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青海省第四人民医院,西宁 810001
曹海芳,副主任医师,从事肝病、消化临床工作,E-mail:hnmeng815@163.com
* 路青华,主任医师,从事肝病、消化临床工作,E-mail:1736853849@qq.com
纸质出版日期:2021-08-05,
网络出版日期:2020-12-11,
收稿日期:2020-10-29,
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曹海芳,张瑜,魏胜泰等.柴胡疏肝散加减治疗慢性胆囊炎胆石症及胆囊功能和炎症因子的影响[J].中国实验方剂学杂志,2021,27(15):63-67.
CAO Hai-fang,ZHANG Yu,WEI Sheng-tai,et al.Effect of Modified Chaihu Shugansan on Gallbladder Function and Inflammatory Cytokines Levels in Treatment of Chronic Cholecystitis Cholelithiasis[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(15):63-67.
曹海芳,张瑜,魏胜泰等.柴胡疏肝散加减治疗慢性胆囊炎胆石症及胆囊功能和炎症因子的影响[J].中国实验方剂学杂志,2021,27(15):63-67. DOI: 10.13422/j.cnki.syfjx.20210331.
CAO Hai-fang,ZHANG Yu,WEI Sheng-tai,et al.Effect of Modified Chaihu Shugansan on Gallbladder Function and Inflammatory Cytokines Levels in Treatment of Chronic Cholecystitis Cholelithiasis[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(15):63-67. DOI: 10.13422/j.cnki.syfjx.20210331.
目的
2
观察柴胡疏肝散加减联合熊去氧胆酸片治疗慢性胆囊炎胆石症(肝胆气滞证)的临床疗效及对炎症因子的影响。
方法
2
将120例患者按随机数字表法分为观察组和对照组各60例。两组患者均给予生活方式干预,口服熊去氧胆酸片治疗,50 mg/次,早晚进餐时分次服用。在此基础上,对照组口服胰胆舒胶囊,4粒/次,3次/d。观察组口服柴胡疏肝散加减,1剂/d。两组疗程均为3个月。进行治疗前后中医症状评分;评价治疗前后慢性胆囊炎症超声情况、胆囊收缩功能和结石情况;检测治疗前后白细胞介素-6(IL-6),IL-8,肿瘤坏死因子-
α
(TNF-
α
)和核转录因子-
κ
B (NF-
κ
B)水平;进行安全性评价;比较两组中医证候疗效,影像学和消除胆囊结石疗效。
结果
2
观察组中医证候疗效、慢性胆囊炎彩色超声疗效和胆石症影像学疗效均明显优于对照组(
Z
=2.104
,Z
=2.076,
Z
=2.101,
P
<
0.05);观察组胆囊壁厚度和胆囊容积均小于对照组(
P
<
0.01),胆囊收缩功能高于对照组(
P
<
0.01);观察组IL-6,IL-8,TNF-
α
和NF-
κ
B均低于对照组(
P
<
0.01)。
结论
2
柴胡疏肝散加减内服联合熊去氧胆酸片治疗慢性胆囊炎胆石症(肝胆气滞证)的临床疗效,影像学和消除胆囊炎胆石症疗效均高于胰胆舒胶囊联合熊去氧胆酸的方案,并可减轻炎症反应,增强胆囊收缩功能,临床使用安全。
Objective
2
To observe the clinical efficacy and influence of modified Chaihu Shugansan combined with ursodeoxycholic acid tablets on inflammatory factors in treatment of chronic cholecystitis cholelithiasis (stagnation of liver and gallbladder Qi).
Method
2
One hundred and ten patients were randomly divided into control group (60 cases) and observation group (60 cases). Both groups received lifestyle intervention, and oral ursodeoxycholic acid tablets, 50 mg/time, taken in the morning and evening meals. Patients in control group additionally took Yidanshu capsules orally, 4 capsules/time, 3 times/day. Patients in observation group additionally took modified Chaihu Shugansan orally, 1 dose/day. The treatment courses continued 3 months in both groups. Before and after treatment, traditional Chinese medicine (TCM) symptom scores were graded, the ultrasound status of chronic gallbladder inflammation, gallbladder contraction function and stones was graded, the levels of interleukin-6 (IL-6), IL-8, tumor necrosis factor-
α
(TNF-
α
) and nuclear transcription factor-
κ
B(NF-
κ
B)Were detected, and safety was evaluated. The efficacy for TCM syndromes, imaging efficacy and the efficacy for eliminating gallbladder stones were compared between the two groups.
Result
2
The efficacy for TCM syndrome, efficacy on color ultrasound for chronic cholecystitis and the efficacy on imaging for cholelithiasis in the observation group were all better than those in the control group(
Z
=2.104
,Z
=2.076,
Z
=2.101,
P
<
0.05). The thickness of gallbladder wall and volume of the gallbladder of the observation group were smaller than those of the control group (
P
<
0.01), and gallbladder contraction function was higher than that in control group (
P
<
0.01). Levels of IL-6, IL-8, TNF-
α
and NF-
κ
B in observation group were lower than those in control group (
P
<
0.01).
Conclusion
2
modified Chaihu Shugansan combined with ursodeoxycholic acid in the treatment of chronic cholecystitis and cholelithiasis (liver and gall Qi stagnation) is better than Yidanshu capsule combined with ursodeoxycholic acid sour scheme in terms of clinical efficacy, imaging efficacy, and elimination of gallbladder stones. It can reduce inflammation, and enhance gallbladder contraction, with high safety in clinical use.
慢性胆囊炎胆石症肝胆气滞证柴胡疏肝散胆囊收缩功能炎症因子
chronic cholecystitischolelithiasisstagnation of liver and gallbladder QiChaihu Shugansangallbladder contractioninflammatory factors
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