liver function indica-tors, changes in inflammatory factor levels, and complications before and after treatment with the modified Da Chaihu Decoction. Results: The total effective rate after treatment with modified Dachaihu decoction (96.61%) was higher than before treatment (89.83%). After χ^(2) test, the difference was statistically significant (χ^(2) =4.291, P=0.038). The TCM symptom scores after treatment with modified Dachaihu decoction were lower than before treatment. The t test showed that the difference was statistically significant (P<0.05). The liver function indicators ALT, AST, TBIL, and GGT after treatment with modified Dachaihu decoction were all lower than before treatment. The t test showed that the differences were statistically significant (P<0.05). IL-6 and TNF-ɑ after treatment with Da Chaihu Decoction were lower than be-fore treatment, and IL-10 was higher than before treatment, with significant differences (P<0.05). Among the 118 pa-tients, there were 2 cases of acute pancreatitis and 3 cases of acute cholangitis. , the overall complication rate was 4.24%. Conclusion: Modified Dachaihu Decoction can significantly improve liver function and reduce inflammatory response in patients with damp-heat syndrome due to common bile duct stones, with few complications and high safety. It can im-prove the treatment effect and promote the recovery of patients.
作者
高建伟
汪东升
邵锋锋
GAO Jianwei;WANG Dongsheng;SHAO Fengfeng(Suzhou Xiangcheng District Second People’s Hospital,Jiangsu Suzhou 215143,China)
出处
《中医药临床杂志》
2024年第6期1144-1148,共5页
Clinical Journal of Traditional Chinese Medicine
关键词
加减大柴胡汤
胆总管结石
湿热证
肝功能
Modified Dachaihu Decoction
Common bile duct stones
Damp-heat syndrome
Liver function
