愈胆止痛汤对胆囊切除术后综合征的疗效研究

Efficacy of Yudan Zhitong Decoction in the Treatment of Postcholecystectomy Syndrome

摘要: 目的：探讨使用愈胆止痛汤治疗肝郁气滞型胆囊切除术后综合征的临床疗效及安全性。方法：选取2024年9月至2026年4月太仓市中医医院收治的80例肝郁气滞型PCS患者，采用随机数字表法分为空白对照组和愈胆止痛汤组，每组40例。空白对照组不予任何药物干预，仅进行健康教育及定期随访；愈胆止痛汤组予愈胆止痛汤口服，每日1剂，分早晚两次服用，疗程2周。比较两组治疗前后胃肠道症状评分、中医证候积分、VAS评分、疗效指数及安全性指标。结果：治疗后，愈胆止痛汤组GSRS总分由(18.6 ± 3.2)分降至(6.8 ± 2.1)分，空白对照组由(18.1 ± 3.0)分降至(15.8 ± 2.8)分，组间差异有统计学意义(P < 0.05)；愈胆止痛汤组中医证候总分由(18.9 ± 3.3)分降至(7.2 ± 2.3)分，空白对照组由(18.4 ± 3.1)分降至(15.6 ± 2.6)分(P < 0.05)；愈胆止痛汤组VAS疼痛评分由(6.8 ± 1.2)分降至(2.1 ± 0.8)分，空白对照组由(6.7 ± 1.3)分降至(5.9 ± 1.4)分(P < 0.05)。愈胆止痛汤组平均疗效指数为(78.5 ± 12.3)%，空白对照组为(15.2 ± 8.5)% (P < 0.01)。愈胆止痛汤组总有效率为92.5% (37/40)，显著高于空白对照组的12.5% (5/40) (χ² = 49.50, P < 0.01)。两组均未见明显不良反应，肝肾功能指标治疗前后无明显变化(P > 0.05)。结论：愈胆止痛汤治疗肝郁气滞型胆囊切除术后综合征疗效确切，可显著降低患者GSRS评分、中医证候积分及VAS疼痛评分，提高疗效指数和总有效率，且安全性良好，值得临床推广应用。

Abstract: Objective: To evaluate the clinical efficacy and safety of Yudan Zhitong Decoction in the treatment of postcholecystectomy syndrome (PCS) with liver depression and qi stagnation pattern. Methods: A total of 80 PCS patients with liver depression and qi stagnation pattern admitted to Taicang Hospital of Traditional Chinese Medicine from September 2024 to April 2026 were enrolled and randomly divided into a blank control group and a Yudan Zhitong Decoction group using a random number table method, with 40 cases in each group. The blank control group received no pharmacological intervention but only health education and regular follow-up. The Yudan Zhitong Decoction group was administered Yudan Zhitong Decoction orally, one dose per day, divided into morning and evening administrations, for a course of 2 weeks. The Gastrointestinal Symptom Rating Scale (GSRS) score, traditional Chinese medicine (TCM) syndrome score, Visual Analogue Scale (VAS) pain score, therapeutic index, and safety indicators were compared between the two groups before and after treatment. Results: After treatment, the GSRS total score in the Yudan Zhitong Decoction group decreased from (18.6 ± 3.2) to (6.8 ± 2.1), while that in the blank control group decreased from (18.1 ± 3.0) to (15.8 ± 2.8), with a statistically significant difference between the groups (P < 0.05). The TCM syndrome total score in the Yudan Zhitong Decoction group decreased from (18.9 ± 3.3) to (7.2 ± 2.3), compared with a decrease from (18.4 ± 3.1) to (15.6 ± 2.6) in the blank control group (P < 0.05). The VAS pain score in the Yudan Zhitong Decoction group decreased from (6.8 ± 1.2) to (2.1 ± 0.8), whereas that in the blank control group decreased from (6.7 ± 1.3) to (5.9 ± 1.4) (P < 0.05). The mean therapeutic index was (78.5 ± 12.3)% in the Yudan Zhitong Decoction group and (15.2 ± 8.5)% in the blank control group (P < 0.01). The overall response rate in the Yudan Zhitong Decoction group was 92.5% (37/40), which was significantly higher than 12.5% (5/40) in the blank control group (χ² = 49.50, P < 0.01). No significant adverse reactions were observed in either group, and no significant changes in liver or kidney function indicators were found before and after treatment (P > 0.05). Conclusion: Yudan Zhitong Decoction demonstrates definite clinical efficacy in the treatment of postcholecystectomy syndrome with liver depression and qi stagnation pattern. It significantly reduces GSRS score, TCM syndrome score, and VAS pain score, improves the therapeutic index and overall response rate, and exhibits good safety, warranting clinical promotion and application.