目的 探討消炎利膽片聯(lián)合哌拉西林鈉他唑巴坦鈉治療慢性膽囊炎的臨床效果。方法 選取2018年10月—2020年10月天津泰達(dá)醫(yī)院收治的126例慢性膽囊炎患者，運(yùn)用隨機(jī)數(shù)字表法將其隨機(jī)分成對(duì)照組（n=63）和治療組（n=63）。對(duì)照組靜脈滴注注射用哌拉西林鈉他唑巴坦鈉，2.25 g加入5%葡萄糖注射液250 mL充分稀釋后給藥，2次/d。治療組在對(duì)照組基礎(chǔ)上口服消炎利膽片，6片/次，3次/d。兩組均連續(xù)治療2周。觀察兩組臨床療效及患者典型癥狀的緩解時(shí)間，并比較治療前后兩組膽囊壁厚度、膽囊排空率、胃電圖相關(guān)參數(shù)及血清總膽汁酸（TBA）、白細(xì)胞介素（IL）-6和瘦素（Lep）水平的變化情況。結(jié)果 治療后，治療組總有效率為95.2%，顯著高于對(duì)照組的81.0%（P<0.05）。治療后，治療組各項(xiàng)典型癥狀（右上腹痛、右上腹不適、膽源性消化不良）的緩解時(shí)間均顯著短于對(duì)照組（P<0.05）。治療后，兩組膽囊壁厚度均顯著降低，但膽囊排空率均顯著增加（P<0.05）；治療后，治療組膽囊壁厚度和膽囊排空率改善優(yōu)于對(duì)照組（P<0.05）。治療后，兩組餐后正常胃電慢波百分比、餐后/餐前功率比均顯著高于本組治療前，但餐后胃電節(jié)律紊亂百分比均顯著低于本組治療前（P<0.05）；治療后，治療組胃電圖參數(shù)改善優(yōu)于對(duì)照組（P<0.05）。治療后，兩組患者血清TBA、IL-6和Lep水平較本組治療前均顯著降低（P<0.05）；且治療后，治療組血清學(xué)指標(biāo)低于對(duì)照組（P<0.05）。結(jié)論 消炎利膽片聯(lián)合哌拉西林鈉他唑巴坦鈉治療慢性膽囊炎具有確切的臨床療效，對(duì)患者的臨床癥狀、膽囊壁厚度和膽囊收縮功能均有顯著改善作用，同時(shí)有助于改善患者紊亂的胃電節(jié)律，減輕其肝臟損傷和體內(nèi)炎癥反應(yīng)，值得臨床推廣應(yīng)用。

Objective To investigate the clinical effect of Xiaoyan Lidan Tablets combined with piperacillin sodium and tazobactam sodium in treatment of chronic cholecystitis. Methods A total of 126 patients with chronic cholecystitis admitted to Tianjin TEDA Hospital from October 2018 to October 2020 were selected and randomly divided into control group (n=63) and treatment group (n=63) by random number table method. Patients in the control group were iv administered with Piperacillin Sodium and Tazobactam Sodium for injection, 2.25 g was added into 5% Glucose injection 250 mL and fully diluted, twice daily. Patients in the treatment group were po administered with Xiaoyan Lidan Tablets on the basis of the control group, 6 tablets/time, three times daily. Both groups were treated continuously for 2 weeks. Clinical efficacy and relief time of typical symptoms of patients in the two groups were observed, and changes of gallbladder wall thickness, gallbladder emptying rate, parameters related to electrogastro, and serum total bile acid (TBA), interleukin (IL)-6 and leptin (LEP) levels in the two groups were compared before and after treatment. Results After treatment, the total effective rate of the treatment group was 95.2%, which was significantly higher than that of the control group (81.0%, P < 0.05). After treatment, the relief time of the typical symptoms (right upper abdominal pain, right upper abdominal discomfort, biliary dyspepsia) in the treatment group was significantly shorter than that in the control group (P < 0.05). After treatment, the gallbladder wall thickness in both groups was significantly decreased, but the gallbladder empty-rate was significantly increased (P <0.05). After treatment, the improvement of gallbladder wall thickness and gallbladder empty-rate in the treatment group was better than that in the control group (P < 0.05). After treatment, the percentage of normal slow wave and the ratio of power to power after meal in two groups were significantly higher than before, but the percentage of disturbance of rhythm after meal was significantly lower than before (P < 0.05). After treatment, the improvement of EEG parameters in treatment group was better than that in control group (P < 0.05). After treatment, the serum levels of total bile acid (TBA), interleukin (IL)-6 and leptin (LEP) in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the serological indexes in the treatment group were lower than those in the control group (P < 0.05). Conclusion Xiaoyan Lidan Tablets combined with piperacillin sodium and tazobactam sodium has definite clinical effect in treatment of chronic cholecystitis, can significantly improve the clinical symptoms, gallbladder wall thickness and gallbladder systolic function of patients, and can improve the patients' disordered gastric electric rhythm, reduce the liver injury and inflammation, which is worthy of clinical promotion and application.

R975

天津市濱海新區(qū)衛(wèi)生計(jì)生委科技基金資助項(xiàng)目（2017BWKY088）