疏肝利胆颗粒对胆管结石术后胆汁成分的影响

目的 :研究疏肝利胆颗粒对胆总管结石患者术后胆汁成分的影响。方法 :选取72例因胆总管结石行胆总管切开取石、T管引流手术患者,随机分为对照组和观察组各36例。对照组给予常规补液、抗感染等处理。观察组在此基础上,术后第2天给予胆汁回输,疏肝利胆颗粒每日1剂口服。总疗程28 d。每日记录胆汁引流量,分别于术中及服中药后7 d、14 d、28 d留取新鲜胆汁,检测胆汁总胆红素(TBIL)、非结合胆红素(UCB)、胆汁酸(TBA)、胆固醇(CHO)、磷脂(PL)、钙离子(Ca~(2+))浓度。结果 :观察组患者术后胆汁引流量明显高于对照组,差异有统计学意义(P<0.05)。观察组患者术后胆汁TBIL、UCB、CHO、Ca~(2+)下降较对照组明显,差异有统计学意义(P<0.05),胆汁TBA、PL升高较对照组明显,差异有统计学意义(P<0.05)。结论:疏肝利胆颗粒可以明显增加胆汁排出量,增加胆汁中总胆红素的排出,提高胆汁酸和磷脂的浓度,使胆汁趋向正常,从而降低胆汁成石性,对防治术后结石复发有一定作用。

Effects of Shugan Lidan Granules on Bile Components after Choledocholithotomy

Objective:To study the effects of Shugan Lidan granules on bile components after removal of common bile duct stones.Methods:Total 72 patients with choledocholithiasis underwent choledocholithotomy and T tube drainage surgery were randomly divided into the control group and observation group with 36 patients in each group,the control group was given conventional rehydration,fighting infection treatment.On base of the control group,the observation group received bile reinfusion,Shugan Lidan granule,one granule daily on the second day,for 28 days.Bile drainage volume was recorded daily.The specimens from fresh bile during operation and the 7 d,14 d,28 d after taking Chinese medicine were detected to the concentrations of bilirubin (TBIL),direct bilirubin (CB),bile acid (TBA),cholesterol (CHO),phospholipids (PL) and cal cium (Ca~(2+)).Results :The bile drainage in the observation group was significantly higher than that in the control group,with significant difference (P< 0.05).The postoperative bile total bilirubin,unconjugated bilirubin,bile acid,cholesterol and calcium in the observation group decreased significantly more than that in the control group,with stastical significance (P< 0.05) while the bile acid and phospholipids increased more compared to the control group,with stastical significance (P< 0.05).Conclusion:Shugan Lidan granules can obviously increase bile excretion,the excretion of total bilirubin in bile and the concentration of bile acids and phospholipids,thereby restoring to the normal bile,reducing the lithogenicity and have a certain role in the prevention of postoperative recurrence of calculi.