Clinical Study On The Effect Of Lidan Paishi Concentrated Decoction On Lipid Metabolism Of Patients With Gallstone Preservation On Postoperative Stone Regeneration

Objective:This topic aims to observe the traditional Chinese medicine treatment after liver syndrome confirmed biliary lithotomy patients postoperative recurrence rate and the change of related serological indexes,explore our hospital preparations cholagogue row stone concentrated decoction on liver syndrome patients with biliary lithotomy superiority,for Chinese medicine in the treatment of cholelith disease provide certain support and theoretical basis for clinical practice.Methods:From April 2018 to February 2019,40 cases of patients admitted to the general surgery department of nanjing integrated traditional Chinese and western medicine hospital affiliated to nanjing university of traditional Chinese medicine and undergoing gallbladder-preserving lithotomy were collected.These patients met the diagnostic criteria of western medicine for gallbladder stones and TCM syndrome differentiation was the diagnostic criteria for hepatobiliary damp-heat type.The patients were divided into two groups according to 1:1,20 cases in the control group and 20 cases in the treatment group.The patients in the control group were treated with conventional therapy after double-mirror cholecystolithotomy.Treatment group in the control group on the basis of joint drainage cholagogic stone strong decoction(10 g radix bupleuri,radix Scutellariae,licorice 6 g,6 g loosestrife 15 g,chicken's gizzard-membrane,15 g,15 g sea sands,hovenia dulcis 9 g,12 g,12 g,red paeony root,root of herbaceous peony wormwood 10 g,green husk 6 g,6 g dried tangerine or orange peel)oral treatment,postoperative day 3 to postoperative March 15 ml,daily morning and evening each medication discontinuation after 2 weeks,2 weeks,4 weeks for a period of treatment,continuous three course of treatment.Serum concentrations of liver nuclear receptor analog-1(LRH-1)were detected at 7 o 'clock in the morning of the next day,3 days and 3 months after the operation.The concentrations of triglyceride(TG),cholesterol(TC)and bile acid(TBA)in the serum of the patients were detected at 7 o'clock in the morning of the next day after admission,the third day after operation and the third month after operation respectively by biochemical analyzer and enzymatic method.Outpatient,WeChat and telephone follow-up were conducted to record the recurrence.Results:(1)ELISA was performed on the specimens 3 months after surgery,and the concentration of lrh-1 in the experimental group was lower than that in the control group,with statistically significant difference(P<0.05).Serum lrh-1 concentration in the experimental group decreased 3 months after surgery and 3 days after surgery,and the difference was statistically significant(P<0.05).(2)three months after surgery,TG,TC and TBA concentrations in the experimental group were lower than those in the control group,with statistically significant differences(P<0.05).Serum concentrations of TG,TC and TBA in the experimental group decreased 3 months after surgery and 3 days after surgery,and the difference was statistically significant(P<0.05).(3)the postoperative recurrence rate of the experimental group was lower than that of the control group,and the difference was not statistically significant(P>0.05).Conclusion:1.This study confirmed that lidanpaishi concentrated decoction can effectively regulate the contents of lrh-1,TC,TG and TBA in the serum of patients with hepatobiliary damp-heat cholecystolithotomy after operation.2.In this study,it is not clear that lidanpaishi concentrated decoction can reduce the recurrence of stones after cholecystolithotomy,which requires further study.