腹腔镜胆管探查联合十二味疏肝利胆冲剂治疗肝外胆管结石20例

目的 观察腹腔镜胆管探查联合十二味疏肝利胆冲剂治疗肝外胆管结石的临床疗效.方法 采用临床随机对照试验,将40例肝外胆管结石患者随机分为研究组和对照组,每组20例.对照组患者行腹腔镜胆总管探查术,术后给予常规补液、抗感染治疗;研究组患者在对照组疗法的基础上口服十二味疏肝利胆冲剂.治疗后观察两组的临床疗效及血常规指标（白细胞、中性粒细胞、血小板）、肝功能指标（天冬氨酸转氨酶、丙氨酸转移酶、碱性磷酸酶、谷氨酰转移酶）、血清胆汁生化指标（总胆汁酸、总胆红素、结合胆红素、非结合胆红素）、T管引流量的变化.结果 两组临床疗效比较,差异无统计学意义（P〉0.05）.研究组在降低血常规指标、肝功能指标、血清胆汁生化指标及提高胆汁引流量方面显著优于对照组.结论 腹腔镜胆管探查联合十二味疏肝利胆冲剂口服,有利于控制术后胆管炎症,促进术后肝功能恢复和残余结石排除,防治结石再生.

Clinical Efficacy of Laparoscopic Common Bile Duct Exploration Combined with Shugan Lidan Granules Composed of Twelve Traditional Chinese Medicines in Treatment of Extrahepatic Bile Duct Stones: A Report of 20 Cases

Objective To observe the clinical efficacy of laparoscopic common bile duct exploration （LCBDE） combined with Shugan Lidan Granules composed of twelve traditional Chinese medicines in the treatment of extrahepatic bile duct stones. Methods A randomized controlled trial was performed in pa- tients with extrahepatie bile duct stones, who were divided into study group （n= 20） and control group （n=20）. The control group underwent LCBDE followed by conventional fluid infusion and anti-infective therapy, while the study group was orally given Shugan Lidan Granules composed of twelve traditional Chinese medicines in addition to the treatment for the control group. After treatment, the clinical out- comes, routine blood indices （leukocytes, neutrophils, and platelets）, liver function indices （aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, and glutamyl transpeptidas~ ~, serum bile acid and bilirubin levels （total bile acid, total bilirubin, direct bilirubin, and indirect bilirubin）, and T-tube drainage volume were evaluated. Results There was no significant difference in clinical outcomes between the two groups （P~0.05）. The study group had significantly lower routine blood indices, liver function indices, and serum bile acid and bilirubin levels and significantly larger bile drainage volume corn- pared with the control group. Conclusion LCBDE Granules are helpful for controlling postoperative bile of liver function and removal of residual stones, and preventing stone recurrence.