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苗药金茵化石颗粒联合化学药治疗慢性结石性胆囊炎的临床观察
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| 篇名： | 苗药金茵化石颗粒联合化学药治疗慢性结石性胆囊炎的临床观察 |
| TITLE： | |
| 摘要： | 目的：探讨苗药金茵化石颗粒联合化学药治疗慢性结石性胆囊炎的临床疗效及安全性。方法：选取2014年1月－2016年1月我院收治的慢性结石性胆囊炎120例，按随机数字表法分为对照组和观察组，各60例。对照组患者餐前给予硫酸镁注射液10 mL，tid；餐后口服阿莫西林片0.5 g，tid+消旋山莨菪碱片10 mg，tid+复方胆通片1片，tid。观察组患者在对照组基础上给予苗药金茵化石颗粒15 g， tid。两组患者均连续治疗4周。观察两组患者临床疗效及上腹疼痛、恶心厌油腻、结石改善情况，并比较两组患者治疗前后的胆囊壁厚度，白细胞介素2（IL-2）、IL-15水平和胆固醇7α羟化酶（CYP7A1）、二磷酸葡萄糖醛酸基转移酶（B-UGT）mRNA及蛋白表达水平，记录两组患者不良反应发生情况。结果：观察组患者的临床总有效率为96.67％，显著高于对照组的88.33％，差异有统计学意义（P＜0.05）。治疗后1 d、1周，观察组患者上腹疼痛改善率分别为63.33％、81.67％，显著高于对照组的36.67％、50.00％，差异均有统计学意义（P＜0.05）；两组患者治疗后2～4周的上腹疼痛改善率以及治疗后恶心厌油腻改善率比较，差异均无统计学意义（P＞0.05）。观察组患者的结石排净率为33.33％，显著高于对照组的11.67％，差异有统计学意义（P＜0.05）。治疗前，两组患者胆囊壁厚度，IL-2、IL-15水平和CYP7A1、B-UCT mRNA及蛋白表达水平比较，差异均无统计学意义（P＞0.05）；治疗后，两组患者胆囊壁厚度和IL-2、IL-15水平均显著降低，CYP7A1、B-UCT mRNA及蛋白表达水平均显著升高，且观察组显著优于对照组，差异均有统计学意义 （P＜0.05）。两组患者不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：苗药金茵化石颗粒联合化学药治疗慢性结石性胆囊炎疗效显著，能有效改善患者右上腹疼痛和恶心厌油腻症状，降低IL-2、IL-15水平，上调CYP7A1、B-UCT mRNA及其蛋白表达，且安全性较高。 |
| ABSTRACT： | OBJECTIVE： To investigate clinical efficacy and safety of Miao medicine Jinyin huashi granules combined with western medicine in the treatment of chronic calculous cholecystitis （CCC）. METHODS： A total of 120 CCC patients in our hospital during Jan. 2014-Jan. 2016 were randomly divided into control group and observation group， with 60 cases in each group. Control group was given 50％ Magnesium sulfate solution 10 mL orally before meal， tid； amoxicillin 0.5 g orally， tid+Racanisodamine tablets 10 mg， tid+Compound dantong tablets 1 slice， tid， after meal. Observation group was additionally treated with Miao medicine Jinyin huashi granules 15 g， tid， on the basis of control group. Both groups were treated for consecutive 4 weeks. Clinical efficacies， the improvement of upper abdominal pain， nausea and greasy， calculus were observed in 2 groups. The thickness of gallbladder， serum levels of IL-2 and IL-5， mRNA and protein expression of CYP7A1 and B-UCT were compared between 2 groups before and after treatment. The occurrence of ADR was recorded in 2 groups. RESULTS： Total response rate of observation group was 96.67％， which was significantly higher than 88.33％ of control group， with statistical significance （P＜0.05）. One d and one week after treatment， the improvement rates of upper abdominal pain were 63.33％ and 81.67％ in observation group， which were significantly than 36.67％ and 50.00％ of control group， with statistical significance （P＜0.05）. There was no statistical significance in the improvement rate of nausea or greasy after treatment between 2 groups （P＞0.05）. The stone-free rate of observation group was 33.33％ and significantly higher than 11.67％ of control group， with statistical significance （P＜0.05）. Before treatment， there was no statistical significance in the thickness of gallbladder wall， serum levels of IL-2 or IL-15， mRNA and protein expression of CYP7A1 or B-UCT between 2 groups （P＞0.05）. After treatment， the thickness of gallbladder wall， serum levels of IL-2 and IL-15 were all decreased significantly in 2 groups， while mRNA and protein expression of CYP7A1 and B-UCT were increased significantly； observation group was significantly better than control group， with statistical significance （P＜0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS： Miao medicine Jinyin huashi granules combined with western medicine show significant therapeutic efficacy for CCC， can effectively improve right upper quadrant pain， nausea and greasy， decrease serum levels of IL-2 and IL-5 and up-regulate mRNA and protein expression of CYP7A1 and B-UCT with good safety. |
| 期刊： | 2017年第28卷第35期 |
| 作者： | 李季冬，王德秀，李溥，杨再波，李永超，王其发，刘方桃，谢亚 |
| AUTHORS： | LI Jidong，WANG Dexiu，LI Pu，YANG Zaibo，LI Yongchao，WANG Qifa，LIU Fangtao，XIE Ya |
| 关键字： | 金茵化石颗粒；化学药；慢性结石性胆囊炎；疗效；安全性 |
| KEYWORDS： | Jinyin huashi granules； Western medicine； Chronic calculous cholecystitis； Therapeutic efficacy； Safety |
| 阅读数： | 352 次 |
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