| Objective: To evaluate the clinical efficacy of Dahuang Lingxian Decoction in the treatment of calculous cholestatic liver disease after operation,and to provide basis for its clinical application in the treatment of calculous cholestatic liver disease.Methods: From January 2022 to October 2022,60 patients who were definitely diagnosed as calculous cholestatic liver disease and agreed to undergo surgical treatment in the Department of Hepatobiliary Surgery,the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine were randomly divided into control group and treatment group.The control group was treated with laparoscopic choledocholithotomy,cholecystectomy,removal of biliary calculi under choledochoscopy,T-tube drainage,and oral ursodeoxycholic acid capsules after the patient had completely removed the calculi.The observation group also underwent laparoscopic choledocholithotomy,cholecystectomy,removal of biliary calculi under choledochoscopy,and T-tube drainage.After the stones were removed,the patients were treated with oral Dahuang Lingxian Decoction.The clinical efficacy of the two groups was compared.The observation indexes included the expression levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),total bile acid(TBA),serum alkaline phosphatase(ALP),γ-glutamyl transpeptidase(γ-GGT)before operation,on the first day after medication,on the seventh day after medication and on the first,second and third months after medication,and the expression levels of PCIII(type III procollagen),IV-C(type IV collagen),LN(laminin)and HA(hyaluronidase)before operation,on the first day after medication,on the seventh day after medication and on the first,second and third months after medication.At the same time,the liver stiffness value(LSM)was measured by transient elastography(TE)on the 1 st,7 th day and the 1 st,2 nd and 3 rd month after medication to determine the degree of liver fibrosis,and the changes of TCM syndrome scores during treatment were collected.The treatment time was 3 months.The TCM syndrome scores of the two groups before and after treatment were statistically analyzed.The original data of the above two groups were collected and analyzed by SPSS26.0software.Results:1.General data such as gender,age,course of disease,and surgical procedure were comparable between the two groups.2.Liver function : Compared with the control group,the expression of ALT,AST,ALP and γ-GGT in the observation group was significantly lower than that in the control group(P < 0.05).With the prolongation of time,the liver function indexes of the two groups at different time points after treatment were significantly lower than those before operation(P < 0.05).3.Comparison of four items of liver fibrosis : there was no significant difference in PCIII expression between the two groups at different time points(P > 0.05);compared with the control group,the expression of IV-C and HA in the observation group was significantly lower than that in the control group at different time points from 7 days after treatment(P < 0.05).4.Comparison of liver LSM values : There was no significant difference in LSM examination between the observation group and the control group before treatment(P > 0.05),which was comparable.The LSM values of the two groups were improved after one month of liver treatment(P < 0.05).There was a significant difference between the observation group and the control group at the second month after treatment(P < 0.05).5.In terms of syndrome scores : there was no statistically significant difference in syndrome scores between the two groups before treatment(P >0.05),and the syndrome scores of the two groups after treatment were lower than those before treatment,and the scores of the observation group were significantly lower than those of the control group after treatment(P < 0.05).6.In terms of efficiency,the total effective rate of the control group was75.0 %,and the total effective rate of the observation group was 88.0 %.The effective rate of the observation group was significantly higher than that of the control group(P > 0.05);in terms of the efficacy of TCM syndromes,the effective rate of syndromes in the observation group was 92.0 %,which was significantly higher than 82.1 % in the control group(P > 0.05).Conclusion(s): Dahuang Lingxian Decoction can effectively promote the recovery of liver function and slow down the trend of liver fibrosis in patients with calculous cholestatic liver disease.It is superior to ursodeoxycholic acid in improving TCM syndromes and is worthy of clinical application. |
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