| 摘要: |
| 目的:研究胆总管结石合并胆囊炎患者在胆总管切开取石术后采用柴胡桂枝干姜汤化裁治疗对患者胃肠功能恢复的效果。方法:纳入2022年4月—2024年4月本院收治的胆总管结石合并胆囊炎患者122例，按随机数字表法随机分为常规组和研究组两组，每组各61例。常规组术后给予常规西药治疗，研究组则在此基础上加用柴胡桂枝干姜汤化裁治疗，观察两组治疗后中医证候积分、主要症状消失时间、住院时间和胃肠激素、炎症指标水平变化。结果:两组治疗后右上腹痛、纳少、腹胀积分明显降低，研究组右上腹痛、纳少、腹胀积分明显低于常规组(P <0.05)；研究组右上腹痛、纳少、腹胀消失时间及住院时间短于常规组(P <0.05)；两组治疗后胃动素、血管活性肠肽(VIP)水平升高，研究组胃动素、VIP水平高于常规组(P <0.05)；两组治疗后中性粒细胞与淋巴细胞比值(NLR)、白细胞介素-6(IL-6)水平降低，研究组NLR、IL-6水平低于常规组(P <0.05)。结论:胆总管结石合并胆囊炎患者在胆总管切开取石术后采用柴胡桂枝干姜汤化裁治疗有助于减轻腹痛、腹胀、纳少等症状，同时还能调节胃肠激素和NLR、IL-6等炎症指标水平，从而促进患者胃肠功能恢复。 |
| 关键词: 胆总管结石 胆囊炎 胆总管切开取石术 柴胡桂枝干姜汤 胃肠功能 |
| DOI：10.3969/j.issn.1007-6948.2025.05.010 |
| 投稿时间：2025-01-07 |
| 基金项目:浙江省中医药科技计划项目(2023ZL090) |
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| Influence of modified Chaihu Guizhi Ganjiang decoction on gastrointestinal function recovery in patients with choledocholithiasis complicated with cholecystitis receiving choledocholithotomy |
| YAN Lin,HUANG Hai,NI Zhong-kai |
| Department of General Surgery, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou 310000, China |
| Abstract: |
| Objective To explore and analyze the effect of modified Chaihu Guizhi Ganjiang decoction on the recovery of gastrointestinal function in patients with choledocholithiasis complicated with cholecystitis after choledocholithotomy. Methods Totally 122 patients with choledocholithiasis and cholecystitis in the hospital were included from April 2022 to April 2024, and were randomly and evenly divided into two groups, with 61 cases in each group. The conventional group was treated with conventional western medicine after surgery, whereas the study group was added with modified Chaihu Guizhi Ganjiang decoction on this basis. The changes of TCM syndromes scores, disappearance durations of main symptoms, hospitalization time, gastrointestinal hormones and inflammatory indicators were observed in both groups after treatment. Results After treatment, the scores of right upper abdominal pain, anorexia and abdominal distension in the two groups were significantly decreased, and the above scores in the study group were significantly lower than those in the conventional group (P <0.05). The disappearance durations of right upper abdominal pain, anorexia and abdominal distension and hospitalization time were shorter in the study group than those in the conventional group (P <0.05). The levels of motilin and vasoactive intestinal peptide (VIP) were enhanced in both groups after treatment, and the levels of motilin and VIP in the study group were higher compared to the conventional group (P <0.05). After treatment, the neutrophil-to-lymphocyte ratio (NLR) and interleukin-6 (IL-6) in both groups were decreased, and the NLR and IL-6 in the study group were lower compared with those in the conventional group (P <0.05). Conclusion The application of modified Chaihu Guizhi Ganjiang decoction after choledocholithotomy is helpful to alleviate the symptoms such as abdominal pain, abdominal distension and anorexia in patients with choledocholithiasis and cholecystitis. In addition, it can also regulate the levels of gastrointestinal hormones, NLR, IL-6 and other inflammatory indicators, so as to promote the recovery of gastrointestinal function. |
| Key words: Choledocholithiasis cholecystitis choledocholithotomy Chaihu Guizhi Ganjiang decoction gastrointestinal function |
