Controlled clinical trial on the therapeutic effect of nasobiliary drainage injection of adjusted Huashilidan Decoction on huge common bile duct stone
-
摘要: [目的]观察鼻胆管注入中药汤对经内镜下逆行胰胆管造影术（ERCP）一次无法取出的胆总管巨大结石的疗效。[方法]将30例经ERCP术证实为胆总管巨大结石且第1次手术未成功患者随机分为2组，实验组和对照组各15例。实验组在常规抗感染、抑酸、抑酶、保肝等西医治疗基础上术后第1天开始经鼻胆管缓慢推注20~50 ml "加减化石利胆汤" ，封闭鼻胆管末端2 h，2次/d，共30 d；对照组在上述基础上以同样的方法给予生理盐水对照。观察2组患者第30天超声及ERCP术中胆总管内径及结石的变化情况。[结果]超声下第30天胆总管内径为（0.69±0.63）cm，对照组为（2.84±0.80）cm（P<0.01）；第二次ERCP（30 d）中发现，实验组与对照组完全溶石例数分别为9例（60.00%）与1例（6.67%），差异有统计学意义（P<0.01）。[结论]鼻胆管注入加减化石利胆汤对ERCP术未取出的胆总管巨大结石有溶石作用，可降低再次ERCP手术率。Abstract: [Objective] To observe the efficacy of traditional Chinese medicine for choledocholithiasis when the operation of endoscopic retrograde cholangiopancreatography (ERCP) failed first time.[Methods] Thirty patients diagnosed with huge common bile duct stone by ERCP and failed during first operation, were devided into 2 groups, half receiving the traditional Chinese medicine treatment of nasobiliary drainage injection as the experimental group and the other half normal saline as the control group.Both groups were also given general treatments including anti-infection, liver protection, acid suppression and so on. The changes of choledocholithiasis were observed after 30 days by ultrasonography and ERCP.[Results] Average diameter of the common bile duct in the experimental and control group was(0.69±0.63) cm and(2.84±0.80) cm respectively on the 30th day by ultrasonography(P<0.01);and the number of litholysis was 9(60%) and 1 patient(6.67%) accordingly(P<0.01).[Conclusion] Adjusted Huashilidan Decoction is effective for litholysis of choledocholithiasis after failure of ERCP and can reduce the rate of second ERCP.
-
-
[1] 王长洪, 杨卓, 麻树人, 等.鼻胆管注入溶石中药治疗胆总管较大结石疗效观察[J].中国中西医结合消化杂志, 2007, 15(4):234-236.
[2] 田金沙, 林一帆, 巩阳, 等.加减利石化胆汤预防胆总管结石ERCP术后复发的临床研究[J].中华中医药学刊, 2013, 31(1):204-205.
[3] 徐海荣, 刘世峰, 刘刚, 等.十二指肠镜治疗胆总管结石的临床应用研究[J].四川医学, 2012, 33(3):461-463.
[4] 郑知强, 姚宇亮, 肖思洁.单纯胆总管结石ERCP/EST与LCBDE的临床对比分析[J].中国医药指南, 2012, 10(36):576-576.
[5] 宛新建, 李兆申, 邹晓平, 等.218例巨大胆总管结石病人临床诊疗分析[J].中华肝胆外科杂志, 2009, 15(9):662-666.
[6] WILLIAMS E J, GREEN J, BEKINGHAM I, et al.Guidelines on the management of common bile duct stones(CBDS)[J].Gut, 2008, 5:1004-1021.
[7] 中华医学会外科学分会胆道外科学组.肝胆管结石病诊断治疗指南[J].中国消化外科杂志, 2007, 6(2):156-161.
[8] 费凛, 苏树英, 李杰原, 等.十二指肠镜下子母镜联合U-100激光治疗难治性胆总管结石的疗效[J].中国全科医学, 2010, 13(11):1220-1221.
[9] 高文艳, 王长洪, 麻树人, 等.内镜下治疗肝内外胆管结石1478例回顾性分析[J].中国中医急症, 2011, 20(1):35-37.
-
计量
- 文章访问数: 61
- PDF下载数: 77
- 施引文献: 0
下载: