Clinical Observation Of Jiawei Dachaihu Decoction After PTGD Operation For Acute Calculous Cholecystitis (liver And Gallbladder Damp-heat Syndrome)

Purpose: To observe the therapeutic effect of modified Dachaihu decoction combined with conventional western medicine on acute calculous cholecystitis after percutaneous transhepatic gallbladder puncture and drainage(PTGD)compared with that of conventional western medicine only after PTGD,and to explore the efficacy,safety and clinical practical value of drugs.Materials and methods: Patients with acute calculous cholecystitis who met the inclusion criteria were randomly divided into control group and treatment group.Both groups were given routine anti-inflammatory and other symptomatic treatment after PTGD.On this basis,the treatment group was treated with traditional Chinese medicine decoction.During the period of admission,the blood routine of the two groups was measured,and the time of white blood cell count(WBC)returning to normal value was recorded;the C-reactive protein(CRP)of the two groups was detected and the time of CRP returning to normal value was recorded;the thickness of gallbladder wall was measured and recorded by color Doppler ultrasonography on the third and seventh days of admission;the purulent or white bile from PTGD of the two groups was monitored.The time of conversion to normal bile was recorded,and the time of fever subsidence in control group and treatment group was recorded.Results:Jiawei Dachaihu Decoction showed no significant difference in the improvement of fever symptoms between the two groups,and there was no significant difference in the time of fever subsidence between the two groups(P > 0.05);compared with the control group,the time of WBC return to normal in the treatment group was better than that in the control group,and there was significant difference in the data between the two groups(P < 0.05),and the time of CRP return to normal in the treatment group was better than that in the control group In group B,there was significant difference between the two groups(P<0.05).The use of modified Dachaihu Decoction could improve the inflammation of patients more effectively.In the improvement of the regression of gallbladder edema,there was no differencebetween the two groups at the initial stage.After seven days of treatment,the effect of the treatment group was better than that of the control group.The gallbladder edema of the two groups further subsided,and the improvement ratio of the treatment group to the regression of gallbladder edema was obvious The control group was more obvious,the difference had statistical significance(P < 0.01);observe and compare the time of PTGD to yellow-green bile,the treatment group needed shorter time to change the color of drainage bile to yellow-green,the treatment group was better than the control group,the difference between the two groups was statistically significant(P < 0.05).Conclusion:1.After PTGD for acute calculous cholecystitis,there was no significant difference in the improvement of fever symptoms among patients treated with modified Dachaihu Decoction combined with conventional Western medicine.2.The application of modified Dachaihu Decoction combined with conventional western medicine after PTGD for acute calculous cholecystitis can accelerate the subsidence of inflammation,accelerate the recovery of symptoms of gallbladder edema,and shorten the time needed for PTGD drainage to convert the bile into yellow-green bile.Modified Dachaihu Decoction combined with conventional western medicine is safe and effective in the treatment of acute calculous cholecystitis after PTGD.