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

【摘要】：目的：Oddi括約肌運動功能障礙在現(xiàn)在已經(jīng)廣泛為醫(yī)學者所了解。而膽總管結石引起的急性膽管炎作為臨床常見病，大量報道證實急性膽管炎的發(fā)生、發(fā)展與Oddi括約肌痙攣密切相關：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。我們的前期試驗證實，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。本實驗以膽總管結石引起的急性膽管炎患者為研究對象，觀察早期應用芍甘湯對膽總管結石引起的急性膽管炎的療效。 方法：采用單盲隨機對照臨床試驗方法，選擇膽總管結石引起的急性膽管炎患者為研究對象，在非手術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，以應用生理鹽水作為對照組。觀察兩組患者非手術治療階段后，發(fā)病48小時內(nèi)疼痛緩解率、體溫降低率、白細胞降低率、手術率。同時觀察治療組發(fā)病距應用芍甘湯0-12小時、12-24小時、24小時以上三組的疼痛緩解率。 結果：比較治療組與對照組在發(fā)病48小時內(nèi)的疼痛緩解率、體溫降低率、白細胞降低率、手術率，治療組均不同于對照組，且經(jīng)統(tǒng)計學分析具有統(tǒng)計學差異。同時發(fā)現(xiàn)，給藥時間距發(fā)病時間越短，疼痛緩解率越高。 結論：對于膽總管結石引起的急性膽管炎患者早期行芍甘湯干預治療，能夠明顯緩解患者腹痛癥狀，減輕痛苦，降低體溫及白細胞計數(shù)，減少了急診手術率。距急性膽管炎發(fā)病時間越短，，芍甘湯對緩解Oddi括約肌痙攣效果越明顯，防止了急性膽管炎的進展，尤其對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.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R657.4

【參考文獻】

相關期刊論文 前10條

1 鄒多武,許國銘,孫振興,李兆申,尹寧;Oddi括約肌測壓對膽囊切除術后腹痛患者的診斷價值[J];第二軍醫(yī)大學學報;1997年02期

2 雒建瑞;王長淼;傅雷;孫藝平;;芍藥甙對家兔離體Oddi括約肌肌環(huán)收縮活動的影響[J];大連醫(yī)科大學學報;2009年06期

3 修麗梅,福島峰子,吉崎克明,櫛引美代子;芍藥甘草湯及其組成成分對子宮收縮抑制作用的研究[J];國外醫(yī)學(中醫(yī)中藥分冊);1997年03期

4 王永謙;李文浦;張文如;孫平生;張靜生;李中宇;張德福;;芍藥甘草湯的研究進展[J];遼寧中醫(yī)雜志;1980年09期

5 胡兵;唐采白;石麗紅;吳毓麟;;Oddi括約肌蠕動方向及膽總管遠端生理狹窄段長度與膽石病成因的相關性研究[J];華北煤炭醫(yī)學院學報;2006年06期

6 張兆旺;孫秀梅;李群;畢俊英;;芍藥甘草湯組方意義的實驗研究[J];山東中醫(yī)學院學報;1990年01期

7 張積強,陳強,劉宗懷;抗瘧新藥青蒿素的研究[J];陜西化工;1996年04期

8 丁慶，譚俊峰，張麗娟，郝戰(zhàn)，夏家紅，鄒聲泉，胡文淑;甲基蓮心堿對豚鼠離體膽道平滑肌的作用[J];同濟醫(yī)科大學學報;1996年04期

9 董家鴻,冷建軍;Oddi括約肌功能障礙[J];中國現(xiàn)代手術學雜志;2002年03期

10 ;功能性胃腸病的羅馬Ⅲ診斷標準[J];現(xiàn)代消化及介入診療;2007年02期

本文編號：2075030