發(fā)布時(shí)間：2018-11-14 15:12

【摘要】：目的:以膽舒膠囊治療作對(duì)照,探討消石利膽膠囊聯(lián)合熊去氧膽酸膠囊(優(yōu)思弗)治療慢性膽囊炎、膽囊結(jié)石的臨床療效。方法:觀察2014年9月至2016年12月期間來(lái)吉林大學(xué)第二醫(yī)院肝膽胰內(nèi)科就診的經(jīng)腹部彩超確診的慢性膽囊炎患者82例。隨機(jī)分為3組,單用膽舒膠囊組即對(duì)照1組27例,口服膽舒膠囊每次2粒,日3次;單用消石利膽膠囊組即對(duì)照2組28例,給予消石利膽膠囊每次3粒,日3次口服;消石利膽膠囊聯(lián)合熊去氧膽酸膠囊(優(yōu)思弗)組即實(shí)驗(yàn)1組27例,給予消石利膽膠囊每次3粒,日3次口服,加用熊去氧膽酸膠囊750mg,日1次口服。經(jīng)腹部彩超確診的慢性膽囊炎膽結(jié)石患者115例。隨機(jī)分為4組,單用優(yōu)思弗組即對(duì)照3組25例,給予優(yōu)思弗750mg,日1次口服;單用消石利膽膠囊組即對(duì)照4組30例,給予消石利膽膠囊每次3粒,日3次口服;膽舒膠囊聯(lián)合優(yōu)思弗組即對(duì)照5組29例,給予膽舒膠囊每次2粒,日3次口服,加用優(yōu)思弗750mg,日1次口服;消石利膽膠囊聯(lián)合熊去氧膽酸膠囊組即實(shí)驗(yàn)2組31例,給予消石利膽膠囊每次3粒,日3次口服加用熊去氧膽酸膠囊750mg,日1次口服。慢性膽囊炎組療程為4周,慢性膽囊炎膽結(jié)石組療程為12周。治療后2周時(shí)檢查并記錄慢性膽囊炎組患者右上腹痛、口苦、后背部疼痛、膽囊區(qū)壓痛、進(jìn)食后腹脹消化不良等一般癥狀改善情況。治療后4周時(shí)檢查并記錄慢性膽囊炎膽結(jié)石患者右上腹痛、口苦、后背部疼痛、膽囊區(qū)壓痛、進(jìn)食后腹脹消化不良等一般癥狀改善情況。慢性膽囊炎膽結(jié)石組分別于治療后4周、12周時(shí)記錄患者膽囊結(jié)石的溶石情況。結(jié)果:1、慢性膽囊炎患者在治療2周時(shí),實(shí)驗(yàn)組患者在右上腹痛、膽囊區(qū)壓痛、口苦、后背部疼痛、進(jìn)食后腹脹消化不良等方面改善情況明顯優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);治療前后癥狀積分(均值)下降實(shí)驗(yàn)組明顯優(yōu)于對(duì)照組(P0.01);組內(nèi)比較治療前后癥狀積分(均值)下降有明顯差異(P0.01)。2、慢性膽囊炎膽結(jié)石患者治療4周時(shí),實(shí)驗(yàn)組患者在右上腹痛、膽囊區(qū)壓痛、口苦、進(jìn)食后腹脹消化不良等癥狀改善方面明顯優(yōu)于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);在后背部疼痛改善上實(shí)驗(yàn)組2明顯優(yōu)于對(duì)照組3及對(duì)照組4,差異有統(tǒng)計(jì)學(xué)意義(P0.05);實(shí)驗(yàn)組2略高于對(duì)照組5,但差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);治療前后癥狀積分(均值)下降實(shí)驗(yàn)組明顯優(yōu)于對(duì)照組(P0.01);組內(nèi)比較治療前后癥狀積分(均值)下降有明顯差異(P0.01)。3、慢性膽囊炎膽結(jié)石患者在4周溶石治療實(shí)驗(yàn)組有效率為45.2%,對(duì)照組3、對(duì)照組4及對(duì)照組5的有效率分別是16.0%、13.3%、20.7%;12周時(shí),實(shí)驗(yàn)組有效率為87.1%,對(duì)照組3、對(duì)照組4及對(duì)照組5的有效率分別是56.0%、53.3%、62.1%;實(shí)驗(yàn)組患者的溶石治療效果與對(duì)照組相比有明顯差異(P0.05)。結(jié)論:消石利膽膠囊聯(lián)合優(yōu)思弗治療單純慢性膽囊炎患者,在改善一般臨床癥狀上明顯優(yōu)于單一藥物治療組,在有效治療療程上聯(lián)合治療組與單一用藥組比較明顯縮短;消石利膽膠囊聯(lián)合優(yōu)思弗治療慢性膽囊炎膽結(jié)石患者,不僅在改善患者臨床癥狀方面,尤其是長(zhǎng)療程12周時(shí),溶石治療效果更為顯著,明顯優(yōu)于對(duì)照組,聯(lián)合治療值得臨床上推廣應(yīng)用。
[Abstract]:Objective: To control the treatment of chronic cholecystitis and cholecystolithiasis in the treatment of chronic cholecystitis and cholecystolithiasis. Methods: 82 cases of chronic cholecystitis diagnosed by abdominal color Doppler ultrasound from the second hospital of Jilin University from September 2014 to December 2016 were observed. The two groups were randomly divided into 3 groups, the single-use cholecuroshu capsule group (27 cases in control group 1), the oral cholecuroshu capsule 2 granules each time, and the day 3 times; the single-use anti-stone choleretic capsule group, i.e., the control group 2, 28 cases, and the anti-calculus and choleretic capsule was given three capsules each time, and the three times of the day were taken orally; Xiaoshi Lidan capsule combined with ursodeoxycholic acid capsule (Youthf), one of the 27 patients in the experimental group, was given three capsules at a time of 3 times per day, and was orally taken with a bear desoxycholic acid capsule (750mg, day 1). 115 patients with chronic cholecystitis and cholelithiasis diagnosed by abdominal color ultrasound. The four groups were randomly divided into 4 groups, 25 cases of control group and 25 cases of control group. The capsules were orally administered once every 2 capsules, daily for 3 times, and with the above-mentioned two groups. The combined bear desoxycholic acid capsule group (31 cases of the experimental group 2) was administered by the combination of the Xiao Shi Lidan capsule combined with the Ursodeoxycholic acid capsule group, which was orally administered with the Ursodeoxycholic acid capsule on the day of 3 times and the day was once orally taken. The treatment course of the chronic cholecystitis group was 4 weeks, and the treatment course of the chronic cholecystitis group was 12 weeks. After 2 weeks of treatment, the patients with chronic cholecystitis were examined and recorded with general symptoms such as abdominal pain, bitter taste, back pain, tenderness in the gallbladder, and abdominal distension and indigestion after eating. After 4 weeks of treatment, the patients with chronic cholecystitis and cholelithiasis were examined and recorded with the general symptoms such as abdominal pain, bitter taste, back pain, tenderness in the gallbladder, abdominal distension and indigestion after eating. The gallstone formation in patients with chronic cholecystitis was recorded at 4 and 12 weeks after treatment. Results: 1. When the patients with chronic cholecystitis were treated for 2 weeks, the patients in the experimental group had abdominal pain in the right, the pain in the gallbladder area, the pain of the mouth, the pain of the back and the back, and the abdominal distension and indigestion after eating. The difference was statistically significant (P <0.05). The integral (mean) of the symptoms before and after treatment was significantly better than that in the control group (P0.01), and there was a significant difference in the reduction of the symptom score (mean) before and after the treatment in the group (P0.01). In the treatment of the patients with chronic cholecystitis and cholelithiasis for 4 weeks, the patients in the experimental group had the abdominal pain in the right, the pain in the gallbladder area, and the bitter taste. There was a significant difference between the control group and the control group (P <0.05), and the experimental group 2 was slightly higher than that in the control group (P <0.05). However, there was no significant difference in the difference between the treatment group and the control group (P 0.01), and the difference of the symptom score (mean value) in the treatment group was significantly different from that in the control group (P0.01). The effective rate of the patients with chronic cholecystitis and cholelithiasis was 40.2% in the experimental group, the control group 3, the control group 4 and the control group 5 were respectively 16. 0%, 13. 3%, 20. 7%, 12 weeks, the effective rate of the experimental group was 87.1%, and the control group 3, The effective rate of the control group 4 and the control group 5 was 56. 0%, 53. 3%, and 62.1%, respectively. The treatment effect of the treatment group in the experimental group was significantly different from that of the control group (P0.05). Conclusion: The treatment of simple chronic cholecystitis with the combination of Xiao-Shi Lidan capsule and high-optimal method is superior to the single-drug treatment group in the improvement of the general clinical symptoms, and the combination of the combination therapy group and the single-use group is obviously shortened in the effective treatment course; In the treatment of patients with chronic cholecystitis and cholelithiasis, the patients with chronic cholecystitis and cholelithiasis are treated with Xiaoshi Lidan Capsule, especially in the 12-week long course of treatment, which is better than that of the control group, and the combination therapy is worthy of clinical popularization and application.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R575.6

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