临床误诊误治

目的 探讨七味肝胆清颗粒联合熊去氧胆酸片治疗慢性胆囊炎的效果及对总胆汁酸、甘胆酸的影响。方法 选取2021年1月—2023年1月确诊的86例慢性胆囊炎为研究对象，按照随机数字表法分为联合组和对照组，每组43例。联合组给予七味肝胆清颗粒联合熊去氧胆酸片治疗，对照组给予熊去氧胆酸片治疗，连续治疗1个月。比较2组的临床疗效、胆囊功能、总胆汁酸、甘胆酸、炎性因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]及不良反应。结果 联合组总有效率为95.35%(41/43)高于对照组74.42%(32/43)(P<0.01)。治疗1个月后，2组胆囊壁厚度较治疗前缩小，胆囊收缩率较治疗前增加；且联合组胆囊壁厚度小于对照组，胆囊收缩率大于对照组(P<0.05)。治疗1个月后，2组总胆汁酸、甘胆酸水平较治疗前降低，且联合组低于对照组(P<0.05)。治疗1个月后，2组血清CRP、TNF-α、IL-6水平较治疗前降低，且联合组低于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论 七味肝胆清颗粒联合熊去氧胆酸片可提高慢性胆囊炎患者的治疗效果，改善胆囊功能，减轻炎症反应，且安全系数高。

Objective To explore the efficacy of Qiwei Gandanqing granule combined with Ursodeoxycholic Acid tablets in the treatment of chronic cholecystitis and its effect on total bile acid and glycocholic acid. Methods A total of 86 patients with chronic cholecystitis diagnosed from January 2021 to January 2023 were selected as the research subjects, and were divided into combination group and control group according to random number table method, with 43 cases in each group. The combination group was treated with Qiwei Gandanqing granules combined with Ursodeoxycholic Acid tablets, and the control group was treated with Ursodeoxycholic Acid tablets for 1 consecutive month. The clinical efficacy, gallbladder function, total bile acid, glycholic acid, inflammatory factor [C-reactive protein(CRP), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6)] and adverse reactions of the two groups were compared. Results The total effective rate of the combination group was 95.35%(41/43), which was higher than that of the control group [74.42%(32/43)](P<0.01). At 1 month after treatment, the thickness of gallbladder wall in the two groups was reduced and the shrinkage rate of gallbladder was increased. The thickness of gallbladder wall in combination group was smaller than that in control group, and gallbladder shrinkage rate was higher than that in control group(P<0.05). At 1 month after treatment, the levels of total bile acid and cholyglycine in the two groups were lower than those before treatment, and lower in the combination group than in the control group(P<0.05). At 1 month after treatment, the serum levels of CRP, TNF-α and IL-6 in the two groups were lower than those before treatment, and lower in the combination group than in the control group(P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05). Conclusion Qiwei Gandanqing granules combined with Ursodeoxycholic Acid tablets can improve the therapeutic effect of patients with chronic cholecystitis, improve gallbladder function, reduce inflammatory reaction, and have high safety coefficient.