Perioperative Administration Of Through The Way Of Strengthen The Spleen And Purgation On Liver And Renal Function In Patients Suffering From Obstructive Jaundice

BackgroundJaundice describing a yellow color of the skin and whites of the eyes is caused by the arisen of serum bilirubin(>34μmol/L 或>2mg/dl). Obstructive Jaundice is caused by obstruction of the bile ducts, the aetiologies of the obstructive jaundice is such as the gallstone, carcinoma of the head of pancreas, carcinoma of the ampullae. The gallstone and the cancer add up to about the 90%~95% of the reason of obstructive jaudice. The obstruction of the bile duct heighten the pressure within the bile duct, induce some of the capillary bile duct break, then the countercurrent of the bile occurs, it leads to the risen of the serum bilirubin. Pathology change of the obstructive jaudice is various:the failure of the liver function, the failure of the renal function, dystrophia of the cruor,dystrophia. Some reports showed that severe obstructibe jaudice(serum bilirubin >171 μ mol/L ~ 342 μ mol/L or 10 ~ 20mg/dl)have 40%~60% possibility to have conplications, and the death rate is 15%~20%. The rate of the renal function is 8. 82 % from the severe obstructibe jaudice patients, and all be dead. So it is important to deal with the perioperative period of the obstructive jaundice patients. But till now, no one has dealed with the OJ in the traditional way systemicly. Astragalus can benefit the Qi and strength the spleen, rhubarb makes diarrhoea. Using the two together to adjust the body, strengthen the spleen at the same time make the Fu-organs unobstructive.ObjectiveTo examine the effects of administration of the combining of rhubarb and astragalus on liver and renal function in patients suffering from obstructive jaundice.MethodsDesign a randomized controlled trial. Thirty patients admitted to the Guang dong hospital of TCM for surgical one intervention on obstructive jaundice were randomly divided into two groups considering some factors:sex, age, gallstone or cancer, the level of the serum bilirubin before the operation.The experimental group , 15 patients who were administered astragalus injection (30ml qd vd) and rhubarb capsule(2 tablets po tid) postoperatively on the'base of genrral treatment , and the control group with 15 patients only been given the general treatment. ResultsThe experimental group has less serum bilirubin level on the postoperative day 5( 65.1 + 6. 3u mol/ L vs 87. 6±7. 9u mol/ L) , the difference is statistically significant in day 5 (P = 0.035). The experimental group has less serum Creat level on the postoperative day 5(58.3 + 3. 1 M mol/ L vs 67.1 +2. 6 u mol/ L) , the difference is statistically significant in day 5 (P= 0.037). The experimental group has more 24-hour urine volume (mg/ kg) from postoperative day 3 , the difference is statistically significant in day 3(26. 4 ±1.4mg/kg vs 25.1 + 2.0 (P=0.048);The postoperative serum AST level had no difference between two groups , however , the experimental group had more rapidly recovery speed. ConclusionPerioperative period administration of rhubarb and astragalus has beneficial effects on liver and renal function in patients suffering from obstructive jaundice.