Analysis On The Therapeutic Effect Of Endoscopic Treatment Of Obstructive Jaundice And The Relation Between Syndrome Differentiation Of TCM

Background:Obstructive jaundice is the common pathologic sign in the clinical, two of the most common causes are benign obstructive jaundice and malignant obstructive jaundice, of which the treatment and the prognosis are different. The prognosis of malignant obstructive jaundice has also relate with a number of factorsPurpose:In this research,72patients with obstructive jaundice were enrolled,we selected age、sex、TBIL、DBIL、ALP、ALT、Child-Pugh score、the stricture position、time of obstruction、 preoperative biliary infection and Cr level to investigate the value in Prognostic analysis of the endoscopic treatment of obstructive jaundice. Meanwhile, we tried to know whether TCM syndrome differentiation has been meaningful in analysis of the prognosis, and tried to find out some objective evidences for TCM syndrome differentiation.Methods:72patients with obstructive jaundice were enrolled into two groups,47in benign obstructive jaundice group and25malignant obstructive jaundice group.According to the reduction degree of serum bilirubin and survival condition in30days,the patients were divided into effective group(58cases) and ineffective group (14cases), and then analysed by statistics. According to TCM standard, Differentiation of all patients were divided into four syndrome types, The syndrome of dampness-heat in the liver and gallbladder type (37cases). The hot-toxic intrinsic type(8cases), inter-obstruction of Cold-wetness type (10cases), inter-obstruction of phlegm-stasis type (17cases), According to the treatment effectiveness analysed the difference between the correlative factors and syndrome differentiation of TCMResults:The levels of TBIL in all groups were significantly lower after treatment, except the group of malignant obstructive jaundice treatment futility. The difference was statistically significant(P<0.01). Results Single variable analysis showed that the stricture position the lever of Cr were of statistical significance in malignant obstructive jaundice (P<0.05). Treatment outcome showed that the syndrome of dampness-heat in the liver and gallbladder type and the hot-toxic intrinsic type were significantly higher than Cold-wetness type (10cases) and phlegm-stagnancy type,The difference was statistically significant(P<0.01). Conclusions:The prognosis of benign obstructive jaundice is better than malignant obstructive jaundice, The infection of high obstruction of bile duct、Child-Pugh score≥10、 preoperative biliary infection and carry a close relationship with the short-term prognosis of the endoscopic treatment of malignant obstructive jaundice;TCM syndrome differentiation showed that the prognosis of YANG jaundice is better YIN jaundice,malignant obstruction、time of obstruction≥30days、Cr≥115umol/L、TBIL>300umol/L may relate with TCM syndrome differentiation.