本文選題：芍甘湯 + 膽總管結(jié)石��； 參考：《大連醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的：Oddi括約肌運(yùn)動(dòng)功能障礙在現(xiàn)在已經(jīng)廣泛為醫(yī)學(xué)者所了解。而膽總管結(jié)石引起的急性膽管炎作為臨床常見病，大量報(bào)道證實(shí)急性膽管炎的發(fā)生、發(fā)展與Oddi括約肌痙攣密切相關(guān)：急性膽管炎可以引發(fā)或伴隨SO痙攣；而SO痙攣又可以加重急性膽管炎。SOD包括SO功能紊亂和狹窄, SO痙攣屬于SOD功能紊亂范疇。我們的前期試驗(yàn)證實(shí)，芍甘湯的主要成分芍藥甙可以舒張Oddi括約肌，從而緩解Oddi括約肌痙攣。本實(shí)驗(yàn)以膽總管結(jié)石引起的急性膽管炎患者為研究對(duì)象，觀察早期應(yīng)用芍甘湯對(duì)膽總管結(jié)石引起的急性膽管炎的療效。 方法：采用單盲隨機(jī)對(duì)照臨床試驗(yàn)方法，選擇膽總管結(jié)石引起的急性膽管炎患者為研究對(duì)象，在非手術(shù)治療階段各種基本處置相同的條件下，治療組41例入院即給予芍甘湯治療，以應(yīng)用生理鹽水作為對(duì)照組。觀察兩組患者非手術(shù)治療階段后，發(fā)病48小時(shí)內(nèi)疼痛緩解率、體溫降低率、白細(xì)胞降低率、手術(shù)率。同時(shí)觀察治療組發(fā)病距應(yīng)用芍甘湯0-12小時(shí)、12-24小時(shí)、24小時(shí)以上三組的疼痛緩解率。 結(jié)果：比較治療組與對(duì)照組在發(fā)病48小時(shí)內(nèi)的疼痛緩解率、體溫降低率、白細(xì)胞降低率、手術(shù)率，治療組均不同于對(duì)照組，且經(jīng)統(tǒng)計(jì)學(xué)分析具有統(tǒng)計(jì)學(xué)差異。同時(shí)發(fā)現(xiàn)，給藥時(shí)間距發(fā)病時(shí)間越短，疼痛緩解率越高。 結(jié)論：對(duì)于膽總管結(jié)石引起的急性膽管炎患者早期行芍甘湯干預(yù)治療，能夠明顯緩解患者腹痛癥狀，減輕痛苦，降低體溫及白細(xì)胞計(jì)數(shù)，減少了急診手術(shù)率。距急性膽管炎發(fā)病時(shí)間越短，，芍甘湯對(duì)緩解Oddi括約肌痙攣效果越明顯，防止了急性膽管炎的進(jìn)展，尤其對(duì)于減輕疼痛效果明顯，減少了患者的痛苦。
[Abstract]:Objective: dysmotility of oddi sphincter is now widely known in medicine. Acute cholangitis caused by choledocholithiasis is a common clinical disease. A large number of reports confirm that the occurrence of acute cholangitis is closely related to spasm of sphincter of oddi: acute cholangitis can cause or accompany so spasm; So spasticity can aggravate acute cholangitis. SOD includes so dysfunction and stenosis, so spasm belongs to SOD functional disorder category. Our previous experiments confirmed that paeoniflorin, the main component of Shaogan decoction, can relax sphincter of oddi and relieve spasm of oddi. In this study, acute cholangitis caused by choledocholithiasis was studied to observe the effect of early application of Shaogan decoction on acute cholangitis caused by choledocholithiasis. Methods: a single blind randomized controlled clinical trial was conducted to select the patients with acute cholangitis caused by choledocholithiasis. The treatment group (41 cases) was treated with Shaogan decoction immediately after admission, and the control group was treated with normal saline. The pain relief rate, hypothermia rate, leukopenia rate and operation rate were observed in 48 hours after non-operative treatment. At the same time, the pain relief rate of the treatment group was observed after the treatment group was treated with Shaogan decoction for 0-12 hours and 12-24 hours and more than 24 hours. Results: the pain relief rate, hypothermia rate, leukopenia rate and operation rate in the treatment group and the control group were all different from those in the control group within 48 hours after the onset of the disease, and there was statistical difference between the treatment group and the control group. At the same time, it was found that the shorter the time of administration, the higher the pain relief rate. Conclusion: early intervention therapy of Shaogan decoction for patients with acute cholangitis caused by choledocholithiasis can obviously relieve abdominal pain, alleviate pain, decrease body temperature and white blood cell count, and reduce the rate of emergency operation. The shorter the onset time of acute cholangitis, the more obvious the effect of Shaogan decoction on relieving sphincter spasm of oddi, which prevented the progression of acute cholangitis, especially in alleviating the pain and reducing the pain of the patients.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R657.4

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