Clinical Study Of Modified Chaihu Guizhi Ganjiang Decoction In The Treatment Of Post-cholecystectomy Diarrhea With Gallbladder Heat And Splenic Cold

Objective:To observe and evaluate the clinical efficacy of modified Chaihu Guizhi Ganjiang Decoction in the treatment of postcholecystectomy diarrhea(PCD)with gallbladder heat and cold spleen and its influence on gastrointestinal hormones.Methods:1.Collect 60 cases of PCD(biliary heat,spleen-cold syndrome)patients in the Nanjing Hospital of Integrated Traditional Chinese and Western Medicine from January 2020 to December 2020.They were randomly divided into experimental group and control group.Each 30 cases were treated with modified Chaihu Guizhi Ganjiang Decoction and compound azimide enteric-coated tablets for 8 weeks.2.Observe the changes of symptoms before and after treatment in the two groups,and evaluate the comprehensive curative effect of the disease and the curative effect of TCM syndromes.Enzyme-linked immunosorbent assay(ELISA)was used to determine the serum levels and changes of gastrointestinal hormones:cholecystokinin(CCK),vasoactive intestinal peptide(VIP)and serotonin(5-HT)in the two groups before and after treatment.Results:1.Evaluation of clinical efficacy:(1)Comprehensive efficacy of disease:The total effective rate of the test group was 92.86%higher than that of the control group,74.07%,but the difference was not statistically significant(P>0.05).Stool traits and defecation frequency were improved in the two groups before and after treatment(P<0.05),and the efficacy of the experimental group and the control group was equivalent(P>0.05).(2)In terms of the efficacy of TCM syndromes,both groups had good therapeutic effects,and the efficacy of the experimental group was better than that of the control group.The total effective rates were 89.29%and 70.37%,respectively,and the difference was statistically significant(P<0.05).In terms of improving the main symptoms of loose stools and mouth bitterness,secondary symptoms of nausea and vomiting,and urgency of defecation,the experimental group was better than the control group(P<0.05).The two groups had the same curative effect in improving the secondary symptoms of fullness of the abdomen,chills,immediate onset of cold,chest and hypochondriac pain,bowel irritation,and abdominal pain(P>0.05).2.Observation of gastrointestinal hormones:The levels of serum gastrointestinal hormones(CCK,VIP,5-HT)before and after treatment were down-regulated in the experimental group and control group(P<0.01),and the experimental group down-regulated the levels of gastrointestinal hormones(CCK,VIP and 5-HT)were better than those of the control group(P<0.01).Conclusion:Modified Chaihu Guizhiganjiang Decoction can improve stool traits and defecation frequency in patients with PCD(biliary heat,spleen-cold syndrome),and effectively relieve loose stools,mouth pain,chest pain,defecation urgency and other symptoms.It can down-regulate the levels of serum gastrointestinal hormones(CCK,VIP and 5-HT),and its mechanism of action may be related to its participation in regulating gastrointestinal hormones and promoting digestion and absorption.