Effect Of Yinchen Xiaochengqi Decoction On Perioperative Liver Function In Patients With Malignant Jaundice

Objective:To study the effect of Yinchen Xiaochengqi Decoction on liver function in patients with malignant jaundice during perioperative period,and to explore the clinical significance of Yinchen Xiaochengqi Decoction in patients with malignant jaundice during perioperative period.Methods:Fifty-six patients with malignant jaundice(periampullary cancer)who underwent Whipple operation First Affiliated Hospital of Henan University of Science and Technology were randomly divided into treatment group(group A,n=28)and control group(group B,n=28).Group B received routine preoperative preparation,while group A received Yinchen Xiaochengqi Decoction daily in addition to routine preoperative preparation.Monitoring indicators: plasma endotoxin(PE),glutamatealanine aminotransferase(ALT),alkaline phosphatase(ALP),total bilirubin(TBIL),serum prealbumin(PA),blood urea nitrogen(BUN),serum creatinine(SCr)were monitored at admission,preoperative ld,4th,8th and 12 th days after operation,and the incidence of postoperative complications(SIRS,MODS,pancreatic fistula,biliary fistula),gastrointestinal tract were also monitored.Exhaust time,hospitalization time.Results :1.There was no significant difference in plasma endotoxin(PE)content between group A and group B at admission(P > 0.05).PE content in group A at each time point was significantly lower than that measured at the previous time point(P <0.05);PE content in group B at each time point was significantly lower than that measured at the previous time point(P < 0.05);PE content in group B was significantly lower than that measured at the previous time point.Meaning(P < 0.05);except for admission,PE content in group A and B at the corresponding time points was significantly higher than that in group B(P < 0.05).2.Total bilirubin(TBIL),alkaline phosphatase(ALP),glutamate-alanine aminotransferase(ALT)and serum prealbumin(PA)were significantly increased and decreased in group A and B at admission.There was no significant difference between group A and group B(P > 0.05),and there was no significant difference between group A and group B at each time point and the TBIL,ALP and ALT detected at the previous time point.The difference was significant(P < 0.05),while PA increased significantly(P < 0.05);TBIL,ALP and ALT in group B at each time pointwere significantly lower than those detected at the previous time point(P < 0.05),while PA increased significantly(P < 0.05);except at admission,the two groups had significant differences(P < 0.05).The decrease and increase of TBIL,ALP,ALT and P A in group A were significantly greater than those in group B at corresponding time points,and the difference was statistically significant(P < 0.05).3.There was no significant difference in blood urea nitrogen(BUN)and creatinine(SCr)between groups A and B at admission(P > 0.05);BUN and SCr in group A at each time point were significantly lower than those measured at the previous time point(P < 0.05);BUN and SCr in group B at each time point were significantly lower than those measured at the previous time point(P < 0.05);BUN and SCr in group B were all compared with those measured at the previous time point There was a significant difference(P < 0.05);except for admission,BUN and SCr in group A and B at the corresponding time points were significantly lower than those in group B at the last time point(P < 0.05).4.The results showed that the incidence of complications such as SIRS,MODS,pancreatic fistula and biliary fistula in group A were 7.1%,3.5%,7.1% and 7.1%,respectively;the incidence of complications such as SIRS,MODS,pancreatic fistula and biliary fistula in group B were 32.1%,17.8%,14.2% and 10.7%,respectively.Statistical analysis showed that the incidence of MODS,pancreatic fistula and SIRS in group A was significantly lower than that in group B(P < 05).The time of gastrointestinal tract ventilation in group A was significantly shorter than that in group B(P < 0.05),and the time of hospitalization in group A was significantly shorter than that in group B(P < 0.05).Conclusion :1.Malignant jaundice patients have different degrees of endotoxemia and liver and kidney function damage.2.The perioperative effects of Yinchen Xiaochengqi Decoction on patients with malignant jaundice are as follows:(1)It can effectively reduce the levels of plasma endotoxin and serum total bilirubin in patients with malignant jaundice during perioperative period,and alleviate the damage of endotoxemia and hyperbilirubinemia to the body.(2)Reduce the degree of liver function damage in patients with malignant jaundice during perioperative period,and promote the recovery of liver function;(3)Improve perioperative renal function damage,thereby reducing the incidence of renal failure.(4)It can effectively prevent and reduce the incidence of complications such as SIRS,MODS,pancreatic fistula and biliary fistula after operation,promote the rapid recovery of gastrointestinal function and shorten the hospital stay.