【摘要】：通過對采用中西醫(yī)結(jié)合方法治療的原發(fā)性肝癌肝切除圍手術期病人恢復情況進行臨床研究,運用利膽活血通腑湯觀察中醫(yī)藥在加速原發(fā)性肝癌肝切除手術病人康復中的作用,客觀評價并探討中醫(yī)藥在肝臟外科加速康復中的意義等。方法:選擇2016年2月至2017年1月因原發(fā)性肝癌入住南通市第三人民醫(yī)院肝膽外科行肝切除的患者40例作為觀察研究對象,隨機分為A、B兩組(觀察組、對照組),每組20例;兩組均采用常規(guī)護肝治療,A組在此基礎上加用中藥利膽活血通腑方,比較兩組術前、術后第1、3、5、7天臨床癥狀及ALT、AST、TBIL等肝功能指標以及腫瘤壞死.-因子α等變化情況,并綜合評估比較臨床癥狀和平均住院日等。結(jié)果:本次實驗滿足入組條件病人40例中,符合標準并全程順利接受研究方法、資料收集完整者34例,其中,觀察組19例,對照組15例。兩組患者在術前各項評判指標無明顯差異,術后第七天觀察組ALT35.53±21.99U/L,AST20.32±6.75U/L對照組ALT80.87±63.10 U/L,AST60.53 ±31.67 U/L(P0.05),術后第五天觀察組 TNF-α 8.26±1.56 pg/ml,TBIL 10.31 ±2.79 umol/L,對照組 TNF-α 10.88±1.83 pg/ml,TBIL 16.33 ±4.97 umol/L(P0.05)。各項臨床癥狀變化指標相比也均具有統(tǒng)計學差異(p0.05)。平均住院日觀察組為12.84±1.74天,對照組為15.67±1.76天(P0.01),有顯著統(tǒng)計學差異。結(jié)論:在肝臟部分切除患者圍手術期使用利膽活血通腑方治療缺血再灌注損傷后,患者平均住院日降低,觀察各項指標觀察組較對照組均有明顯改善,患者術后臨床癥狀反應情況也較對照組好。表明原發(fā)性肝癌肝切除圍手術期病人采用中西醫(yī)結(jié)合治療方法,以利膽活血通腑為主法,使用利膽活血通腑方可有效降低部分炎癥介質(zhì)水平、減輕肝臟缺血再灌注損傷等,加速肝臟功能修復,促進患者快速康復。
[Abstract]:Through the clinical study on the recovery of patients with primary liver cancer treated by combination of traditional Chinese and western medicine during the perioperative period of hepatectomy, the role of traditional Chinese medicine in accelerating the rehabilitation of patients undergoing hepatectomy for primary liver cancer was observed by using Lidan Huoxue Tong Fu decoction. Objective evaluation and explore the significance of TCM in the accelerated rehabilitation of liver surgery. Methods: from February 2016 to January 2017, 40 patients admitted to the third people's Hospital of Nantong City for hepatectomy were randomly divided into two groups (observation group, control group) with 20 cases in each group. Both groups were treated with routine liver protection therapy. Group A was treated with traditional Chinese medicine Lidan Huoxue Tong Fu recipe on this basis. The clinical symptoms and ALT,AST, were compared between the two groups before and after operation. Liver function indexes such as TBIL and tumor necrosis.-factor 偽 were evaluated and compared with clinical symptoms and average hospitalization days. Results: among the 40 patients who met the condition of entering the group, they met the standard and accepted the study method successfully. The data were collected completely in 34 cases, including 19 cases in the observation group and 15 cases in the control group. On the seventh day after operation, ALT35.53 鹵21.99U / L AST 20.32 鹵6.75U/L control group ALT80.87 鹵63.10 U / L AST 60.53 鹵31.67 UL / L (P0.05). On the fifth day after operation, TNF- 偽 in the observation group was 8.26 鹵1.56 pg/ml,TBIL 10.31 鹵2.79 umol/L, control group, TNF- 偽 10.88 鹵1.83 pg/ml,TBIL 16.33 鹵4.97 umol/L (P0.05). The changes of clinical symptoms were also statistically different (p 0.05). The average hospitalization days were 12.84 鹵1.74 days in the observation group and 15.67 鹵1.76 days in the control group (P0.01). Conclusion: after the treatment of ischemia-reperfusion injury with Lidan Huoxue Tong Fu prescription in the perioperative period of partial hepatectomy patients, the average hospitalization time of the patients decreased, and the observed indexes in the observation group were significantly improved than those in the control group. The clinical symptoms and reactions of the patients after operation were also better than those of the control group. The results showed that patients with primary liver cancer were treated with integrated traditional Chinese and western medicine in perioperative period of hepatectomy. The main method was to facilitate the treatment of gallbladder and blood circulation, and the use of Lidan Huoxue Tong Fu decoction to effectively reduce the level of inflammatory mediators and alleviate the hepatic ischemia-reperfusion injury, and so on. Accelerate the repair of liver function and promote the rapid recovery of patients.
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R735.7

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