| Objective: To investigate the effect of Lidanpaishi decoction in choledochoscope treatment of postoperative residual stone(damp-heat type of liver and gallbladder).Methods: A total of 60 patients with residual stones after cholelithiasis(clinical typing: Damp-heat syndrome of liver and gallbladder)and T tube remained were admitted to the Department of Hepatobiliary and pancreatic endoscopic hernia surgery of the First Affiliated Hospital of Hunan University of Chinese Medicine from February 2019 to February 2021.They were randomly divided into observation group and control group according to the order of admission,with 30 patients in each group.The control group accept choledochofiberscopy directly after sufficient preoperative preparation;The observation group was given lidanpaishi decoction(Chicken's Gizzard-membrane 30 g,Agrocyst 20 g,Jinqiancao 20 g,Yujin 15 g,Polygonum cuspidatum 15 g,Bupleurum bupleurum 15 g,Paeonia lactiflora 10 g,Muxiang 10 g,Radix Scutellariae 10 g,Rhubarb 10 g,Licorice 6g)(200 ml each time,2 times a day)for 14 days before operation.(1)Observing the changes of CRP,ALP,TBIL,DBIL,ALT and AST before and after Lidan Paishi Decoction treatment.(2)Comparing the mean time of lithotomy between the two groups.(3)Comparing the one-time stone removal rate between the two groups.(4)Comparing the incidence of postoperative complications(fever,sinus and biliary hemorrhage,acute pancreatitis,diarrhea,sinus and biliary perforation)between the two groups.SPSS21.0 software system was used for data analysis.Results :1.Comparison of general dataThere was no significant difference in age,gender,previous biliary operation and stone distribution between the two groups(P>0.05),indicating comparability between the two groups.2.Comparison of indexes in observation group before and after Lidanpaishi decoction treatmentThe CRP,ALP,TBIL,DBIL,ALT and AST values of the observation group decreased significantly after 14 days' treatment with Lidanpaishi decoction compared with those before treatment,and the average values of all indexes after treatment were lower than the upper limit of normal reference values of the corresponding terms,with statistical significance(P<0.05).3.Comparison of mean time to lithotomyThe average operative lithotomy time of the observation group was 42.40±8.18 min,and that of the control group was 62.1±12.78 min.The average operative lithotomy time of the observation group was significantly shorter than that of the control group,and the difference between the two groups was statistically significant(P<0.05).4.Comparison of one-time stone removal rate between the two groups21 patients in the observation group and 12 patients in the control group had all calculi removed.The removal rate of one-time stones in the observation group was 70.0%,and that in the control group was 40.0%.The observation group was significantly higher than the control group.5.Comparison of postoperative complications between the two groupsIn the observation group,postoperative complications occurred in 3 patients,including 1patient with fever and diarrhea,and 2 patients with diarrhea.No sinus tract,biliary tract hemorrhage,perforation,acute pancreatitis occurred,and the complication rate was 10%.A total of 12 patients in the control group developed postoperative complications,including 5patients with fever and diarrhea,2 patients with acute pancreatitis,fever and diarrhea,and 7patients with diarrhea,without sinus tract,biliary tract hemorrhage or perforation,with a complication rate of 40%.The incidence of postoperative complications was significantly lower in the observation group than in the control group.Conclusion:1.Lidan Paishi Decoction can effectively inhibit biliary tract inflammation,improve liver function,and promote stone drainage.2.The application of this formula before choledochoscopy lithotomy can effectively shorten the time of surgical lithotomy,improve the stone clearance rate and reduce surgical complications. |
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