Clinic Research About Advantages Of ERCP Combine With Chinese Traditional Medicine "YinBai" Mixture To Treat Obstructive Jaundice Which Results From Common Duct Stones

Objective:To research the advantages of ERCP combine with Chinese medicine "YinBai" mixture to treat obstructive jaundice which results from common duct stones.Method:120 patients with diagnosis of common bile duct stones were divided randomize into four groups:operation control group (group A), endoscopic control group (group B), Chinese medicine "YinBai" mixture combine with operation group (group C) and Chinese medicine "YinBai" mixture combine with endoscopic group (group D). The group A were treated by operation and liver-protecting medicine (diammonium glycyrrihizinate) for 10 days; The group B were treated by ERCP+EST+Stone Exctraction+ENBD and liver-protecting medicine (diammonium glycyrrihizinate) for 10 days too; The treatment method of group C is operation and Chinese medicine "YinBai" mixture taken orally for 10 days; The treatment method of group D is ERCP+EST+Stone Exctraction+ENBD and Chinese medicine "YinBai" mixture orally for 10 days.①The biochemical parameters, including AKP,ALT,AST,TBIL,DBIL,LPS,IL-6, were analyzed on different days: 1st day before operation,5th and 10th post-operation.②Differentiation of all patients were divided into four syndrome types [The syndrome of dampness-heat in the liver and gallbladder type (The SDHLG Type), The hot-toxic intrinsic type (The HTI Type),The syndrome of blockage of qi in the liver and spleen type (The SBQLS Type), and the syndrome of cold-dampness disturbing spleen type (The SCDS Type)]. Observing the clinical symptoms, signs and blood biochemical parameters on 10th days after the operation, clinical efficiency was analyzed statistically by scoring system.Result:①On 5th and 10th day, compared with preoperation, the TBIL DBIL,AKP,ALT and AST of all groups are significantly lower (P＜0.05 or P＜0.01), the TBIL,DBIL,AKP,ALT and AST of Chinese medicine "YinBai" mixture combine with operation group and Chinese medicine "YinBai" mixture combine with endoscopic group are significant lower than operation control group and endoscopic control group, there is no significantly difference between the two Chinese medicine "YinBai" mixture groups;②On 10th day, compared with preoperation, the LPS of all groups are significantly lower (P＜0.05), and the LPS of the two Chinese medicine "YinBai" mixture groups are significantly lower than two control groups (P＜0.05 or P＜0.01), there is no significant difference between the two Chinese medicine "YinBai" mixture groups;③On 10th day, compared with preoperation, the IL-6 of all groups are significantly lower (P＜0.05), the IL-6 of the two Chinese medicine "YinBai" mixture groups are significantly lower than two control groups (P＜0.05 or P＜0.01), the IL-6 of the two endoscopic groups are significantly lower than two operation groups (P＜0.01).④On 10th day, in the two Chinese medicine "YinBai" mixture groups and the control groups, the efficiency of the SDHLG type and the HTI type is significant better (P＜0.01), than the SBQLS type and the SCDS type (P＜0.01). Moreover, in both of the SDHLG type and the HTI type, the efficiency of Chinese medicine "YinBai" mixture groups is significant better than the control groups (P＜0.05).Conclusion:The new treatment of ERCP combining with Chinese medicine "YinBai" mixture has advantages in treating with early obstructive jaundice caused by common bile duct stones. It can not only play a good role in lifting the biliary obstruction with Minimally invasive operation, but also in helping prevent liver cell injury, the hepatic functions recovery, lower serum bilirubin levels, and reduce the serum levels of endotoxin and cytokines Effectively. Then it is able to decrease the system inflammatories and organ injuries. And the clinical efficacy in the syndrome of dampness-heat in the liver and gallbladder type and the hot-toxic intrinsic type is better than the syndrome of blockage of qi in the liver and spleen type and the syndrome of cold-dampness disturbing spleen type.