本文選題：利膽健脾湯 + 慢性膽囊炎��； 參考：《云南中醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:本課題旨在對(duì)肝郁脾虛型慢性膽囊炎的臨床研究,探討利膽健脾湯治療慢性膽囊炎(肝郁脾虛型)的臨床療效及安全性評(píng)估,進(jìn)一步探尋中醫(yī)藥對(duì)慢性膽囊炎的治療作用,為中醫(yī)治療慢性膽囊炎(肝郁脾虛型)提供新的方法。方法:臨床選擇符合納入標(biāo)準(zhǔn)的慢性膽囊炎患者82例,隨機(jī)分為治療組和對(duì)照組各41例。治療組給予口服利膽健脾湯(炒柴胡10g、黨參30g、茯苓30g、杭白芍15g、炒白術(shù)15g、香櫞15g、粉葛30g、金錢草15g、茵陳15g、炒雞內(nèi)金10g、甘草10g-藥物來源均選用云南省中醫(yī)醫(yī)院的中藥房提供的中藥小包裝,由云南省中醫(yī)醫(yī)院中藥房煎藥機(jī)統(tǒng)一代煎中藥),日1劑,3次/日,每次150ml(一袋),飯后半小時(shí)溫服。對(duì)照組予口服膽舒膠囊治療(四川濟(jì)生堂生產(chǎn)批號(hào):國藥準(zhǔn)字Z20026078)治療,3次/日,2粒(0.9g)/次,飯后半小時(shí)口服。兩組均于治療4周后進(jìn)行臨床療效及安全性指標(biāo)觀察并記錄。結(jié)果:治療前兩組患者在年齡、性別和病程分布及治療前彩超情況上比較均無統(tǒng)計(jì)學(xué)差異(P0.05),具有可比性。1.治療后治療組疾病總有效率為92.5%,與對(duì)照組的總有效率70.0%比較差異有顯著統(tǒng)計(jì)學(xué)意義(P0.01)。2.治療組改善中醫(yī)證候有效率為95.0%,與對(duì)照組有效率75.0%相比較差異有顯著統(tǒng)計(jì)學(xué)意義(P0.01)。3.治療前后各單個(gè)癥狀積分變化的比較:治療組在改善倦怠乏力、情緒抑郁或煩躁易怒、腹脹、大便稀溏/便秘方面明顯優(yōu)于對(duì)照組(P0.01),在改善右脅脹滿不適、噯氣嘆息、食少納呆癥狀方面優(yōu)于對(duì)照組(P0.05),而在改善右脅疼痛、口苦、惡心/嘔吐癥狀方面二者比較無明顯差異(P0.05)。4.治療組改善膽囊彩色B超聲像的有效率為82.5%,與對(duì)照組改善膽囊彩色B超聲像的有效率65.0%比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。5.試驗(yàn)期間兩組患者在尿液分析、大便常規(guī)+潛血和心電圖檢查均未發(fā)現(xiàn)明顯異常變化,均未出現(xiàn)明顯不良反應(yīng)和副作用;其中兩組血常規(guī)、肝功、腎功組內(nèi)比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:利膽健脾湯具有改善慢性膽囊炎(肝郁脾虛型)的療效。與對(duì)照組比較在改善中醫(yī)證候及膽囊彩色B超聲像方面療效更佳;在改善倦怠乏力、情緒抑郁或煩躁易怒、大便稀溏/便秘、腹脹、右脅脹滿不適、食少納呆、噯氣嘆息癥狀方面優(yōu)于對(duì)照組。并且其安全性良好,可以將其作為治療慢性膽囊炎(肝郁脾虛型)的用藥選擇及參考。
[Abstract]:Objective: to study the clinical effect and safety of Lidan Jianpi decoction in the treatment of chronic cholecystitis with liver stagnation and spleen deficiency. To explore the therapeutic effect of traditional Chinese medicine on chronic cholecystitis and provide a new method for the treatment of chronic cholecystitis. Methods: 82 patients with chronic cholecystitis were randomly divided into treatment group (n = 41) and control group (n = 41). The treatment group was given orally Lidan Jianpi decoction (fried Bupleurum 10g, Codonopsis lanceolata 30g, Poria cocos 30g, Hangzhou White Peony 15g, fried Atractylodes macrocephalae 15g, Citron 15g, Pueraria lobata 30g, Cynthia chinensis 15g, Yinchen 15g, Fried Chicken Neijin 10g, Licorice 10g- Drug Source of Yunnan traditional Chinese Medicine Hospital Small packaging of traditional Chinese medicine, The decoction machine of traditional Chinese medicine store of Yunnan traditional Chinese Medicine Hospital was used as the sole agent of traditional Chinese medicine, one dose per day, three times a day, 150 ml (one bag, half an hour after meal). The control group was treated with oral Danshu capsule (Sichuan Jishengtang production lot number: Z20026078). The clinical efficacy and safety indexes were observed and recorded 4 weeks after treatment in both groups. Results: there was no statistical difference between the two groups in age, sex, course of disease and color Doppler ultrasound before treatment (P 0.05). After treatment, the total effective rate of disease in the treatment group was 92.5%, which was significantly different from that in the control group (70.0%). The effective rate of improving TCM syndromes in the treatment group was 95.0%, which was significantly different from that of the control group (75.0%). Comparison of scores of individual symptoms before and after treatment: the treatment group was superior to the control group in improving burnout, depression or irritability, abdominal distension, loose stools / constipation, improving the right flank full of discomfort, belching and sighing. There was no significant difference between the two groups in improving the pain of right flank, bitter mouth and nausea / vomiting symptoms in the control group (P 0.05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05, P 0. 05). The effective rate of improving the B-ultrasound image of gallbladder in the treatment group was 82.5, which was significantly higher than that in the control group (65.0%). During the trial, no abnormal changes were found in urine analysis, stool routine occult blood and electrocardiogram examination, and there were no obvious adverse reactions and side effects in both groups, including blood routine, liver function, liver function, There was no significant difference in renal function group (P 0.05). Conclusion: Lidan Jianpi decoction can improve chronic cholecystitis. Compared with the control group, it was more effective in improving TCM syndromes and cholecyst color B ultrasound images, and in improving burnout, depression or irritability, loose stool / constipation, abdominal distension, right flounder, full of discomfort, low food intake, etc. The symptoms of belching and sighing were better than that of the control group. And its safety is good, can be used as the treatment of chronic cholecystitis (liver stagnation and spleen deficiency type) drug choice and reference.
【學(xué)位授予單位】：云南中醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R259

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 寶剛;;蒙醫(yī)治療慢性膽囊炎(膽陳熱癥)35例臨床觀察[J];中國民族醫(yī)藥雜志;2016年08期

2 李榕萍;;自擬疏肝利膽湯治療慢性膽囊炎98例療效觀察[J];藥品評(píng)價(jià);2016年08期

3 徐兆景;;葛根素藥理作用機(jī)制探討及臨床應(yīng)用[J];中國現(xiàn)代藥物應(yīng)用;2016年08期

4 馬蕾;梁國英;;謝晶日從肝脾論治膽脹病經(jīng)驗(yàn)[J];湖南中醫(yī)雜志;2015年05期

5 周繼;;自擬疏肝理氣湯治療膽囊術(shù)后綜合征臨床觀察[J];安徽醫(yī)藥;2015年05期

6 ;中國慢性膽囊炎、膽囊結(jié)石內(nèi)科診療共識(shí)意見(2014年,上海)[J];臨床肝膽病雜志;2015年01期

7 游昕;熊大國;郭志斌;商友劍;;茯苓多種化學(xué)成分及藥理作用的研究進(jìn)展[J];安徽農(nóng)業(yè)科學(xué);2015年02期

8 吳海斌;丁濤;;耳穴貼壓法聯(lián)合西藥治療慢性結(jié)石性膽囊炎的臨床療效[J];遼寧中醫(yī)雜志;2014年11期

9 秦研;張曉彤;;針刺日月穴對(duì)膽囊炎患者膽囊收縮功能的影響[J];山西中醫(yī);2014年11期

10 李培林;;金錢草藥性與臨床應(yīng)用[J];實(shí)用中醫(yī)內(nèi)科雜志;2014年06期

相關(guān)碩士學(xué)位論文 前1條

1 劉秀梅;膽寧湯對(duì)膽囊切除術(shù)后綜合征胃腸激素水平的影響及其臨床療效觀察[D];山東中醫(yī)藥大學(xué);2012年

，

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