本文選題：疏肝二金湯 + 慢性膽囊炎�。� 參考：《湖南中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的:探討疏肝二金湯治療慢性膽囊炎肝膽氣滯證的臨床療效和安全性,以及其對膽囊收縮功能的影響。方法:將符合納入標(biāo)準(zhǔn)的60例慢性膽囊炎肝膽氣滯證患者,采用隨機(jī)數(shù)字表法分為兩組,治療組和對照組各30例。分別予以疏肝二金湯、膽石利通片治療30天,觀察患者在治療前后臨床癥狀及超聲檢查下膽囊大小、形態(tài)等變化,并通過脂餐試驗測定膽囊排空指數(shù),觀察膽囊收縮功能變化情況。結(jié)果:1.臨床療效評定:治療后,治療組和對照組的總有效率分別為93.33%、66.67%,兩組比較有統(tǒng)計學(xué)意義(P0.05)。兩組治療前后綜合癥狀積分和積分差值比較有統(tǒng)計學(xué)意義(P0.05)。對治療前后兩個主癥的積分情況進(jìn)行比較時,治療組均有統(tǒng)計學(xué)意義(P0.05);對照組第一個主癥(右脅脹痛或隱痛)治療前后比較有統(tǒng)計學(xué)意義(P0.05),而第二個主癥(疼痛因情志變化而加重或減輕)治療前后比較無統(tǒng)計學(xué)意義(P0.05)。2.超聲檢查療效評定:兩組治療前后超聲檢查提示治療組的有效率為93.33%,明顯高于對照組(68.75%),兩者比較有統(tǒng)計學(xué)意義(P0.05)。治療后兩組患者的膽囊排空指數(shù)分別較前比較,均有統(tǒng)計學(xué)意義(P0.05);兩組治療前后GBEF差值比較有統(tǒng)計學(xué)意義(P0.05)。治療后兩組患者的膽囊收縮功能分別較前比較,均有統(tǒng)計學(xué)意義(P0.05)。治療后兩組患者膽囊收縮功能之間比較無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:疏肝二金湯治療可改善慢性膽囊炎肝膽氣滯證患者總的臨床癥狀,提高總有效率,且在改善主癥方面有優(yōu)勢。也可改善該病患者超聲檢查下膽囊的壁厚、毛糙度及透聲性等,并增強(qiáng)膽囊收縮功能,提示疏肝二金湯可能能夠通過促進(jìn)膽囊的收縮,加大膽囊排空率,達(dá)到利膽作用。
[Abstract]:Objective: to investigate the clinical efficacy and safety of Shugan Erjin decoction in treating chronic cholecystitis with stagnation of liver-gallbladder qi and its effect on gallbladder contraction. Methods: sixty cases of chronic cholecystitis with liver and gallbladder qi stagnation were divided into two groups by random number table, 30 cases in treatment group and 30 cases in control group. The patients were treated with Shugan Erjin decoction and cholestasis Litong tablet for 30 days. The changes of gallbladder size and shape were observed before and after treatment, and the gallbladder emptying index was measured by fat meal test. The changes of gallbladder contraction function were observed. The result is 1: 1. Evaluation of clinical efficacy: after treatment, the total effective rates of the treatment group and the control group were 93.33 and 66.67, respectively. The two groups had statistical significance (P 0.05). Before and after treatment, there were significant differences in the score and the difference between the two groups (P 0.05). When comparing the scores of the two main symptoms before and after treatment, In the treatment group, there was significant difference between the first main symptom (right flank pain or latent pain) before and after treatment, but the second main symptom (the pain was aggravated or alleviated due to the change of emotion) had no statistical significance before and after treatment. Evaluation of the curative effect of ultrasonic examination: the effective rate of the treatment group was 93.33, which was significantly higher than that of the control group (68.75g / kg) before and after treatment, and the comparison between the two groups was statistically significant (P 0.05). After treatment, the gallbladder emptying index of the two groups was significantly higher than that of the former, and the difference of GBEF between the two groups before and after treatment was statistically significant (P 0.05). After treatment, the gallbladder contraction function of the two groups was significantly higher than that of the former group (P 0.05). There was no significant difference in gallbladder systolic function between the two groups after treatment (P 0.05). Conclusion: Shugan Erjin decoction can improve the total clinical symptoms of chronic cholecystitis patients with stagnation of liver-gallbladder qi, improve the total effective rate, and have an advantage in improving the main symptoms of chronic cholecystitis. It can also improve the wall thickness, roughness and sound permeability of gallbladder under ultrasonic examination, and enhance the contraction function of gallbladder. It suggests that Shugan Erjin decoction can promote the contraction of gallbladder, increase the rate of gallbladder emptying, and achieve the effect of choledochism.
【學(xué)位授予單位】：湖南中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R259

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