目的 探讨胆舒胶囊联合头孢曲松治疗慢性胆囊炎的临床疗效。方法 选择2019年1月—2021年12月东南大学医学院附属南京同仁医院收治的148例慢性胆囊炎患者，按照随机数字表法分为对照组和治疗组，每组各74例。对照组给予注射用头孢曲松钠，每次将2 g加入0.9%氯化钠注射液250 mL中均匀混合后静脉滴注，1次/d。治疗组在对照组基础上口服胆舒胶囊，2粒/次，3次/d。两组疗程均为2周。观察两组的临床疗效，比较治疗前后两组主症积分、中医症状总积分、胃肠道生活质量指数（GIQLI）总分、胆囊壁厚度、胆囊收缩功能指标[胆囊空腹体积（GFV）、胆囊最小残余体积（MGRV）、胆囊最大排空率（MGER）]及血清肿瘤坏死因子（TNF）-α、白细胞介素（IL）-6、胆囊收缩素（CKK）、总胆汁酸（TBA）水平。结果 治疗后，治疗组总有效率为94.59%，显著高于对照组的83.78%（P＜0.05）。治疗后，两组主症积分、中医症状总积分均显著降低，GIQLI总分均显著升高（P＜0.05）；治疗后，治疗组主症积分、中医症状总积分、GIQLI总分改善均优于对照组（P＜0.05）。治疗后，两组胆囊壁厚度、GFV、MGRV均较治疗前显著降低，MGER均显著升高（P＜0.05），治疗后，治疗组胆囊壁厚度和胆囊收缩功能指标改善均优于对照组（P＜0.05）。治疗后，两组血清TNF-α、IL-6、CCK、TBA水平均较治疗前显著降低（P＜0.05）；治疗后，治疗组血清TNF-α、IL-6、CCK、TBA水平均显著低于对照组（P＜0.05）。结论 胆舒胶囊联合头孢曲松治疗慢性胆囊炎疗效肯定，可缓解反复右上腹胀痛或不适等症状、改善胆囊功能及生活质量，并可进一步降低血清TNF-α、IL-6、CCK、TBA水平，值得临床推广应用。

Objective To investigate the clinical efficacy of Danshu Capsules combined with ceftriaxone in the treatment of chronic cholecystitis. Methods A total of 148 patients with chronic cholecystitis admitted to Nanjing Tongren Hospital Affiliated to Southeast University School of Medicine from January 2019 to December 2021 were selected and divided into control group and treatment group according to random number table method, with 74 cases in each group. Patients in the control group were iv administered with Ceftriaxone Sodium for Injection, 2 g is added into 0.9% sodium chloride injection 250 mL each time and mix evenly before intravenous infusion, once daily. Patients in the treatment group were po administered with Danshu Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, the scores of main symptoms, the total score of TCM symptoms, the total score of gastrointestinal quality of life index (GIQLI), the thickness of the gallbladder wall, the index of gallbladder contraction function [gallbladder fasting volume (GFV), minimum residual gallbladder volume (MGRV), maximum gallbladder emptying rate (MGER)], and serum tumor necrosis factor (TNF)-α, interleukin (IL)-6, cholecystokinin (CKK), total bile acid (TBA) levels in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 94.59%, significantly higher than that of the control group (83.78%) (P < 0.05). After treatment, the main symptom score and total TCM symptom score were significantly decreased, and the total GIQLI score was significantly increased in both groups (P < 0.05). After treatment, the improvement of main symptom score, TCM symptom score and GIQLI total score in the treatment group was better than that in the control group (P < 0.05). After treatment, the thickness of gallbladder wall, GFV and MGRV of the two groups were significantly decreased, while the MGER was significantly increased (P < 0.05). After treatment, the improvement of gallbladder wall thickness and gallbladder systolic function indexes in the treatment group was better than that in the control group (P < 0.05). After treatment, serum levels of TNF-α, IL-6, CCK and TBA in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the levels of TNF-α, IL-6, CCK and TBA in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Danshu Capsules combined with ceftriaxone has definitely effective in treatment of chronic cholecystitis, and can relieve the symptoms of recurrent right upper abdominal distension pain or discomfort, improve gallbladder function and life quality, and can further reduce the serum levels of TNF-α, IL-6, CCK, TBA, which is worthy of clinical application.

R975