柴芩利胆合剂联合熊去氧胆酸对高复发风险胆总管切开取石一期缝合术后患者的疗效研究OA
Efficacy of Chaiqin Lidan formula combined with ursodeoxycholic acid in patients with high-risk recurrent choledocholithiasis after primary closure following choledochotomy
目的:观察柴芩利胆合剂联合熊去氧胆酸胶囊对高复发风险胆总管切开取石一期缝合术后患者的临床疗效,探讨其在促进术后恢复及降低结石复发风险方面的作用.方法:采用前瞻性对照研究方法,纳入2023年6月-2025年6月在上海市中医医院肝胆外科行胆总管切开取石一期缝合术的高复发风险胆总管结石患者120例,随机分为联合组和对照组,各60例.对照组术后给予熊去氧胆酸胶囊治疗,联合组在此基础上加用柴芩利胆合剂.比较两组术后肝功能指标[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBil)]恢复情况、临床症状改善时间、术后并发症发生率及随访期内结石复发情况.结果:术后第7天,联合组ALT、AST及TBil水平均低于对照组,差异具有统计学意义(P＜0.001).两组腹痛、腹胀等临床症状改善时间差异无统计学意义(P＞0.05),联合组术后并发症发生率为5.0％,对照组为11.7％,差异无统计学意义(P=0.186).6个月随访期内,联合组结石复发率为3.3％,对照组为8.3％,差异无统计学意义(P=0.436).结论:柴芩利胆合剂联合熊去氧胆酸可有效改善高复发风险胆总管切开取石一期缝合术后患者的肝功能,对降低术后并发症发生率及短期结石复发率也可能具有一定优势.
Objective To investigate the clinical efficacy of Chaiqin Lidan formula combined with ursodeoxycholic acid capsules in patients at high risk of recurrence after primary closure following choledochotomy for common bile duct stones,and to explore its role in promoting postoperative recovery and reducing the risk of stone recurrence.Methods A prospective controlled study was conducted involving 120 patients with common bile duct stones at high risk of recurrence who underwent primary closure following choledochotomy in the Department of Hepatobiliary Surgery,Shanghai Municipal Hospital of Traditional Chinese Medicine,between June 2023 and June 2025.The patients were randomly assigned to a combination group and a control group,with 60 patients in each group.The control group received ursodeoxycholic acid capsules postoperatively,while the combination group was additionally treated with Chaiqin Lidan formula.Postoperative liver function indices[alanine aminotransferase(ALT),aspartate aminotransferase(AST),and total bilirubin(TBil)],time to improvement of clinical symptoms,incidence of postoperative complications,and stone recurrence during the follow-up period were compared between the two groups.Results On postoperative day 7,levels of ALT,AST,and TBil in the combination group were significantly lower than those in the control group(P＜0.001).The difference in the time to improvement of clinical symptoms between the two groups was not statistically significant(P＞0.05).The incidence of postoperative complications was 5.0％in the combination group,which was lower than 11.7％in the control group;however,the difference was not statistically significant(P=0.186).During the 6-month follow-up period,the stone recurrence rate was 3.3％in the combination group and 8.3％in the control group,with no statistically significant difference between the groups(P=0.436).Conclusion Chaiqin Lidan formula combined with ursodeoxycholic acid can effectively improve liver function in patients at high risk of recurrence after primary closure following choledochotomy.The combination therapy may reduce postoperative complications and short-term stone recurrence.
辛海贝;白斌;苏显;周飞龙;梁晓亮;张敏峰
上海中医药大学附属市中医医院外二科(上海 201899)上海中医药大学附属市中医医院外二科(上海 201899)上海中医药大学附属市中医医院外二科(上海 201899)上海中医药大学附属市中医医院外二科(上海 201899)上海中医药大学附属市中医医院外二科(上海 201899)上海中医药大学附属市中医医院外二科(上海 201899)
医药卫生
胆总管结石胆总管切开取石一期缝合柴芩利胆合剂熊去氧胆酸复发
Choledocholithiasisprimary closure after choledochotomyChaiqin Lidan formulaursodeoxycholic acidrecurrence
《中国中西医结合外科杂志》 2026 (3)
350-354,5
上海市嘉定区自然科学研究课题(JDKW-2025-0012)
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