利胆排石汤联合熊去氧胆酸预防经内镜逆行胰胆管造影术后胆总管结石复发的效果及其对胆汁成分和脂质代谢的影响
| 作者: |
1王凯峰,
2曹瑞丽,
2赵所燕
1 霸州市第三医院药房，河北 霸州 065700 2 霸州市第三医院内科，河北 霸州 065700 |
| 通讯: |
曹瑞丽
Email: 1123699884@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2022.02.006 |
| 基金: | 廊坊市科技支撑计划项目 (2019013156)。 |
摘要
目的：探讨利胆排石汤联合熊去氧胆酸预防经内镜逆行胰胆管造影(endoscopic retrograde cholangiopancreatography，ERCP)术后胆总管结石复发的效果及对胆汁成分、脂质代谢的影响。方法：选取2019年3月至2020年3月于河北省霸州市第三医院行ERCP取石术的胆总管结石患者60例，随机分为对照组与观察组(各30例)。对照组术后服用熊去氧胆酸片预防结石复发，观察组术后服用利胆排石汤联合熊去氧胆酸片预防结石复发，连续用药6个月。评估两组中医症状，并分析两组胆汁成分[总胆固醇(total cholesterol，TC)、总胆汁酸(total bile acid，TBA)、总胆红素(total bilirubin，TBIL)]和脂质代谢[血清TC、三酰甘油(triglyceride，TG)、低密度脂蛋白(low-density lipoprotein，LDL)、高密度脂蛋白(high-density lipoprotein，HDL)]变化；同时记录两组不良反应情况及术后6、12个月的结石复发率。结果：术后7 d和6个月，观察组中医症状积分、血清TC、TG、LDL水平显著低于对照组(P<0.05)，血清HDL水平显著高于对照组(P<0.05)。术后3、7 d观察组胆汁TC、TBIL水平显著低于对照组(P<0.05)，TBA水平显著高于对照组(P<0.05)。观察组术后6个月结石复发率与对照组相比差异无统计学意义(P>0.05)，术后12个月结石复发率显著低于对照组(P<0.05)。两组不良反应发生率比较，差异无统计学意义(P>0.05)。结论：利胆排石汤联合熊去氧胆酸可有效预防ERCP术后胆总管结石复发，并且可改善患者胆汁成分及脂质代谢。
关键词：
胆总管结石；经内镜逆行胰胆管造影；熊去氧胆酸；利胆排石汤；复发；脂质代谢
Effect of Lidanpaishi Decoction combined with ursodeoxycholic acid on preventing recurrence of choledocholithiasis after endoscopic retrograde cholangiopancreatography and its influence on bile composition and lipid metabolism
CorrespondingAuthor: CAO Ruili Email: 1123699884@qq.com
DOI: 10.3978/j.issn.2095-6959.2022.02.006
Foundation: This work was supported by the Langfang Science and Technology Support Plan Project, China (2019013156).
Abstract
Objective: To investigate the effect of Lidanpaishi Decoction combined with ursodeoxycholic acid on preventing the recurrence of choledocholithiasis after endoscopic retrograde cholangiopancreatography (ERCP) and its influence on bile composition and lipid metabolism. Methods: Sixty patients with choledocholithiasis who underwent ERCP in the Third Hospital of Bazhou City from March 2019 to March 2020 were randomly divided into a control group and an observation group (30 cases each). To prevent stone recurrence after operation, the control group was treated with ursodeoxycholic acid tablets, while the observation group was treated with Lidanpaishi Decoction combined with ursodeoxycholic acid tablets for a consecutive 6 months. The traditional Chinese medicine (TCM) symptoms of the two groups were evaluated, and the changes of bile components [total cholesterol (TC), total bile acid (TBA), total bilirubin (TBIL)] and lipid metabolism [serum TC, triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL)] were analyzed. The adverse reactions and recurrence rates of stones at the 6th and 12th months after operation were recorded. Results: At the 7th day and the 6th month after operation, the TCM symptom score, serum TC, TG and LDL levels in the observation group were significantly lower than those in the control group (P<0.05), and the serum HDL level was significantly higher than that in the control group (P<0.05). The levels of bile TC and TBIL in the observation group were significantly lower than those in the control group at the 3rd and 7th days after operation (P<0.05), while the level of TBA was significantly higher than that in the control group (P<0.05). The recurrence rate of stones at the 12th month after operation was significantly lower than that in the control group (P<0.05). There was no statistically significant difference in adverse reactions rates between the two groups (P>0.05). Conclusion: Lidanpaishi Decoction combined with ursodeoxycholic acid can effectively prevent the recurrence of choledocholithiasis after ERCP, and improve the bile composition and lipid metabolism of patients.
Keywords：
choledocholithiasis; endoscopic retrograde cholangiopancreatography; ursodeoxycholic acid; Lidanpaishi Decoction; recurrence; lipid metabolism