目的 探讨利胆排石颗粒联合熊去氧胆酸片治疗肝内胆管结石的临床疗效。方法 选取2020年1月—2021年9月在南阳市中心医院就诊的100例肝内胆管结石患者，根据随机数字表法将所有患者分为对照组和治疗组，每组各50例。对照组患者口服熊去氧胆酸片，10 mg/kg，2次/d。治疗组在对照组基础上温水冲服利胆排石颗粒，2袋/次，2次/d。两组患者连续治疗6个月。观察两组的临床疗效，比较两组的症状改善情况、结石和血清中总胆红素（TBIL）、直接胆红素（DBIL）、天门冬氨酸氨基转氨酶（AST）、丙氨酸氨基转移酶（ALT）水平。结果 治疗后，治疗组的总有效率为96.00%，明显比对照组总有效率84.00%高，组间比较差异有统计学意义（P＜0.05）。治疗后，两组的发热、黄疸、腹痛发生率显著降低（P＜0.05），且治疗组发热、黄疸、腹痛发生率较对照组降低更明显（P＜0.05）。治疗后，两组的最大结石直径显著减小（P＜0.05），且治疗组最大结石直径明显小于对照组（P＜0.05）。治疗后，两组的血清TBIL、DBIL、AST、ALT水平均显著降低（P＜0.05），且治疗组血清TBIL、DBIL、AST、ALT水平明显低于对照组（P＜0.05）。结论 利胆排石颗粒联合熊去氧胆酸片可提高肝内胆管结石的疗效，改善临床症状，促进结石缩小，改善肝胆功能，且安全性良好。

Objective To investigate the clinical effect of Lidan Paishi Granules combined with Ursodeoxycholic Acid Tablets in treatment of intrahepatic bile duct calculi. Methods Patients (100 cases) with intrahepatic bile duct calculi in Nanyang Central Hospital from January 2020 to September 2021 were randomly divided into control and treatment groups, and each group had 50 cases. Patients in the control group were po administered with Ursodeoxycholic Acid Tablets, 100 mg/kg, twice daily. Patients in the treatment group were po administered with Lidan Paishi Granules on the basis of the control group, 2 bags/time, twice daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies were evaluated, and the improvement of main symptoms, stone size and the serum levels of TBIL, DBIL, AST, and ALT in two groups were compared. Results After treatment, the total effective rate of the treatment group was 96.00%, which was significantly higher than that of the control group (84.00%) (P < 0.05). After treatment, the incidence of fever, jaundice, and abdominal pain in two groups were significantly decreased (P < 0.05), and the incidence of fever, jaundice, and abdominal pain in the treatment group were significantly lower than that in the control group (P < 0.05). After treatment, the maximum stone diameter of two groups were significantly decreased (P < 0.05), and the maximum stone diameter of the treatment group was significantly lower than that of the control group (P < 0.05). After treatment, the serum levels of TBIL, DBIL, AST, and ALT in two groups were significantly decreased (P < 0.05), and the serum levels of TBIL, DBIL, AST, and ALT in the treatment group were significantly lower than those in the control group (P < 0.05).Conclusion Lidan Paishi Granules combined with Ursodeoxycholic Acid Tablets can improve the curative effect of intrahepatic bile duct calculi, further improve clinical symptoms,promote the reduction of calculi, and improve hepatobiliary function, with good safety.

R975