胆宁片、胆通、熊去氧胆酸治疗慢性胆道感染、胆石病的临床疗效对照研究

中药胆宁片具有疏肝利胆、通下清热作用，含有大黄、虎杖、青皮、陈皮等成分。应用胆宁片给已制备成胆囊结石的豚鼠经口灌胃治疗，显示胆宁片具有溶石作用，对胆固醇结石溶解作用与熊去氧胆酸相仿。临床应用中药胆宁片与西药胆通、熊去氧胆酸对照治疗４２９例慢性胆道感染、胆石病，经９个月的疗程分析，胆宁片总有效率为９０．６０％，胆通为７２．５％，ＵＤ－ＣＡ为５１．１８％，以胆宁片临床疗效为最优（Ｐ＜０．０１）。胆宁片结合体外震波碎石（ＥＳｗＬ）与ＵＤＣＡ结合ＥＳＷＬ的结石消溶率，明显高于单纯药物治疗的结石消溶率（Ｐ＜０．０１），说明胆结石经ＥＳＷＬ后，使用中药胆宁片，能达到与ＵＤＣＡ相同的消溶结果（Ｐ＞０．０５）。

Treatment of Chronic Biliary Tract Infection and Gallstone Diseases with Dan Ning Tab.Hiter-chol and UDCA(A Comparative Clinical Trial)

an Ning Tab,a remedy of T CM which consists of rhubarb,green tangerine peel,giantknotweed rhizome and dried orange peel,etc,has the properties of clearing thd liver,promotingbile secretion ,clearingheat and purgation. A pplying the remedy to guinea-pig model of implant-ed cholelithiasis showed that Dan Ning Tab has litholytic effect,and the effect in d issolvingcholesteral stone is similar to that of UDCA.The pharmacological effects of the remedy were alsofound as increase of bile acid in the bile ,decrease of mueus viscosity and increase of bile flow rate.Clinical use of Dan Ning Tab in treating 429 patients with Chronic biliary tract infection andcholelithiasis compared with western drugs hitrechol and UDCA revealed that the overall effectiverate after 9-month treatment were 90.66%,72.5%and 51.18%,respectively;the clinical effectof Dan Ning Tab was significantly superior to that of the two drugs(P<0.01).The results onimage examination after 9-month treatment also showed that Dan Ning Tab had the samelitholytic effect as oral litholytic drugs hitrechol and UDCA ,the rate of gallstone dissolved were7.69%,5%and 3 94%,respectively(P>0.05).A comparative study between oral drug aloneand oral drug plus ESWL revealed that the rate of gallst one d issolved in Dan Ning Tab plusESWL and UDCA plus ESWL were 96.67%and 90.9%,respectively, which were much higherthan that of oral drug administration only(P<0.01).The study also showed that after ESWLDan Ning Tab could be a similar litholytic result as generally acknowled ged oral litholytic drugUDCA.