目的 探讨羟甲烟胺联合氨苄西林治疗慢性胆囊炎的临床效果。方法 选取2017年4月—2018年10月南阳医学高等专科学校第一附属医院收治的100例慢性胆囊炎患者，以随机数字表法将研究对象分为对照组（n=50例）和治疗组（n=50例）。对照组口服氨苄西林胶囊，0.75 g/次，3次/d。治疗组在对照组基础上口服羟甲烟胺片，1.0 g/次，3次/d，饭前服用，连服3 d后调整为0.5 g/次，3次/d。两组均连续治疗4周。对比两组临床疗效及主要症状缓解时间；观察两组治疗前后胆囊收缩功能、胆囊壁厚度及血清白细胞介素（IL）-6、IL-8、肿瘤坏死因子（TNF）-α、瘦素（LEP）、一氧化氮（NO）和超氧化物歧化酶（SOD）水平变化。结果 治疗组总有效率为94.0%，显著高于对照组80.0%（P<0.05）。治疗组主要症状（右上腹疼痛、恶心、腹胀）的缓解时间均显著短于对照组（P<0.05）。两组治疗后胆囊收缩率均较本组治疗前显著提高，但空腹胆囊容积、餐后残余容积及胆囊壁厚度均较本组治疗前显著降低（P<0.05）；且治疗后，治疗组对胆囊收缩功能及胆囊壁厚度的改善效果均显著优于对照组（P<0.05）。两组治疗后血清IL-6、IL-8、TNF-α、LEP、NO水平均较本组治疗前显著降低，血清SOD水平则均较本组治疗前显著上升（P<0.05）；但治疗后，治疗组比对照组对血清IL-6、IL-8、TNF-α、LEP、NO水平的降低作用及对血清SOD水平的升高作用更显著（P<0.05）。结论 羟甲烟胺联合氨苄西林治疗慢性胆囊炎的整体疗效确切，能安全有效地缓解患者主要症状，改善胆囊功能，进一步抑制机体炎症反应与氧化应激反应，值得推广应用。

Objective To investigate the clinical effect of hydroxymethy imicotinamide combined with ampicillin in treatment of chronic cholecystitis.Methods A total of 100 patients with chronic cholecystitis who were treated in the First Affiliated Hospital of Nanyang Medical College from April 2017 to October 2018 were selected and divided into control group (n=50) and treatment group (n=50) by random number table method. Patients in the control group were po administered with Ampicillin Capsules, 0.75 g/time, three times daily. Patients in the treatment group were po administered with Hydroxymethy Imicotinamide Tablets on the basis of the control group before meals, 1.0 g/time, three times daily. The dosage was adjust to 0.5 g/time, three times daily after 3 d. Both groups were treated continuously for 4 weeks. The clinical efficacy and main symptom relief time of the two groups were compared. The gallbladder contraction function, gallbladder wall thickness and serum interleukin (IL)-6, IL-8, tumor necrosis factor (TNF)-α, leptin (LEP), nitric oxide (NO), superoxide dismutase (SOD) level in two groups were compared.Results The total effective rate of treatment group was 94.0%, which was significantly higher than that of control group (80.0%,P<0.05). The relief time of main symptoms (right upper abdominal pain, nausea and abdominal distension) in the treatment group was significantly shorter than that in the control group (P<0.05). After treatment, gallbladder shrinkage rate in both groups was significantly increased compared with before treatment, but the fasting gallbladder volume, postprandial residual volume and gallbladder wall thickness were significantly decreased compared with before treatment in both groups (P<0.05). After treatment, the improvement of gallbladder systolic function and gallbladder wall thickness in the treatment group was significantly better than that in the control group (P<0.05). After treatment, the levels of serum IL-6, IL-8, TNF-α, LEP and NO in two groups were significantly decreased, while the level of serum SOD was significantly increased (P<0.05). However, after treatment, the decrease of serum IL-6, IL-8, TNF-α, LEP, NO levels and the increase of serum SOD levels in treatment group were more significant than those in control group (P<0.05).Conclusion Hydroxymethy imicotinamide combined with ampicillin has clear overall effect in treatment of chronic cholecystitis, and can relieve the main symptoms of patients safely and effectively, and also can improve the gallbladder function, and further inhibit the inflammatory response and oxidative stress reaction of the body, which is worthy of promotion and application.

R975

南阳医学高等专科学校科技计划项目（3186518）