陈凯锋　李明　赵娟娟　袁通立

【摘要】 目的：探讨消炎利胆止痛汤治疗慢性胆囊炎患者的临床效果及对安全性的影响。方法：回顾性分析2019年10月-2020年10月收治的98例慢性胆囊炎患者的临床资料，根据治疗方案分为观察组（n=52）和对照组（n=46）。对照组给予常规西医对症治疗，在对照组治疗的基础上，观察组给予消炎利胆止痛汤治疗。比较两组患者的疗效和不良反应发生情况;比较两组治疗前后的血清炎症因子、胃肠功能指标、中医证候积分。结果：观察组治疗总有效率为94.23%（49/52），高于对照组的80.43%（37/46）（P<0.05）。与同组治疗前比较，两组治疗后的血清IL-2、IL-6和腹胀、右上腹隐痛、恶心呕吐积分均降低，而血清MOT、GAS水平均升高（P<0.05）;觀察组治疗后的血清IL-2、IL-6和腹胀、右上腹隐痛、恶心呕吐积分均低于对照组，血清MOT、GAS水平均高于对照组（P<0.05）。两组不良反应发生率比较，差异无统计学意义（P>0.05）。结论：在常规西医对症治疗基础上加用消炎利胆止痛汤治疗慢性胆囊炎，有助于降低患者炎症因子水平，改善患者胃肠道功能、症状，提高疗效，且安全可靠。

【关键词】 消炎利胆止痛汤 慢性胆囊炎 炎症因子

[Abstract] Objective： To investigate the clinical effect of Xiaoyan Lidan Zhitong Decoction in the treatment of chronic cholecystitis and its influence on safety. Method： The clinical data of 98 patients with chronic cholecystitis from October 2019 to October 2020 were analyzed retrospectively. According to the treatment plan， they were divided into observation group （n=52） and control group （n=46）. The control group was given routine western medicine symptomatic treatment， and the observation group was given Xiaoyan Lidan Zhitong Decoction on the basis of the control group treatment. The curative effect and adverse reaction between the two groups were compared， serum inflammatory factors， gastrointestinal function indexes and the TCM syndrome scores were compared between the two groups before and after treatment were compared. Result： The effective rate of the observation group was 94.23% （49/52）， which was higher than the 80.43% （37/46） of the control group （P<0.05）. Compared with the same group before treatment， serum IL-2， IL-6， abdominal distension， right upper abdominal pain， nausea and vomiting scores were decreased in both groups after treatment， while serum MOT and GAS levels were increased （P<0.05）; after treatment， the levels of serum IL-2， IL-6， scores of abdominal distension， right upper abdominal dull pain， nausea and vomiting in observation group were lower than those in control group， while the levels of serum MOT and GAS were higher than those in control group （P<0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （P>0.05）. Conclusion： On the basis of the conventional symptomatic treatment of western medicine， adding Xiaoyan Lidan Zhitong Decoction in the treatment of chronic cholecystitis is helpful to reduce the level of inflammatory factors in patients， improve the gastrointestinal function and symptoms of patients， and improve the efficacy， and is safe and reliable.

[Key words] Xiaoyan Lidan Zhitong Decoction Chronic cholecystitis Inflammatory factors

First-authors address： Hunan University of Chinese Medicine Graduate School， Changsha 410036， China

doi：10.3969/j.issn.1674-4985.2021.11.034

慢性胆囊炎是胆囊的慢性炎症改变，多数为慢性结石性胆囊炎，其临床表现无特异性，多数为上腹部或心窝处隐隐作痛，餐后饱胀不适和嗳气，在食用油腻食品后可出现恶心和呕吐，从而影响患者健康状况及生存质量[1-2]。慢性胆囊炎的西医对症治疗效果差强人意，仍有待改善[3]。近年来中药汤药在慢性胆囊炎治疗中的应用增加，消炎利胆止痛汤在其中的应用有助于提高疗效和改善症状[4]。中西医结合治疗在慢性疾病中的应用成为新趋势，但目前关于消炎利胆止痛汤与西医结合治疗慢性胆囊炎研究仍较少。因此，本研究在西医对症治疗的基础上采用消炎利胆止痛汤治疗慢性胆囊炎，观察了其对疗效、血清因子及中医证候积分及其安全性的影响，现报道如下。……