Clinical Observation Of Dahuanglingxian Granule In Preventing Recurrence Of Hepatolithiasis After Surgery

Objective: Through the intervention of Dahuanglingxian granule in patients with hepatolithiasis after surgery,the postoperative bile drainage volume,bile composition and postoperative recurrence rate were observed,and the clinical mechanism of Dahuanglingxian granule in preventing the recurrence of postoperative stones was further explored,providing a theoretical basis and reference for the clinical prevention and treatment of hepatolithiasis after surgery.Methods: Ninty patients with intrahepatic cholelithiasis after operation were selected,and were divided into routine control group,drug control group and Dahuanglingxian group according to the random control principle of statistical analysis software,with 30 patients in each group.The conventional control group was given postoperative conventional treatment such as anti-infection,liver protection,external treatment of traditional Chinese medicine,"T" tube drainage,etc.The drug control group and Dahuanglingxian group were given routine treatment,while Dan ning tablets and Dahuanglingxian granules were given continuous treatment for 3 months.Observe and record the blood index of patients and the change of postoperative bile drainage flow,measure the components of bile in each group and make statistical analysis,conduct regular follow-up,and understand the recurrence rate of patients with stones.Results:(1)The blood indexes of the each groups after treatment were significantly better than those before treatment,and the average values of most of the indexes reached the normal range.After treatment,the inter-group comparison showed that the improvement of WBC,N%,ALT,AST,TBIL and DBIL in the drug control group and the large huanglingxian group was significantly stronger than that in the conventional control group(P=0.000,P=0.039,P=0.023,P=0.024,P=0.002,P=0.006;P=0.000,P=0.042,P=0.014,P=0.008,P=0.017,P=0.006);Compared with the drug control group,the differences of WBC and total bilirubin in patients of da huang lingxian group were statistically significant(P=0.023,P=0.033).(2)The difference in bile drainage volume between the drug control group and the Dahuanglingxian group on the third day and the seventh day after surgery was statistically significant compared with the conventional control group(P=0.037,P=0.016;P=0.024,P=0.010),and on the 14 th day after the operation,the bile drainage volume of Dahuanglingxian group was compared with that of the drug control group and the conventional control group,and the difference was statistically significant(P=0.043,P=0.018).(3)On the 14 th day after surgery,the levels of bilirubin and total cholesterol in the drug control group and the Dahuanglingxian group were lower than those in the conventional control group,and the levels of total bile acid were higher than those in the conventional control group,with statistically significant differences(P=0.002,P=0.012,P=0.048;P=0.001,P=0.009,P=0.012);The total bile acid level of Dahuanglingxian group was higher than that of the drug control group on the 14 th day after surgery,and the difference was statistically significant(P=0.041).(4)Compared with the conventional control group,the drug control group and Dahuanglingxian group for intrahepatic bile duct stones after the total effective rate is higher,and the difference has statistical significance(P=0.026;P = 0.044);There was no statistically significant difference in the recurrence rate between the groups at the third month after surgery,but there was a difference in the recurrence rate at the sixth month after surgery,and the difference was statistically significant(P=0.043;P = 0.038).(5)Univariate analysis showed that bile duct stenosis and stone residue had statistical significance(P=0.012,P=0.005),and multivariate analysis of Logistic regression model showed bile duct stenosis(OR=11.911,95%ci: 2.001-70.898,P=0.006)and stone residue(OR=20.892,95%ci:3.464 ~ 126.001,P=0.001)was an independent risk factor with a high probability of stone recurrence.The area under the ROC curve of the two groups of factors was 0.778 and 0.823,respectively,which were between 0.7 and 0.9.The diagnostic value was moderate,and the results were statistically significant(P=0.002,P=0.000).(6)No significant adverse reactions or special events occurred in the Dahuanglingxian group,indicating that Dahuanglingxian granules were safe and effective.Conclusions:(1)Dahuanglingxian granule can inhibit inflammation and repair liver function,regulate postoperative bile volume and metabolism of bile components in intrahepatic bile duct stones,reduce the secretion of pathological bile,and prevent the recurrence of stones.(2)Bile duct stenosis and stone residue are independent risk factors for recurrence of hepatolithiasis.