张志友　刘文生　李鹰　章世海

[摘要] 目的 探討胆清胶囊联合熊去氧胆酸胶囊治疗保胆取石术后结石复发的临床效果。 方法 选取2014年4月～2016年4月南京中医药大学附属南京市中西医结合医院收治的行内镜下微创保胆取石术的患者69例为研究对象。根据随机数字表法将患者分为对照组（n = 34）和研究组（n = 35）。对照组患者给予熊去氧胆酸胶囊治疗，研究组在此基础上联合胆清胶囊治疗。比较两组患者治疗2个月后的临床效果，比较两组患者治疗前后胆囊指标，观察两组患者治疗期间不良反应发生情况，随访2年，观察其复发情况。 结果 研究组患者总有效率高于对照组，差异有统计学意义（P < 0.05）。两组患者治疗后胆囊壁厚度较治疗前降低，且研究组低于对照组（P < 0.05）；胆囊收缩率较治疗前升高，且研究组高于对照组（P < 0.05）。研究组患者治疗后2年复发率明显低于对照组，差异有统计学意义（P < 0.05）。两组患者不良反应发生率比较，差异无统计学意义（P > 0.05）。 结论 胆清胶囊联合熊去氧胆酸胶囊治疗保胆取石术后结石复发效果确切，安全性佳，可有效降低胆囊结石复发，改善胆囊功能，具有一定的临床应用价值。

[关键词] 胆清胶囊；熊去氧胆酸胶囊；保胆取石术；结石复发

[中图分类号] R575.6 [文献标识码] A [文章编号] 1673-7210（2018）11（b）-0121-04

[Abstract] Objective To investigate the clinical effect of Danqing Capsules combined with Ursodeoxycholic Acid Capules in the treatment of stone recurrence after gallbladder preserving lithotomy. Methods Sixty-nine patients who underwent endoscopic minimally invasive gallbladder preserving lithotomy in Nanjing Integrated Chinese and Western Medicine Affiliated to Nanjing University of Chinese Medicine from April 2014 to April 2016 were selected as the research subjects. The patients were divided into control group （n = 34） and study group （n = 35） according to the random number table method. The patients in the control group were treated with Ursodeoxycholic Acid Capules， and the study group was treated with Ursodeoxycholic Acid Capules and Danqing Capsules. The patients′ clinical efficacy in the two groups after 2 months of treatment was compared， the patients′ gallbladder index in the two groups before and after treatment was compared， the patients′ adverse reactions in the two groups during the treatment were observed. After two years of follow-up， the recurrence was observed. Results The total effective rate of patients in the study group was higher than that of control group， there was a significant difference between the two groups （P < 0.05）. After treatment the thickness of the gallbladder wall in the two groups was lower than that before treatment， and the study group was lower than the control group （P < 0.05）， the gallbladder contraction rate was higher than that before treatment， and the study group was higher than the control group （P < 0.05）. The recurrence rate after treatment for 2 years of study group was lower than that of control group， the difference was statistically significant （P < 0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （P > 0.05）. Conclusion Danqing Capsules combined with Ursodeoxycholic Acid Capules in the treatment of gallstone recurrence after cholecystolithiasis is effective and safe， it can effectively reduce the recurrence of gallstones and improve the function of gallbladder， and it has certain clinical value.

[Key words] Danqing Capsules； Ursodeoxycholic Acid Capsules； Gallbladder preserving lithotomy； Stone recurrence

胆囊结石是指发生在胆囊内的结石所引起的疾病，临床主要表现为胆绞痛、胆囊积液、上腹隐痛、黄疸等[1]。我国胆囊结石的发病率达8%～10%，且随着我国人口老龄化的加剧，其发病率呈不断上升趋势[2]。关于胆囊结石的治疗方法多样，主要以外科手术为主，胆囊切除术一直被视为胆囊结石治疗的金标准[3]。然而越来越多医疗工作者认识到，胆囊结石恐会引起一系列副作用。而内镜下微创保胆取石术就是在此种环境下产生的一种新型的治疗方法[4]。……