加味大柴胡汤对阻塞性黄疸大鼠TLR4表达的影响

目的 探讨加味大柴胡汤在临床上辅助治疗阻塞性黄疸的理论机制.方法 制作阻塞性黄疸大鼠模型,分为7、14、21 d共3个时段,每个时段分3组,即:(1)假手术+生理盐水组(SO+NS组);(2)胆总管结扎+生理盐水组(BDL+NS组);(3)胆总管结扎+加味大柴胡汤组(BDL+MMDB组).每组6只SPF级SD大鼠,在各时段取大鼠肝组织及下腔静脉血,检测AST、ALB及TB;用RT-PCR检测,TLR4 mRNA的表达.结果 胆总管结扎7 d时,BDL+MMDB组与BDL+Ns组外周血TB、AST比SO组均上升,且后者明显.BDL+MMDB组与SO组及BDL+NS组相比,差异均有统计学意义(P<0.01).胆总管结扎14、21 d时,BDL+MMDB组与BDL+Ns组外周血TB、AST持续升高,且后者增高更明显.BDL+MMDB组与SO组及BDL+Ns组相比,差异均有统计学意义(P<0.01).正常肝组织中TLR4mRNA的表达不明显.胆总管结扎7、14、21 d时,BDL+MMDB组与BDL+Ns组TLR4 mRNA表达持续显著增加,且后者增加更明显.同时段中BDL+MMDB组与S0组相比、BDL+MMDB组与BDL+NS组相比,差异均有统计学意义(P<0.01).结论 加味大柴胡汤可以通过降低肝组织中TLR4,从而减轻内毒素所致肝脏的损伤.     

加味大柴胡汤对阻塞性黄疸大鼠胆汁酸代谢的影响及机制

目的探讨加味大柴胡汤对阻塞性黄疸大鼠胆汁酸代谢及胆汁酸受体(FXR)表达的影响。方法制作急性阻塞性黄疸大鼠模型后,将其分为7、14、21 d三个时段,每个时段分为BDL +MMDB、BDL+TUDCA、BDL+NS、SO十NS等四组,每组6只SD大鼠；在各时段剖腹取大鼠肝组织及下腔静脉血,检测TBA、ALT、TB、ALP；用光学显微镜观察大鼠肝的病理变化；用逆转录-聚合酶链反应(RT-PCR)法检测FXR mRNA表达。结果胆道梗阻7、14、21 d后。血清TBA含量分别增加为(168．45±97．79)、(182．66±52．33)、(247．29±68．63)μmol/L(P＜0．01),随梗阻时间的延长而逐步加重；FXR mRNA表达减弱为0．555±0．123、0．457±0．096、0．305±0．199(P＜0．05)。加味大柴胡汤治疗7、14、21 d后,血清TBA分别下降为(39．18±19．68)、(126．30±35．43)、(153,99±27．00)μmol/L(P＜0．01),FXR mRNA表达上调为1．488±O．179、1．450±0．547、1．388±0．618(P＜0．05),肝脏组织损伤减轻。结论加味大柴胡汤可以通过上调FXR mRNA表达来降低血胆汁酸浓度,从而减轻肝脏损害。     

茵陈蒿汤治疗热重于湿证阻塞性黄疸患者的临床疗效研究

目的探讨茵陈蒿汤联合常规治疗对热重于湿证阻塞性黄疸患者的临床疗效。方法:选取2020年6月—2021年12月天津市南开医院收治的热重于湿证阻塞性黄疸(良、恶性胆道梗阻均可)96例,随机分为对照组和治疗组,每组48例,所有患者行手术、内镜取石或置入胆道支架等操作解除梗阻。术后,对照组给予常规治疗(丁二磺酸腺苷蛋氨酸肠溶片),观察组在对照组基础上加用茵陈蒿汤,疗程1周。检测患者黄疸指标[总胆红素(TBIL)、直接胆红素(DBIL)]、肝功能[谷丙转氨酶(ALT)、谷氨酰转移酶(GGT)]、血总胆汁酸(TBA)、尿TBA、中医证候评分、临床疗效变化。结果:与术后第1天比较,两组患者解除胆道梗阻后第7天的TBIL、DBIL、ALT、GGT、血TBA均有所降低(P ＜0.05),与对照组比较,治疗组降低更明显(P ＜0.05);两组患者尿TBA、24h尿量均增加(P ＜0.05),与对照组比较,治疗组增加更加明显(P ＜0.05)。治疗组中医症状量化评分低于对照组(P ＜0.05);治疗组总有效率优于对照组(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:阻塞性黄疸热重于湿证患者胆道梗阻解除后,给予茵陈蒿汤联合常规治疗可以促进患者胆汁酸排泄,减轻黄疸,保护肝功能,有效改善患者中医临床症状,进而提高患者的临床治疗有效率,耐受性较好。     

大黄素对阻塞性黄疸大鼠肝损害的保护作用

目的探讨大黄素防止肝纤维化的作用。方法用SD大鼠120只随机分为：(1)假手术+生理盐水组(SO+NS组)；(2)单纯胆总管结扎+生理盐水组(BDL+NS组)；(3)胆总管结扎+大黄素组(BDL+ED组),每组40只。BDL+NS组作胆总管结扎、生理盐水灌胃；BDL+ED组行胆总管结扎、大黄素混悬液灌胃。分别于14、21 d各处死每组大鼠的50%,观察肝纤维化情况和检测肝功能、小肠细菌移位。结果结扎胆总管大鼠的肠黏膜、肝纤维化及肝功能的受损随结扎时间延长而逐渐加重,但用大黄素组有显著减轻,结扎后21 d BDL+NS组与BDL+ED组比较,细菌移位率为(85%比50%,P＜0．05)；肝纤维化程度(按0～4级计)为[0、4、6、8、2比4、10、3、3、0只,(P＜0．01)]；肝功能：ALT[(212．4±19．2)U/L比(146．5±16．2)U/L(P＜0．01)]；AST [(709．6±39．9)U/L比(612．2±30．8)U/L(P＜0．05)]；TB[(174．4±32．2)μmol/L比(159．8±27．2)μmol/L P＜0．05)]。结论大黄素能降低阻塞性黄疸时的肠道细菌移位率,对肝功能有明显保护作用,可有效减轻梗阻性黄疸时的肝纤维化。     

阻塞性黄疸大鼠肝组织细胞凋亡及相关基因bcl-2、bax的表达

目的　探讨阻塞性黄疸肝损害的调控机制。方法　用末端脱氧核苷酸转移酶介导生物素标记(TUNEL)技术和免疫组织化学方法检测 4 0只阻塞性黄疸大鼠肝脏组织细胞凋亡状态及凋亡相关基因bcl 2和bax蛋白的表达。结果　胆总管结扎后 ,随结扎时间的延长细胞凋亡增加 ,结扎 14d后细胞凋亡达高峰 ,凋亡指数 (AI)达 5 8.2 3± 1.5 8,各组AI差异有显著性 (P <0 .0 5 )。在阻塞性黄疸过程中 ,bcl 2蛋白表达越强 ,bax蛋白表达越弱 ,AI亦越少。结论　bcl 2和bax蛋白均参与了阻塞性黄疸肝组织中细胞凋亡的调节。     

阻塞性黄疸大鼠肠黏膜屏障功能变化及力肽的治疗作用

目的探讨阻塞性黄疸大鼠肠黏膜屏障功能变化以及力肽的治疗作用。方法将36只Wistar大鼠随机分成胆管结扎组（BDL）、假性手术组（SL）、胆管结扎＋力肽治疗组（Dipeptiven）3组,分别于术后24h、72h、1周和2周测定血浆内毒素值（Endotoxin,ET）,并于2周后作细菌移位率和肠黏膜组织学检查。结果BDL组厌氧菌移位阳性率（58．33％）及各时间点血浆ET值显著高于SL组（0）和Dipeptiven组（8．33％）（P〈0．01）,Dipeptiven组在各时间点血浆ET值较BDL组显著降低（P〈0．01）。组织学检查显示,BDL组肠黏膜发生了实质性损害。结论阻塞性黄疸时肠黏膜屏障损害可能促进肠道细菌移位,导致感染易感性增高。而力肽可改善受损小肠黏膜结构及减轻肠道细菌移位。     

阻塞性黄疸时胆汁酸肝损害作用的研究

为探时胆汁酸是否是造成阻塞性黄疸(简称阻黄)肝细胞损害的因素。实验1：研究阻黄模型鼠的肝脏形态学改变与胆汁酸血症的关系：35只雄性SD大鼠随机分为3组。阻黄1(BDL1)组11只，以胆总管结扎切断复制阻黄模型，术后1周处死。阻黄2(BDL2)组11只，术式同BDL1组，术后2周处死。假手术(SO)组13只，仅作胆总管游离，术后1周处死。动物处死时，取心脏内血液测血清总胆汁酸（TBA)，并取肝脏组织作光镜及电镜检查。实验2：研究管饲胆酸钠(PO组)的肝脏形态学改变。将13只SD大鼠营饲10％胆酸钠4mg/kg．观察1、2、3、4、24h后的血清TBA变化及肝脏形态学改变。实验3：研究阻黄模型鼠的肝细胞内胆汁酸含量变化。取上述SO组、BDL2组和PO组各5只鼠的肝脏组织．制成肝细胞悬液．应用离子选择性微电极测定肝细胞内胆汁酸活度。结果：实验1，BDL1组和BDL2组血清TBA明显升高．光镜下有肝细胞变性坏死及胆小营增生，电镜下有线粒体减少、变形嵴消失等改变。实验2，营饲胆酸钠后，血清TBA与BDL2组相近，肝细胞亦有变性坏死及线粒体损害，但无胆小管增生。实验3，SO组、BDL2组和PO组的肝细胞内胆汁酸活度分别为422±76、5456±1265、6456±1313μmol／L。BDL2组较SO组升高12倍．与PO组相接近。结论：胆汁酸是导致阻黄肝细胞损害的因素之一。     

大柴胡汤对急性坏死性胰腺炎大鼠模型的影响

目的:研究大柴胡汤对急性坏死性胰腺炎(ANP)大鼠的作用.方法:54只雄性SD大鼠随机分为假手术组、ANP组和大柴胡汤组,制模后3 h、6 h、12 h时间点分别处死6只.记录腹水量,测定血清淀粉酶,HE染色观察胰腺、肺、肠壁组织病理改变;按Schmidt方法对组织病理改变进行严重度评分.伊文思蓝(EB)染料血管外渗法检测组织毛细血管通透性.结果:大柴胡汤组腹水量明显低于ANP组(P<0.05);各时间点ANP组血清淀粉酶水平高于假手术组(P<0.01);ANP组胰腺、肺、肠壁组织EB含量均显著高于假手术组(P<0.05);大柴胡汤组血清淀粉酶水平较ANP组显著降低(P<0.05);大柴胡汤组胰腺、肺、肠壁组织病理改变较ANP组减轻;胰腺、肺、肠壁组织EB含量均显著低于ANP组(P<0.05).结论:大柴胡汤预处理可以改善ANP大鼠模型的疾病严重程度,其机理可能与降低毛细血管通透性有关.     

加味大柴胡汤加用L-精氨酸对阻黄大鼠血浆内毒素的影响

目的　探讨L 精氨酸、加味大柴胡汤及两者合用对保护阻塞性黄疸大鼠的肝功能、抑制脂质过氧化损伤、缓解内毒素血症的作用。方法　制作急性阻塞性黄疸大鼠模型 ,分为 7、14及 2 1d 3个时段 ,每个时段分为 5组 ,每组 6只大鼠。在各时相点 ,检测内毒素和NO2 -/NO3 -的含量。结果　门静脉血浆内毒素的含量 :胆管结扎 7d后 ,门静脉血浆内毒素含量BDL NS组明显高于其他组 (P <0 .0 1)。而BDL L Arg 中药组与BDL L Arg及BDL 中药组间比较差异有显著性 (P <0 .0 5 )。胆管结扎 14d ,门静脉血浆内毒素含量BDL L Arg 中药组与BDL L Arg及BDL 中药组比较差异也有显著性 (P <0 .0 5 )。但在 2 1d时段门静脉内毒素含量BDL L Arg组与BDL NS组比差异无显著性 ,而BDL 中药组及BDL L Arg 中药组门静脉内毒素含量较上述两组差异有显著性 (P <0 .0 1)。结论　在阻塞性黄疸发病早、中期 ,采用加味大柴胡汤加L Arg治疗对保护肝功能与缓解内毒素血症作用较佳     

阻塞性黄疸大鼠肝细胞凋亡及蛋白激酶C信号通道的调控作用

目的探讨阻塞性黄疸肝损害的调控机制。方法采用胶原酶原位肝灌注法获取大鼠肝细胞，行原代培养，用蛋白激酶(PK)C激动剂帕斯酶埃(PMA)、拮抗剂切勒斯埃作用于肝细胞，再用50μmol／L甘氨鹅脱氧胆酸钠(GCDC)作用后行流式细胞术(FCM)及用末端脱氧核苷酸转移酶(TdT)介导的脱氧核苷酸(duTP)缺口末端标记技术(TUNEL)检测肝细胞凋亡情况。结扎大鼠胆总管后3、7、14、21d处死大鼠，用TUNEL技术及免疫组织化学方法检测阻塞性黄疸大鼠肝脏组织细胞凋亡状态及PKC蛋白的表达。结果随PMA浓度的增加，肝细胞的凋亡明显增加。随Chelerythrine的增加，肝细胞的凋亡明显减少。大鼠胆总管结扎后随结扎时间的延长细胞凋亡指数(AI)增加，结扎14d后AI达高峰。PKC表达越强，AI就越高。结论PKC信号通道参与了阻塞性黄疸肝细胞凋亡的调节，并在阻塞性黄疸肝损害的发生和发展中起重要作用。     

谷氨酰胺对阻塞性黄疸大鼠免疫功能的影响

目的 探讨谷氨酰胺对阻塞性黄疸大鼠免疫功能的影响和机理。方法 健康雄性Wistar大鼠50只，按随机数字表随机分成空白对照组（n=10）、阻塞性黄疸组（n=20）和谷氨酰胺治疗组（n=20）。血清TNF-α和IL-10水平测定用放射免疫法，肝功能用自动生化分析仪测定，同时检测细菌移位情况。结果 阻塞性黄疸组在制模后1、2周血清TNF-α较空白对照组明显下降，血清IL-10水平、TBIL、ALT及AST较空白对照组明显升高；而在应用谷氨酰胺后1、2周血清TNF-α较空白对照组和阻塞性黄疸组有明显升高，IL-10、TBIL、ALT及AST较阻塞性黄疸组明显下降，细菌移位较阻塞性黄疸组也明显减少。结论 谷氨酰胺能够改变阻塞性黄疸大鼠血清TNFa、IL-10功能的变化，增强大鼠免疫功能，减少肠道细菌移位。     

The Effects of Dimethylsulfoxide in Experimental Obstructive Jaundice

Material and methods: Thirty rats were divided into three groups, as sham, control and DMSO groups. Laparatomy was performed on each animal in the control and DMSO groups and common bile ducts were ligated. Common bile duct was observed but was not ligated for the rats in the sham group. Saline solution injection (1.5 mg/kg/intraperitoneally (ip)) was begun on the first day of surgical procedure and repeated once a day for the next 5 days. The same procedure was performed with DMSO (1.5 mg/kg/ip) instead of saline in the DMSO group. The rats were sacrificed on the postoperative seventh day, at which time venous blood and liver tissue specimens were taken. Main outcome measurements: On the 7^th postoperative day, the bilirubin, AST, ALT, ALP and GGT levels of the control and DMSO groups were significantly higher in comparison with the sham group (p < 0.01). On the 7^th postoperative day, the erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) levels of the control and DMSO groups were significantly lower than those of the sham group (p < 0.01), but there was no statistical difference between the two groups (p > 0.05). Erythrocyte and liver malondialdehyde (MDA) levels in the control and DMSO groups were significantly higher compared with the sham group (p < 0.01). However, the MDA levels were significantly lower in the DMSO group compared to the control group (p < 0.01).

Conclusion: It is stated that free oxygen radicals seem to play a role in the liver tissue injury, secondary to obstructive jaundice. In our experimental study, exogenic DMSO seems to have decreased lipid peroxidation and to have improved some of the parameters of liver tissue injury due to the obstructive jaundice in rats.     

Obstructive Jaundice Alters Proliferating Cell Nuclear Antigen Expression in Rat Small Intestine

Translocation of bacteria and endotoxin has long been documented in obstructive jaundice, and altered intestinal barrier function is considered to be one of the important mechanisms for this phenomenon. Proliferating cell nuclear antigen (PCNA), also known as cyclin, is an auxiliary protein of DNA polymerase-, and the level of synthesis correlates directly with rates of cellular proliferation and DNA synthesis. This study was designed with the aim of evaluating the effect of obstructive jaundice on PCNA expression in small bowel epithelium. Male Sprague-Dawley rats were randomized to four groups. Group A (n = 10, control group) underwent a sham operation. Group B (n = 9, obstructive jaundice group for 1 week) underwent common bile duct ligation. Group C (n = 8, obstructive jaundice group for 2 weeks) underwent common bile duct ligation. Group D (n = 8, obstructive jaundice group for 2 weeks) underwent common bile duct ligation with oral glutamine intake. After periods of 7 days and 2 weeks, segments of small bowel were harvested from groups A & B and groups C & D, respectively. Nuclear immunohistochemical expression of PCNA in small bowel was evaluated. The PCNA-labeling index [(PCNA-positive cells/500 cells) × 100] was quantified. Comparisons among the four groups were performed. The PCNA-labeling index in small bowel of group B was significantly higher than that of group A (29.0% vs 21.2%, p = 0.001). After 2 weeks of common bile duct ligation, the PCNA-labeling index in small bowel of group C was significantly lower than that of group A (19.4% vs 21.2%, p = 0.045). With oral glutamine intake daily, the PCNA-labeling index in small bowel of Group D was restored and was significantly higher than that of group A (24.5% vs 21.2%, p = 0.002). Obstructive jaundice for 1 week upgraded PCNA expression in rat small intestine. PCNA expression in rat small intestine later became depressed after obstructive jaundice for 2 weeks. Oral glutamine intake daily could effectively restore the PCNA expression in small bowel of rats subjected to obstructive jaundice for 2 weeks.     

茵陈利胆汤联合经皮经肝胆管穿刺引流术治疗胆管癌合并梗阻性黄疸的临床效果研究

目的:观察茵陈利胆汤联合经皮经肝胆管穿刺引流术(PTCD)治疗胆管癌合并梗阻性黄疸的临床疗效。方法:选择2018年10月—2020年10月在海军军医大学第三附属医院中西医结合科住院的胆管癌合并梗阻性黄疸患者72例,根据患者年龄、病程及胆红素水平配对分为对照组与治疗组各36例,两组患者充分行PTCD术解除梗阻,同时根据病情予保肝、抗感染、补充电解质等对症治疗,治疗组在上述基础上加用茵陈利胆汤中药煎剂,治疗14 d,观察并比较两组患者治疗前后中医临床症状积分、肝功能指标、体能状态卡氏评分(KPS)。结果:治疗14 d后,两组患者黄染、纳差、乏力临床症状积分及总胆红素(TBIL)、谷丙转氨酶(ALT)差异有统计学意义(P<0.05),治疗组明显优于对照组。两组患者治疗后KPS均较治疗前好转,治疗组改善优于对照组,差异有统计学意义(P<0.05)。治疗组总有效率为88.9%,高于对照组75.0%,差异有统计学意义(P<0.05)。结论:茵陈利胆汤联合PTCD不仅能促进患者胆汁排泄,恢复肝功能,而且有改善患者纳差、乏力等作用。     

法尼酯X受体在胆管癌中的表达特点

目的：探讨法尼酯X受体（farnesoid X receptor,FXR）在人胆管组织中表达及其与胆管癌发生的关系。方法：用免疫组织化学EnVision法检测FXR在12例人胆管癌、5例癌旁阴性切缘及3例正常胆管组织中的表达。采用等级秩和检验统计分析;使用SPSS15．0分析软件包分析数据;P〈0．05为有显著性差异。结果：FXR在胆管癌、阴性切缘和正常胆管组织中均有表达。在癌旁无瘤切缘和正常胆管组织中的表达显著高于癌组织（P〈0．01）,而在癌旁无瘤切缘与正常胆管组织中,表达无显著差异（P〉0．05）。在×400视野下,显示FXR细胞核与细胞浆中均有表达。结论：FXR可能是一个保护性受体,其表达下降是胆管癌形成的机制之一。     

Evaluation of Pringle Maneuver During Liver Resection in a Rat Model of Surgical Obstructive Jaundice

Temporary portal triad clamping (Pringle maneuver) during liver resection reduces intraoperative blood loss. A normal liver can safely tolerate normothermic ischemia for up to 60 min. However, its safety in patients with surgical obstructive jaundice (SOJ) is not known. Therefore, we investigated the effect of hepatic ischemia in an experimental rat model of SOJ created by ligating the bile duct. Four groups of rats were created: Group I (sham operation, 10 days later, liver resection); Group II (sham operation, 10 days later, liver resection with 5 min of hepatic ischemia); Group III (bile duct ligation, 10 days later, liver resection); and Group IV (bile duct ligation, 10 days later, liver resection with 5 min of hepatic ischemia). The ischemic injury was assessed by the survival of rats, liver tissue malondialdehyde and total glutathione (markers of free radical injury), serum alanine aminotransferase, aspartate aminotransferase, and liver histology. The results showed decreased survival (47.6% vs. 90% [p =. 046]), increased liver tissue malondialdehyde (161 ± 35 vs. 129 ± 33 μg/gm liver tissue [p ≤. 05]), and decreased liver tissue total glutathione (565 ± 169 vs. 1075 ± 276 nmol/gm liver tissue [p ≤. 05]) in rats with SOJ subjected to hepatic ischemia when compared to nonjaundiced rats. The changes in serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase showed an increasing trend in the SOJ group but were not statistically significant. Ischemic changes in liver histology were seen more often in the SOJ group but were not statistically significant. These data suggest that temporary portal triad clamping in an experimental model of SOJ is detrimental to the outcome of liver resection.     

梗阻性黄疸的围手术期处理

1　概述1.1　梗阻性黄疸的原因根据大量临床资料统计 ,引发梗阻性黄疸最常见的原因是胆总管结石、胰头癌、肝门恶性淋巴结长大 ;其次是壶腹部癌、胰腺炎、肝继发性病变 ;少见的原因有良性狭窄 (医源性、创伤 )、复发性胆管炎、Mirizzi’s综合征、硬化性胆管炎、胆管癌、胆道闭锁和胆总管囊肿。1.2　诊断与鉴别诊断①实验室检查 :对鉴别梗阻性黄疸较有价值的血化验是结合胆红素 >3 5mmol/L ;转氨酶增高ALP/GGT >AST/ALT ;白蛋白可能降低 ;PTT延长。尿化验为结合胆红素增高。②超声诊断 :是诊断梗阻性黄疸的首选方法 ,胆管扩张是梗阻…     

A Case of Peribiliary Cyst Presenting with Obstructive Jaundice

A 77-year-old woman with a complaint of itching was shown to have an elevated serum bilirubin level. She had no history of liver disease. Computed tomography and magnetic resonance cholangiopancreatography revealed a 17-mm-diameter cystic lesion obstructing the main hepatic duct at the hepatic hilum. Drip infusion cholangiographic computed tomography and endoscopic retrograde cholangiography showed that the cyst did not communicate with the biliary tree; thus, a peribiliary cyst was diagnosed. Cystectomy was performed, and the jaundice resolved. Peribiliary cysts are generally asymptomatic and rarely cause obstructive jaundice. They are usually multiple and caused by an underlying liver disorder with a poor prognosis. Our case suggests that peribiliary cysts can arise in healthy liver and cause symptoms. Cystectomy is the treatment of choice if the cyst is solitary.     

经皮经肝胆管引流术联合异甘草酸镁治疗恶性梗阻性黄疸患者肝功能损伤的疗效观察

目的：评价经皮经肝胆管引流术（ percutaneous transhepatic cholangial drainage ,PTCD）联合异甘草酸镁治疗恶性梗阻性黄疸患者肝功能损伤的临床疗效及安全性。方法2009年6月～2013年6月,恶性梗阻性黄疸120例,在PTCD术后常规护肝治疗的基础上,按就诊顺序依次分入观察组（加用异甘草酸镁100 mg/d）和对照组（加用还原型谷胱甘肽1200 mg/d）各60例。治疗7天后,比较丙氨酸氨基转移酶（ ALT）、天冬氨酸氨基转移酶（ AST）、白蛋白（ ALB）、γ-谷氨酰转肽酶（γ-GT）、碱性磷酸酶（ ALP）、总胆红素（ TBil）、直接胆红素（ DBil）及肿瘤坏死因子α（ TNF-α）、核因子κB（ NF-κB）的变化;观察与药物有关的不良反应。结果治疗1周后,观察组与对照组TBil、DBil、ALT、AST、ALP、TNF-α、NF-κB较治疗前均明显下降（P＜0.05）,且观察组下降更明显（P＜0．05）。2组ALB、γ-GT治疗前后差异无显著性,2组间比较差异亦无显著性（P＞0.05）。结论恶性梗阻性黄疸患者PTCD术后异甘草酸镁治疗肝功能损伤对恢复肝功能、消退黄疸有促进作用。