本文選題：金茵化石顆粒　切入點(diǎn)：化學(xué)藥　出處：《中國藥房》2017年35期

【摘要】：目的:探討苗藥金茵化石顆粒聯(lián)合化學(xué)藥治療慢性結(jié)石性膽囊炎的臨床療效及安全性。方法:選取2014年1月-2016年1月我院收治的慢性結(jié)石性膽囊炎120例,按隨機(jī)數(shù)字表法分為對照組和觀察組,各60例。對照組患者餐前給予硫酸鎂注射液10 m L,tid;餐后口服阿莫西林片0.5 g,tid+消旋山莨菪堿片10 mg,tid+復(fù)方膽通片1片,tid。觀察組患者在對照組基礎(chǔ)上給予苗藥金茵化石顆粒15 g,tid。兩組患者均連續(xù)治療4周。觀察兩組患者臨床療效及上腹疼痛、惡心厭油膩、結(jié)石改善情況,并比較兩組患者治療前后的膽囊壁厚度,白細(xì)胞介素2(IL-2)、IL-15水平和膽固醇7α羥化酶(CYP7A1)、二磷酸葡萄糖醛酸基轉(zhuǎn)移酶(B-UGT)m RNA及蛋白表達(dá)水平,記錄兩組患者不良反應(yīng)發(fā)生情況。結(jié)果:觀察組患者的臨床總有效率為96.67%,顯著高于對照組的88.33%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后1 d、1周,觀察組患者上腹疼痛改善率分別為63.33%、81.67%,顯著高于對照組的36.67%、50.00%,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);兩組患者治療后2~4周的上腹疼痛改善率以及治療后惡心厭油膩改善率比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。觀察組患者的結(jié)石排凈率為33.33%,顯著高于對照組的11.67%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療前,兩組患者膽囊壁厚度,IL-2、IL-15水平和CYP7A1、B-UCT m RNA及蛋白表達(dá)水平比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05);治療后,兩組患者膽囊壁厚度和IL-2、IL-15水平均顯著降低,CYP7A1、B-UCT m RNA及蛋白表達(dá)水平均顯著升高,且觀察組顯著優(yōu)于對照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組患者不良反應(yīng)發(fā)生率比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:苗藥金茵化石顆粒聯(lián)合化學(xué)藥治療慢性結(jié)石性膽囊炎療效顯著,能有效改善患者右上腹疼痛和惡心厭油膩癥狀,降低IL-2、IL-15水平,上調(diào)CYP7A1、B-UCT m RNA及其蛋白表達(dá),且安全性較高。
[Abstract]:Objective: to investigate the clinical efficacy and safety of Jinyin fossil granules combined with chemical drugs in the treatment of chronic calculous cholecystitis. Methods: 120 cases of chronic calculous cholecystitis treated in our hospital from January 2014 to January 2016 were selected. According to the random digital table method, they were divided into control group and observation group. 60 patients in each group were treated with magnesium sulfate injection 10 mL / L before meal and 10 mg / kg anisodamine tablet 10 mg / kg of anisodamine tablet after meal respectively. The patients in the observation group were given the fossil of Jinyin vaccine on the basis of the control group, while the patients in the observation group were given the tablet of Amoxicillin 0.5 g / L after meal and 1 tablet of compound Dantong tablet (10 mg / g) of Anisodamine tablets. The patients in both groups were treated continuously for 4 weeks. The clinical curative effect and upper abdominal pain were observed in both groups. After treatment, the thickness of gallbladder wall, the level of IL-15 and the expression levels of cholesterol 7 偽 -hydroxylase CYP7A1C, glucuronyltransferase B-UGTM RNA and protein before and after treatment were compared between the two groups. Results: the total effective rate of the patients in the observation group was 96.67, which was significantly higher than that in the control group (88.33), and the difference was statistically significant (P 0.05). The improvement rate of upper abdominal pain in the observation group was 63.33 and 81.67 respectively, which was significantly higher than that in the control group (36.67 and 50.005), and the difference was statistically significant (P 0.05), and the improvement rate of upper abdominal pain and nausea and anaerobic greasy after 24 weeks treatment were compared between the two groups. There was no significant difference between the two groups (P 0.05). The stone excretion rate in the observation group was 33.33, which was significantly higher than that in the control group (11.67%). The difference was statistically significant (P 0.05). Before treatment, the level of IL-2 IL-15 and the expression of CYP7A1 B-UCT m RNA and protein were compared between the two groups. After treatment, the thickness of gallbladder wall and the level of IL-15 decreased significantly, and the expression of CYP7A1B-UCT m RNA and protein in the observation group were significantly higher than that in the control group. There was no significant difference in the incidence of adverse reactions between the two groups. Conclusion: the therapeutic effect of Jinyin fossil granules combined with chemical drugs on chronic calculous cholecystitis is significant. It can effectively improve the right upper abdominal pain and nausea, reduce the level of IL-15, and up-regulate the expression of CYP7A1 B-UCT m RNA and its protein.
【作者單位】： 黔南布依族苗族自治州中醫(yī)醫(yī)院普外科;黔南民族師范學(xué)院貴州省高校民族藥用植物資源開發(fā)工程研究中心;
【基金】：貴州省中醫(yī)藥管理局中醫(yī)藥、民族醫(yī)藥科學(xué)技術(shù)研究課題(No.QYZZ2015084) 貴州省普通高等學(xué)校民族藥用植物資源開發(fā)工程研究中心建設(shè)項(xiàng)目(No.黔教合KY字[2014]227號)
【分類號】：R575.61

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