利胆消石合剂对胆总管结石患者ERCP术后胆汁成分影响的临床研究

Effect of Lidan Xiaoshi Mixture on bile composition after ERCP in patients with common bile duct stones： a clinical study

关键词:  利胆消石合剂  胆总管结石  胆汁成分

Key words:  Lidan Xiaoshi Mixture  common bile duct stone  bile composition

摘要:

[目的] 观察利胆消石合剂对胆总管结石患者内镜下逆行胆胰管造影术（ERCP）术后胆汁成分的影响。[方法] 将70例符合纳入标准的患者随机分为中药组及对照组，各35例，治疗过程中两组分别脱落3例和7例，最终中药组完成治疗32例，对照组28例。对照组ERCP术后予常规对症治疗，中药组在该基础上予利胆消石合剂口服5 d。两组患者均在术后第1、3、5日于鼻胆管取胆汁检测总胆汁酸、总胆红素（TBIL）、结合胆红素、总胆固醇、钙离子、β-葡萄糖苷酶（β-Gase）及糖蛋白含量并进行比较。[结果] 术后第5日，中药组TBIL、非结合胆红素（UCB）浓度和UCB%低于对照组，在复发患者中，中药组β-Gase浓度低于对照组。[结论] 利胆消石合剂能够改善胆总管结石患者ERCP术后胆汁的成石性。

Abstract:

[Objective] To observe the effect of Lidan Xiaoshi Mixture on bile composition after endoscopic retrograde cholangiopancreatography(ERCP) in patients with common bile duct stones. [Methods] Seventy patients who met the inclusion criteria were randomly divided into 35 patients in the traditional Chinese medicine(TCM) group and 35 patients in the control group,3 and 7 patients shed from each of the two groups during the treatment,and 32 patients in the TCM group and 28 patients in the control group finally completed the treatment. The control group was treated with routine symptomatic treatment after ERCP,and the Chinese medicine group was treated with Lidan Xiaoshi Mixture orally for 5 days on this basis. Bile samples were obtained from the nasobiliary duct on postoperative days 1,3,and 5 for total bile acid(TBA),total bilirubin(Tbil),conjugated bilirubin(CB),total cholesterol (TC),calcium (Ca),β-Gase and glycoprotein content and contrasted. [Results] On postoperative day 5,Tbil,unconjugated bilirubin(UCB) concentrations,and UCB% were significantly lower in the TCM group than in the control group,and in patients with relapse,β-gase concentration was significantly lower than that of the control group. [Conclusion] Lidan Xiaoshi Mixture can reduce the lithiasis of bile after ERCP in patients with CBDS.