目的 探討膽舒膠囊聯(lián)合頭孢曲松治療慢性膽囊炎的臨床療效。方法 選擇2019年1月—2021年12月東南大學(xué)醫(yī)學(xué)院附屬南京同仁醫(yī)院收治的148例慢性膽囊炎患者，按照隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各74例。對(duì)照組給予注射用頭孢曲松鈉，每次將2 g加入0.9%氯化鈉注射液250 mL中均勻混合后靜脈滴注，1次/d。治療組在對(duì)照組基礎(chǔ)上口服膽舒膠囊，2粒/次，3次/d。兩組療程均為2周。觀察兩組的臨床療效，比較治療前后兩組主癥積分、中醫(yī)癥狀總積分、胃腸道生活質(zhì)量指數(shù)（GIQLI）總分、膽囊壁厚度、膽囊收縮功能指標(biāo)[膽囊空腹體積（GFV）、膽囊最小殘余體積（MGRV）、膽囊最大排空率（MGER）]及血清腫瘤壞死因子（TNF）-α、白細(xì)胞介素（IL）-6、膽囊收縮素（CKK）、總膽汁酸（TBA）水平。結(jié)果 治療后，治療組總有效率為94.59%，顯著高于對(duì)照組的83.78%（P＜0.05）。治療后，兩組主癥積分、中醫(yī)癥狀總積分均顯著降低，GIQLI總分均顯著升高（P＜0.05）；治療后，治療組主癥積分、中醫(yī)癥狀總積分、GIQLI總分改善均優(yōu)于對(duì)照組（P＜0.05）。治療后，兩組膽囊壁厚度、GFV、MGRV均較治療前顯著降低，MGER均顯著升高（P＜0.05），治療后，治療組膽囊壁厚度和膽囊收縮功能指標(biāo)改善均優(yōu)于對(duì)照組（P＜0.05）。治療后，兩組血清TNF-α、IL-6、CCK、TBA水平均較治療前顯著降低（P＜0.05）；治療后，治療組血清TNF-α、IL-6、CCK、TBA水平均顯著低于對(duì)照組（P＜0.05）。結(jié)論 膽舒膠囊聯(lián)合頭孢曲松治療慢性膽囊炎療效肯定，可緩解反復(fù)右上腹脹痛或不適等癥狀、改善膽囊功能及生活質(zhì)量，并可進(jìn)一步降低血清TNF-α、IL-6、CCK、TBA水平，值得臨床推廣應(yīng)用。

Objective To investigate the clinical efficacy of Danshu Capsules combined with ceftriaxone in the treatment of chronic cholecystitis. Methods A total of 148 patients with chronic cholecystitis admitted to Nanjing Tongren Hospital Affiliated to Southeast University School of Medicine from January 2019 to December 2021 were selected and divided into control group and treatment group according to random number table method, with 74 cases in each group. Patients in the control group were iv administered with Ceftriaxone Sodium for Injection, 2 g is added into 0.9% sodium chloride injection 250 mL each time and mix evenly before intravenous infusion, once daily. Patients in the treatment group were po administered with Danshu Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, the scores of main symptoms, the total score of TCM symptoms, the total score of gastrointestinal quality of life index (GIQLI), the thickness of the gallbladder wall, the index of gallbladder contraction function [gallbladder fasting volume (GFV), minimum residual gallbladder volume (MGRV), maximum gallbladder emptying rate (MGER)], and serum tumor necrosis factor (TNF)-α, interleukin (IL)-6, cholecystokinin (CKK), total bile acid (TBA) levels in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 94.59%, significantly higher than that of the control group (83.78%) (P < 0.05). After treatment, the main symptom score and total TCM symptom score were significantly decreased, and the total GIQLI score was significantly increased in both groups (P < 0.05). After treatment, the improvement of main symptom score, TCM symptom score and GIQLI total score in the treatment group was better than that in the control group (P < 0.05). After treatment, the thickness of gallbladder wall, GFV and MGRV of the two groups were significantly decreased, while the MGER was significantly increased (P < 0.05). After treatment, the improvement of gallbladder wall thickness and gallbladder systolic function indexes in the treatment group was better than that in the control group (P < 0.05). After treatment, serum levels of TNF-α, IL-6, CCK and TBA in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the levels of TNF-α, IL-6, CCK and TBA in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Danshu Capsules combined with ceftriaxone has definitely effective in treatment of chronic cholecystitis, and can relieve the symptoms of recurrent right upper abdominal distension pain or discomfort, improve gallbladder function and life quality, and can further reduce the serum levels of TNF-α, IL-6, CCK, TBA, which is worthy of clinical application.

R975