【作者】 徐颖博；

【导师】 崔乃强；

【作者基本信息】 天津医科大学 ， 中西医结合临床， 2010， 硕士

【摘要】 目的：观察复方中药对胆管结石术后患者胆汁成分以及对肝脏功能的影响。方法：选取80例行胆管探查+T型管引流术或经内镜鼻胆管引流术(ENBD)治疗的胆管结石患者,随机分为两组：对照组和中药组,分别于服药前和服药后1,3,5,7天清晨取胆汁5m1,检测胆汁总胆红素(TBIL)、非结合胆红素(UCB)、胆汁酸(TBA)、胆固醇(CHO)、磷脂(PL)、Ca2+浓度及胆汁中细菌源性和内源性β-葡萄糖醛酸酶(β-G)活性；并于服药前和服药后3天清晨空腹取血5ml,检测血清总胆红素(TBIL)、直接胆红素(DBIL)、胆汁酸(TBA)、碱性磷酸酶(ALP)、丙氨酸氨基转移酶(ALT)、γ-谷氨酰转肽酶(GGT)和胆固醇(CHO)。结果：(1)中药组可以增加胆汁中总胆红素(TBIL)、胆汁酸(TBA)和磷脂(PL)的含量,降低内源性β-G活性,同时降低非结合胆红素(UCB)和Ca2+的浓度；(2)中药组可明显降低血清总胆红素(TBIL)、直接胆红素(DBIL)、胆汁酸(TBA)、碱性磷酸酶(ALP)、丙氨酸氨基转移酶(ALT)、γ-谷氨酰转肽酶(GGT)、胆固醇(CHO)。结论：复方中药可以明显增加胆管结石术后患者胆汁中总胆红素的排出,增加胆汁酸和磷脂的浓度,降低游离胆红素和Ca2+浓度,降低内源性p-G活性,降低胆汁淤积对肝功能的损害,从而降低胆汁成石性,改善肝脏功能,对于防治术后结石的复发有-定作用。更多还原

【Abstract】 Objective:To study the effects of Chinese herbal medicine on bile ingredients and liver function of postoperative patients with bile duct stones.Methods:80 patients suffered from bile duct stones with choledochostomy+T tube drainage or endoscopic nasobiliary drainage (ENBD) were selected. The patients were divided into two groups randomly:control group and Chinese herbal medicine group, and the drained bile was collected before and on the 1,3,5,7 th day after treatment to detect TBIL、UBC、PL and Ca2+,We also detected the enzymatic activities of the bacterialβ-glucuronidase and the humanβ-glucuronidase by using Fishman’s method. the serum was collected before and on the 3 th day after treatment to detect TBIL、DBIL、TBA、ALP、ALT、GGT and CHO.Results:(1) Bile TBIL、TBA and PL gradually increased after treatment with herbal medicine, (p<0.05).The density of CHO、UBC、Ca2+and the activities of the humanβ-glucuronidase were decreased obviously during the treatment with herbal medicine (p<0.05). (2) the serum of TBIL、DBIL、TBA、ALP、ALT、GGT CHO were decreased obviously during the treatment with herbal medicine (p< 0.05).Conclusions:The bile TBIL、TBA and PL were gradually increased，however the density of CHO、UBC、Ca2+and the activities of the humanβ-glucuronidase were decreased obviously during the treatment with herbal medicine, reduce the function of cholestatic liver injury, thereby reduce the bile into the stone, improve liver function,it is important to prevent recrudescence of postoperative stones.更多还原