关键词: 慢性胆囊炎, 胆结石, 腹腔镜胆囊切除术, 疏利通泄汤, 胃肠功能, 治疗

Abstract: Objective The aim of this study was to explore the efficacy of Shuli Tongxie Decoction, herbal medicine, in the treatment of patients with chronic cholecystitis (CC) and cholelithiasis after laparoscopic cholecystectomy (LC). Methods 78 patients with CC and cholelithiasis were enrolled in our hospital between May 2018 and May 2021, and were randomly divided into control group and observation group with 39 cases in each. ALL patients in the series underwent LC, and the patients in the control group were given ursodeoxycholic acid (UDCA), while those in the observation group were treated with UDCA and the herbal medicine combination for 8 weeks. Serum total bile acid (TBA), unconjugated bilirubin (UCB) and calcium ion (Ca²⁺), serum interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α),adrenocorticotropic hormone (ACTH), malondialdehyde (MDA), superoxide dismutase (SOD), gastrin (GAS), motilin (MOT) and vasoactive intestinal peptide (VIP) levels were routinely detected. Results At the end of the treatment, serum TBA, UCB and Ca²⁺ levels in the combination treatment group were (6.9±1.4)μmol/L, (7.4±1.1)μmol/L and (1.9±0.2) mmol/L, all significantly lower than [(10.7±1.8)μmol/L, (12.6±1.4)μmol/L and (2.2±0.3)mmol/L, respectively, P<0.05]; serum IL-6, TNF-α, ACTH and MDA levels were (4.8±2.7) ng/L, (1.4±0.2)μg/L, (31.4±3.8)ng/mL and (2.2±0.6)nmol/L, significantly lower than [(19.6±4.4)ng/L, (2.6±0.3)μg/L, (42.7±4.9)ng/mL and (4.9±0.7)nmol/L, while serum SOD level was (149.4±7.1)U/mL, significantly higher than [(96.6±6.7)U/mL, P<0.05] in the control; serum GAS and MOT levels were (103.9±7.9)ng/L and (280.5±13.3)ng/L, both much higher than [(93.6±8.1)ng/L and (243.6±14.6)ng/L, P<0.05], while serum VIP level was (35.9±5.3)pg/mL, much lower than [(49.1±5.7)pg/mL, P<0.05] in the control; six months after operation, the stone relapsed in one case in the combination group, and that was three cases in the control (P>0.05). Conclusion The oral administration of herbal medicine, Shuli Tongxie Decoction, after LC in preventing stone relapse might be helpful, and needs further clinical investigation.

Key words: Chronic cholecystitis, Cholelithiasis, Laparoscopic cholecystectomy, Shuli Tongxie Decoction, herbal medicine, Gastrointestinal function tests, Therapy