利胆排石汤联合纤维十二指肠镜治疗胆总管结石40例临床观察

摘要

目的：观察利胆排石汤联合纤维十二指肠镜治疗胆总管结石的临床疗效。方法：将80例胆总管结石患者随机分为观察组、对照组各40例。对照组给予纤维十二指肠镜治疗，观察组在对照组治疗的基础上给予利胆排石汤治疗，手术前后1周内每日1剂，水煎服。观察两组患者发热、黄疸、腹痛等临床症状积分改善情况及治疗前和治疗后3个月时天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、淀粉酶(AMY)、总胆红素(TBIL)水平。结果：黄疸、发热、恶心呕吐、腹痛等症状积分治疗后观察组分别为(0.75±0.12)、(2.33±0.22)、(2.57±0.24)、(0.54±0.26)分，对照组分别为(1.57±0.22)、(1.43±0.37)、(1.47±0.24)、(1.74±0.26)分，2组均较治疗前明显好转(P＜0.05)，且观察组优于对照组(P＜0.05)。 TBIL、AMY、ALT、AST等指标治疗后观察组分别为(12.54±2.25)μmol/L，(48.43±18.87)、(33.54±6.42)、(33.34±4.25)U/L，对照组分别为(19.75±6.25)μmol/L，(84.53±13.57)、(34.71±6.24)、(33.94±5.16)U/L，2组均较治疗前明显好转(P＜0.05)，且观察组优于对照组(P＜0.05)。结论：利胆排石汤联合纤维十二指肠镜治疗胆总管结石可改善患者临床症状及血清TBIL、AMY、ALT、AST水平。%Objective:To observe curative effects of duodenofiberscope and LiDan PaiShiTang in the treatment for choledocholithiasis. Method:Eighty patients were randomized into the observation group and the control group. The control group received duodenofiberscope and the observation group took LiDan PaiShi Tang, one dose per day in one week before and after surgery, water decocted. The levels of total bilirubin (TBiL), amylase (AMY), alanine aminotransferase (ALT), aspartate aminotransferase (AST) were observed before treating and in three months after treating as well as the improvements of clinical symptoms scale including fever, jaundice, abdominal pain and oth-ers. Result:Symptom scales of jaundice, fever, nausea and vomiting, abdominal pain after treating were (0.75 ±0.12), (2.33±0.22),( 2.57±0.24) and (0.54±0.26) in the observation group, (1.57±0.22), (1.43±0.37), (1.47±0.24) and (1.74± 0.26) in the control group, both groups were improved greatly than before treating (P<0.05), the improvement of the observation group was superior to that of the control group (P<0.05). The indexes of TBiL, AMY, ALT and AST in the observation group were (12.54±2.25)μmol/L, (48.43±18.87) U/L,(33.54±6.42) U/L and (33.34±4.25) U/L, which of the control group were (19.75 ±6.25)μmol/L, (84.53 ±13.57) U/L, (34.71 ±6.24) U/L and (33.94 ±5.16) U/L, both groups were improved remarkably than before treating in both groups (P<0.05), the observation group was superior to the control group (P<0.05). Conclusion:Duodenofiberscope and LiDan PaiShi Tang in treating choledocholithia-sis could improve clinical symptom and the levels of the indexes in the serum which include TBiL, AMY, ALT and AST.