目的 探討利膽排石顆粒聯(lián)合熊去氧膽酸片治療肝內(nèi)膽管結(jié)石的臨床療效。方法 選取2020年1月—2021年9月在南陽市中心醫(yī)院就診的100例肝內(nèi)膽管結(jié)石患者，根據(jù)隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，每組各50例。對(duì)照組患者口服熊去氧膽酸片，10 mg/kg，2次/d。治療組在對(duì)照組基礎(chǔ)上溫水沖服利膽排石顆粒，2袋/次，2次/d。兩組患者連續(xù)治療6個(gè)月。觀察兩組的臨床療效，比較兩組的癥狀改善情況、結(jié)石和血清中總膽紅素（TBIL）、直接膽紅素（DBIL）、天門冬氨酸氨基轉(zhuǎn)氨酶（AST）、丙氨酸氨基轉(zhuǎn)移酶（ALT）水平。結(jié)果 治療后，治療組的總有效率為96.00%，明顯比對(duì)照組總有效率84.00%高，組間比較差異有統(tǒng)計(jì)學(xué)意義（P＜0.05）。治療后，兩組的發(fā)熱、黃疸、腹痛發(fā)生率顯著降低（P＜0.05），且治療組發(fā)熱、黃疸、腹痛發(fā)生率較對(duì)照組降低更明顯（P＜0.05）。治療后，兩組的最大結(jié)石直徑顯著減?。?i>P＜0.05），且治療組最大結(jié)石直徑明顯小于對(duì)照組（P＜0.05）。治療后，兩組的血清TBIL、DBIL、AST、ALT水平均顯著降低（P＜0.05），且治療組血清TBIL、DBIL、AST、ALT水平明顯低于對(duì)照組（P＜0.05）。結(jié)論 利膽排石顆粒聯(lián)合熊去氧膽酸片可提高肝內(nèi)膽管結(jié)石的療效，改善臨床癥狀，促進(jìn)結(jié)石縮小，改善肝膽功能，且安全性良好。

Objective To investigate the clinical effect of Lidan Paishi Granules combined with Ursodeoxycholic Acid Tablets in treatment of intrahepatic bile duct calculi. Methods Patients (100 cases) with intrahepatic bile duct calculi in Nanyang Central Hospital from January 2020 to September 2021 were randomly divided into control and treatment groups, and each group had 50 cases. Patients in the control group were po administered with Ursodeoxycholic Acid Tablets, 100 mg/kg, twice daily. Patients in the treatment group were po administered with Lidan Paishi Granules on the basis of the control group, 2 bags/time, twice daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and the improvement of main symptoms, stone size and the serum levels of TBIL, DBIL, AST, and ALT in two groups were compared. Results After treatment, the total effective rate of the treatment group was 96.00%, which was significantly higher than that of the control group (84.00%) (P < 0.05). After treatment, the incidence of fever, jaundice, and abdominal pain in two groups were significantly decreased (P < 0.05), and the incidence of fever, jaundice, and abdominal pain in the treatment group were significantly lower than that in the control group (P < 0.05). After treatment, the maximum stone diameter of two groups were significantly decreased (P < 0.05), and the maximum stone diameter of the treatment group was significantly lower than that of the control group (P < 0.05). After treatment, the serum levels of TBIL, DBIL, AST, and ALT in two groups were significantly decreased (P < 0.05), and the serum levels of TBIL, DBIL, AST, and ALT in the treatment group were significantly lower than those in the control group (P < 0.05).Conclusion Lidan Paishi Granules combined with Ursodeoxycholic Acid Tablets can improve the curative effect of intrahepatic bile duct calculi, further improve clinical symptoms,promote the reduction of calculi, and improve hepatobiliary function, with good safety.

R975