“以通为用，以降为顺”理论指导利胆通舒汤灌肠对胆囊结石腹腔镜下胆囊切除术后恢复的疗效

Guided by the Theory of “Facilitating Flow and Harmonizing Downward Movement”: The Efficacy of Lidan Tongshu Decoction Enema on Postoperative Recovery after Laparoscopic Cholecystectomy for Gallstones

摘要: 目的：探讨利胆通舒汤灌肠治疗对腹腔镜胆囊切除术(LC)后患者的不良反应的有效性。方法：回顾性分析2022-05至2024-05黑龙江中医药大学附属第一医院外二科行LC的68例胆囊结石患者，对照组和观察组各34例。术后给予常规治疗，观察组在对照组基础治疗上增加利胆通舒汤灌肠，比较2组患者的术后第1 d、第5 d腹痛、腹胀情况以及白细胞计数、淋巴细胞百分比、中性粒细胞百分比、ALT、AST情况。结果：观察组在术后第5 d腹痛视觉模拟评分(VAS)小于对照组(P < 0.01)，术后第5 d的腹胀评分均少于对照组(P < 0.01)，术后第5 d白细胞计数、ALT、AST均明显低于对照组(P < 0.05)，术后第5 d淋巴细胞百分率、中性粒细胞百分率无明显差异(P > 0.05)。结论：与对照组相比，LC后给予利胆通舒汤灌肠能减轻患者腹痛、腹胀不适症状，降低炎症反应，促进患者术后恢复。

Abstract: Objective: This study aims to explore the effectiveness of Lidan Tongshu Decoction enema in mitigating postoperative adverse reactions in patients undergoing laparoscopic cholecystectomy (LC). Methods: A retrospective analysis was conducted on 68 patients with gallstones who underwent LC between May 2022 and May 2024 at the Second Department of Surgery, First Affiliated Hospital of Heilongjiang University of Chinese Medicine. The patients were divided into a control group and an observation group, each comprising 34 cases. Postoperatively, both groups received standard treatment, with the observation group receiving an additional Lidan Tongshu Decoction enema. The two groups were compared in terms of postoperative abdominal pain and bloating on day 1 and day 5, as well as white blood cell count, lymphocyte percentage, neutrophil percentage, ALT, and AST levels. Results: On postoperative day 5, the Visual Analog Scale (VAS) score for abdominal pain was significantly lower in the observation group compared to the control group (P < 0.01). Additionally, the abdominal bloating score on postoperative day 5 was significantly lower in the observation group (P < 0.01). On postoperative day 5, the white blood cell count, ALT, and AST levels were significantly lower in the observation group (P < 0.05), while there were no significant differences in lymphocyte percentage and neutrophil percentage between the two groups (P > 0.05). Conclusion: Compared to the control group, the administration of Lidan Tongshu Decoction enema after LC can alleviate symptoms of abdominal pain and bloating, reduce inflammatory responses, and promote postoperative recovery.