中药对胆管结石术后患者引流胆汁成分的影响

目的:观察几组中药对胆管结石术后患者胆汁成分的影响,为预防和治疗胆石症提供依据。方法:选取40例行胆管探查+T型管引流术或经内镜鼻胆管引流术(ENBD)治疗的胆管结石病、完全自愿的住院病人,术后随机分为四组,分别服用中药1,中药2,以及中药1+2,取服药前及服药后1,3,5,7天的胆汁,检测胆汁总胆红素(TBIL)、非结合胆红素(UCB)、Ca2+浓度及胆汁中细菌源性和内源性β-葡萄糖醛酸酶(β-G)活性。结果:(1)中药1+2可以增加胆汁中总胆红素(TBIL)的含量,降低细菌性和内源性β-G活性,同时降低非结合胆红素(UCB)和Ca2+的浓度。(2)中药1可降低内源性β-G活性,同时降低非结合胆红素(UCB)和Ca2+的浓度。(3)中药2可以降低细菌性和内源性β-G活性,同时降低非结合胆红素(UCB)的浓度。结论:中药1和中药2联合服用能增加胆管结石术后患者胆汁中总胆红素的排出,降低游离胆红素和Ca2+浓度,降低降低细菌性和内源性β-G活性,从而降低胆汁成石性,适用于胆管结石的预防和治疗。

Effects of Chinese Herbal Medicine on Bile Ingredients of Postoperative Patients under Bile Drainage due to Bile Duct Stones

Objective：To study the effects of Chinese herbal medicine on bile ingredients of postoperative patients under bile drainage due to bile duct stones. Methods ：40 voluntary patients suffered from bile duct stones with choledochostomy, T tube drainage or endoscopic nasobiliary drainage （ENBD）were selected. After operation the patients were divided into four groups randomly,each group was treated with Chinese herbal medicine orally,and the drained bile was collected before and on the 1,3,5,7 th day after treatment to detect TBIL,UBC and Ca^2＋ , We also detected the enzymatic activities of the bacterialβ- glucuronidase and the humanβ - glucuronidase by using Fishman, s method. Results：Bile TBIL gradually increased after treatment with herbal medicine 1 plus herbal medicine 2, （P 〈 0. 05）. The density of UBC,Ca^2＋ and the activities of the bacterialβ- glucuronidase and the humanβ -glucuronidase were decreased obviously during the treatment with herbal medicine 1 plus herbal medicine 2 （P 〈 0. 05）. Conclusion：The Bile TBIL was gradually increased , however the density of UBC,Ca^2＋ and the activities of the bacterial - glucuronidase and the humanβ - glucuronidase were decreased obviously during the treatment with herbal medicine 1 plus herb- al medicine 2, so the bile duct stones can be better prevented and treated by herbal medicine 1 plus herbal medicine 2.