中药利胆灵对胆色素结石患者引流胆汁中胆汁酸的影响

Effect of LiDanLing on bile acid in drained bile in patients with pigment gallstone

关键词:  利胆灵  胆色素结石  胆汁成分

Key words:  LiDanLing medicine  pigment gallstone  bile components

摘要:

[目的]观察利胆药物对胆色素结石患者引流术后胆汁成分的影响,为胆石病的三级预防提供佐证。[方法]选取27例行胆总管控查+T管引流术或鼻胆导管引流术(ENBD)治疗的原发性胆管结石患者,于手术后分别服用熊去氧胆酸片、利胆灵以及强去氧胆酸片+利胆灵,取服药前及服药后1、3、5、7d胆汁,检测胆汁总胆汁酸(TBA)以及3种结合型胆汁酸[甘氨胆酸(GCA)、牛磺胆酸(TCA)、甘氨鹅脱氧胆酸(GCDCA)]。[结果]1)熊去氧胆酸片及其联合中药组胆汁TBA、GCA、TCA、GCDCA治疗后升高幅度明显(P<0.05)。2)单纯中药组与对照组比较升高幅度无明显变化。[结论]中药利胆灵联合应用熊去氧胆酸能增加胆色素结石患者引流术后胆汁中的总胆汁酸及结合型胆汁酸的含量,有效扩大机体胆酸池,从而降低胆汁成石性,可用于临床胆色素类结石的预防,尤其适合术后预防结石复发。

Abstract:

[Objective] To study the effects of LiDanLing(chloretic herb) medicine on the compositions of bile acid in drained bile in patients with pigment gallstone. [Methods] Twenty-seven patients suffered from primary pigment stones with choledochostomy, T tube drainage or ENBD were selected. After operation the patient was treated with LiDanLing medicine orally, and the drained bile was collected before and on the 1, 3, 5, 7th day after treatment to detect TBA and GCA, TCA, GCDCA by HPLC. [Results] Bile TBA, GCA, TCA and GCDCA gradually increased after treatment with ursodeoxycholic acid tablets and LiDanLing medicine plus ursodeoxycholic acid tablets (P<0.05). The increasing extent of TCM only group had no obvious change when compared with control group(P>0.05). [Conclusions] Bile TBA and GCA, TCA, GCDCA are gradually increased during treatment with LiDanLing medicine plus ursodeoxycholic acid tablets, so LiDanLing medicine can prevent pigment gallstone.