养肝柔肝法对胆色素结石患者术后T管胆汁成分的影响

目的 观察具有养肝柔肝作用的中药养肝利胆颗粒剂对胆色素结石患者术后T管胆汁成分的影响，为胆石病的三级预防提供佐证。方法 选取11例行胆总管探查＋T管引流术治疗的原发性胆管结石患者，于术后服用养肝利胆颗粒剂，取服药前及服药后1、2、3、7d胆汁，检测胆汁总胆汁酸（TBA）、总胆红素（TBIL）、结合胆红素（CB）、非结合胆红素（UCB）。并以HPLC方法作胆汁胆红素组分分析。结果 （1）胆汁TBIL、TBA治疗后稳定的上升（P＜0．05）。（2）单结合胆红素（MCB）与UCB呈现逐步降低（P＜0．05）。（3）MCB与UCB的比例服药后有较大幅度的升高（P＜0．05）；同时，双结合胆红素（DCB）与MCB及UCB的比例也逐步上升（P＜0．05）。（4）在胆红素各组分中，治疗后MCB及UCB的百分比在逐渐下降，DCB的百分比稳步上升（P＜0．01）。结论 养肝柔肝法能降低胆色素结石患者T管胆汁中的MCB和UCB，增加总胆汁酸的含量，降低其胆汁成石性，可用于临床胆色素类结石的预防，尤其适合术后预防结石复发。

Effect of Yang-gan-rou-gan Herbal Medicine on Postoperative T-Tube Drainge Bile Compositions in Patients with Pigment Gallstone

Objective:To study the effects of Yang gan rou gan(YGRG) herbal medicine on postoperative T tube drainage bile compositions in patients with pigment gallstone diseases Methods:On 11 patients with primary bile duct pigment stones choledochostomies with T tube biliary drainage were performed After operation the patient was treated with YGRGherbal medicine orally,and the draining bile was collected before treatment and on 1,2,3,7th day after treatment to test TBA,TBIL,CB,UCB,and MCB using HPLC technique.Results:1.Bile TBIL and TBA gradually increased after treatment( P <0 05).2.Bile Mcb and UCB gradually decreased after treatment( P <0 05) 3 The ratio of DBC to MCB and UCB in bile steadily increased( P <0 05) 4 The percentage of MCB and UCB in bile was decreasing while DCB was increasing during the treatment( P <0 05) Conclusion:YGRG therapy of TCM has beneficial effects in patients with pigment gallstone disease,such as reducing bile MCB and UCG,in creasing bile TBA and decreasing the lithogenesity of the bile The therapy can be applied in prevention of postoperative gallstone recurrence especially in patients with pigment gallstone disease