| Objective:To observe the time of exhaust defecation,degree of gallbladder inflammation,gallbladder function,recurrence of stones and effects on digestive tract symptomsin patients with cholelithiasis treated with DHLX The microenvironment formed by gallstone is the entry point,to explore the mechanism of DHLX regulating gallbladder microenvironment of gallstone formation in combination with animal experimentsMethods:Part?(Clinical Studies):Select 60 patients with cholecystolithiasis and gallbladder lithotomy was performed,it was randomly divided into DHLX treatment group(treatment group)-30 cases and ursodeoxycholic acid group treatment group(control group)-30 cases.Through postoperative exhaust defecation,improvement of inflammation and hepatocyte injury before and after blood biochemical contrast therapy.The changes of gallbladder and gallstones were observed by ultrasonography,final evaluation of the clinical efficacy of the drug.Part ?(Experimental Research):C57BL/6 mice were randomly divided into normal control group(blank group),model group,ursodeoxycholic acid group(western medicine group)and DHLX group(traditional Chinese medicine group),building a cholithiasis model,to observe the rate of gallstone formation in mouse gallbladder,to detect the amount of protein expression LRH-1 and SRBI in mouse liver tissue,to observe the effect of UCDA and DHLX on improving survival rate and reducing gallstone formation rate in mice,and to use RT-PCR and WB to detect the difference of LRH-land SRBI expression in mouse liver tissue.Results:Part ?(Clinical Studies):?Comparison of postoperative exhaust and defecation time between two groups:Compared with the control group,the time of anal exhaust and defecation in the treatment group was shortened obviously,the difference was statistically significant(P<0.001).?WBC and CRP and TBIL and TBA effects were compared between the two groups,the difference was not statistically significant(P>0.05);Group effect analysis:WBC and CRP and TBIL and TBA at different points in time,the difference was statistically significant(P<0.001),Paired comparison of different time points,the difference was statistically significant(P<0.001),Compare the interaction terms with the group at the time point,the difference was not statistically significant(P>0.05).?Comparison of gallbladder inflammation in two groups:Before treatment and 1 week after treatment,the proportion of patients with poor permeability,rough wall and edema of wall,the difference was not statistically significant(P>0.05).12 weeks after treatment,compared with the control group,in the treatment group,the condition of bile permeability,wall roughness and wall edema was improved obviously,the difference was statistically significant(P<0.05).?Comparison of gallbladder contraction rate between two groups:effects were compared between the two groups,the difference was not statistically significant(P>0.05);Group effect analysis:Gallbladder contraction rate at different points in time,the difference was statistically significant(P<0.001);Paired comparison of different time points,the difference was statistically significant(P<0.001);Simple effect analysis was performed to compare the two groups of patients at different time points within the same group,the difference was statistically significant(P<0.001).?Comparison of clinical symptoms between the two groups:Before treatment,Comparison of clinical symptoms of abdominal distension,abdominal pain,diarrhea and anorexia between the two groups,differences were not statistically significant(P>0.05)1 week after treatment,comparison with controls,the abdominal distension,abdominal pain,diarrhea and anorexia were significantly decreased in the treatment group.differences were statistically significant(P<0.05).12 week after treatment,comparison with controls,the abdominal distension,abdominal pain,diarrhea and anorexia were significantly decreased in the treatment group.differences were statistically significant(P<0.05).? Comparison of curative effect between two groups:The total efficiency of the treatment group was 96.7%,the total efficiency of the control group was 90%,total efficiency comparison between the two groups,differences were not statistically significant(P=0.806).?During treatment and during follow-up,routine examination of two groups of patients was reviewed,ECG,urine routine,blood routine,stool routine,etc,there was no obvious abnormality.A record of adverse reactions was found,There were 2 cases(6.6%)of adverse reactions in the treatment group,and 4 cases(13.3%)of adverse reactions in the control group,Compared with the two groups,the difference was not statistically significant.Part ?(Experimental Research):?8 weeks after drug intervention,comparison of stone rate among mice,the rate of stone composition of western medicine decreased obviously,differences were statistically significant(P<0.05).?Detection by RT-PCR method the gene expression of LRH-1 and SRBI mRNA in liver tissue:Compared with blank group,the expression of LRH-land SRBI mRNA in model group,western medicine group and Chinese medicine group was increased,the difference was statistically significant(P<0.001);Compared with model group,the expression of LRH-land SRBI mRNA in western medicine group and Chinese medicine group was increased,the difference was statistically significant(P<0.001);Compared with western medicine group,the expression of LRH-1 and SRBI mRNA in Chinese medicine groupwas increased,the difference was statistically significant(P<0.001).?Detection by Western Blotting method the gene expression of LRH-1 and SRBI in liver tissue:Compared with blank group,the expression of LRH-1 and SRBI mRNA in model group,western medicine group and Chinese medicine group was increased,the difference was statistically significant(P<0.001);Compared with model group,the expression of LRH-1 and SRBI mRNA in western medicine group and Chinese medicine group was increased,the difference was statistically significant(P<0.001);Compared with western medicine group,the expression of LRH-1 and SRBI mRNA in Chinese medicine groupwas increased,the difference was statistically significant(P<0.001).Conclusion:1.DHLX can prevent the formation of gallstone is equivalent to UCDA.2.DHLX can prevent gallstone and reduce gallbladder inflammation and increase gallbladder contraction rate.3.DHLX can obviously relieve the symptoms of abdominal pain after fat meal,abdominal distension after full meal,nausea and anorexia,and alleviate the pain of patients.4.DHLX can down-regulate gene transcription and protein expression of lithogenic factor LRH-1 and SRBI.5.DHLX can regulate the imbalance state of gallstone microenvironment,so that the microenvironment can achieve balance through adjustment,and finally achieve the purpose of preventing stone formation. |
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