| Research Objective: Through the study of traditional Chinese medicine(tcm)conservative treatment of gallbladder polyps,the use of soothing the liver and strengthening the spleen,Rougan Sanjie treatment of liver-qi stagnation and spleen-deficiency type of gallbladder polyps,to observe the clinical efficacy,to provide the thought and method of traditional Chinese medicine conservative treatment for gallbladder polyp of stagnation of liver-qi and deficiency of spleen.Research method: Sixty-two patients were randomly divided into control group(N = 31)and treatment group(N = 31).The control group took ursodeoxycholic acid tablet(Shanghai Shikangte Pharmaceutical Co.,Ltd.,Chinese medicine standard character H20067926,50 mg per tablet),8-10 mg per kg daily,in the morning and evening,and combined with healthy living habits.On the basis of the control group,the treatment group was treated with traditional Chinese medicine,mainly with the methods of soothing the liver and strengthening the spleen,softening the liver and dispersing the nodules,and combined with the methods of drying dampness and expelling phlegm,removing qi and blood stasis,clearing heat and dispersing the nodules.After treatment for 6months,the patients in the control group and the treatment group were reexamined by colour ultrasound,and the results of colour ultrasound were analyzed,including the number of polyps(single or multiple)and polyp size(the diameter of the largest polyp),statistical analysis of the overall effective rate after treatment and the effective rate of TCM syndrome,colour ultrasound results,TCM symptoms,tCM syndrome integral and recurrence rate.Research results:(1)The total effective rate was 21.4% and 28.6% in the control group and 71.4% and 78.6% in the treatment group respectively.After treatment,the total effective rate of the two groups was Z =-3.778,p = 0.000,p< 0.01.The effective rate of TCM syndrome was Z =-4.633,p = 0.000,p< 0.01.There was a significant difference in the effective rate between the two groups after treatment,the effective rate of the treatment group(healthy life + Ursodeoxycholic acid tablet + soothing the liver and strengthening the spleen,softening the liver and dispersing the mass)was significantly higher than that of the control group(healthy life +Ursodeoxycholic acid tablet).(2)comparison of the results of colour ultrasound: the size of gallbladder polyps and the number of polyps were compared.In the control group,the average size of polyps was 5.43 ± 1.526 mm before treatment and 4.75 ± 1.602 mm after treatment,p = 0.110,P >0.05.There was no significant difference in the average size of polyps before and after treatment,the results showed that the control group had no significant effect on reducing the size of gallbladder polyps.In the treatment group,the average size of polyps was 6.29 ± 1.761 mm before treatment and 3.86 ± 1.508 mm after treatment,P = 0.000,p < 0.05.There was significant difference in the average size of polyps before and after treatment,it indicated that the treatment group had a significant effect on reducing the size of gallbladder polyps in patients with liver depression and spleen deficiency.The average size of polyps in 56 patients after treatment was 4.30± 1.606 mm,in which the average size of polyps in the control group was4.75 ± 1.602 mm,and the average size of polyps in the treatment group was 3.86 ± 1.508 mm.There was a significant difference between the two groups in the average size of the polyps after treatment,indicating that the effect of the treatment group in reducing the size of the polyps of the gallbladder of the liver-qi stagnation and spleen-deficiency type was better than that of the control group.There was no significant difference in the number of gallbladder polyps before and after treatment in the control group(p = 0.763,P >0.05),the results showed that the control group had no significant effect on reducing the number of polyps in patients with gallbladder polyp of stagnation of liver-qi and deficiency of the spleen,and the comparison of the number of polyps before and after treatment in the treatment group was P = 0.005,p < 0.05,there was a significant difference in the number of polyps before and after treatment in the treatment group,indicating that the treatment group had a significant effect on reducing the number of polyps in patients with gallbladder polyps of liver-qi stagnation and spleen deficiency type.After treatment,the number of polyps in the control group and the treatment group was significantly lower than that in the control group(p = 0.022,p < 0.05).(3)Comparison of TCM symptoms:After treatment,the comparison between the control group and the treatment group showed that the treatment group was superior to the control group in improving the main symptoms(right flank pain,abdominal distension,loose stools)and secondary symptoms(abdominal pain,diarrhea,decreased appetite)(p < 0.05),however,there was no significant difference in the improvement of emotional discomfort,lassitude and laxity(P > 0.05).It is indicated that the treatment group(healthy living + ursodeoxycholic acid tablet + soothing liver and invigorating spleen,softening liver and dispersing knot method)has the effects of right flank distention,abdominal distention,loose stool and diarrhea in patients with gallbladder polyp of liver depression and spleen deficiency type,take food to reduce symptoms such as good efficacy.The control group(healthy living + ursodeoxycholic acid)had no obvious effect on improving the symptoms.(4)TCM syndrome integral:The TCM syndrome scores of the control group were 7.00(7.00,9.00)before treatment and 6.00(5.00,7.00)after treatment,there was no significant difference between before and after treatment in the control group(P > 0.05),it is indicated that the control group has no significant effect on reducing the TCM syndrome integral of the patients with gallbladder polyp of liver depression and spleen deficiency type.The TCM syndrome integral of the treatment group was 8.00(7.00,11.00)before treatment and 3.00(1.00,4.00)after treatment.The TCM syndrome integral of the treatment group was significantly different from that of the control group(p < 0.01),it is indicated that the treatment group has obvious curative effect on the patients with gallbladder polyp of liver depression and spleen deficiency type.After treatment,the average scores of TCM syndrome were compared between the control group(healthy life + Ursodeoxycholic acid tablet)and the treatment group(healthy life + Ursodeoxycholic acid tablet +soothing the liver and strengthening the spleen,softening the liver and dispersing the mass),p < 0.01;It indicated that the treatment group was superior to the control group in reducing the TCM syndrome integral of patients with gallbladder polyp of liver depression and spleen deficiency type.(5)Comparison of recurrence rate: The recurrence rate was 32.1% in the control group and 3.6% in the treatment group.There was significant difference between the two groups(p = 0.005,p < 0.05),it showed that the recurrence rate of the treatment group was lower than that of the control group.Conclusion:The method of soothing the liver and strengthening the spleen,softening the liver and dispersing the knot has obvious curative effect,little toxic and side effect,good safety and low recurrence rate Both the control group(healthy living + Ursodeoxycholic acid tablet)and the treatment group(healthy living + Ursodeoxycholic acid tablet +soothing the liver and strengthening the spleen,softening the liver and dispersing the mass)could reduce the colour ultrasound results and TCM syndrome scores of the patients with gallbladder polyp of liver depression and spleen deficiency type,but the treatment group(healthy living +Ursodeoxycholic acid tablet + soothing the liver and strengthening the spleen,softening the liver and dispersing the mass)was superior to the control group(healthy living + Ursodeoxycholic acid tablet).The method of soothing the liver and strengthening the spleen,softening the liver and dispersing the knot was better than the control group in improving the symptoms of right flank distension,abdominal distension,loose stool,abdominal pain and diarrhea,and decreasing appetite. |
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