The Effect of Oral Xiaoyan Lidan Tablets on The Bile Composition in Patients with Intrahepatic Bile Duct Stones_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LIUYang ,  CHENGNan-sheng , YEHui , LIFu-yu , CHENLi-ping , YOUZhen , ZHOURong-xing

Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding?author：

CHENGNan-sheng, Email: nscheng2002@163.com

Keywords：

Xiaoyan Lidan tablets; Hepatolithiasis; Total bile acid; Cholesterol; Phospholipid

DOI：

10.7507/1007-9424.20140288

Video：

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Objective To observe the effects of oral Xiaoyan Lidan tablets(XYLDT) on the bile composition(total bile acids, cholesterol, phospholipids) in patients with intrahepatic duct stones after common bile duct exploration(CBDE) with T tube drainage, to explore its possible preventive effects on stone recurrence. Methods Forty consecutive patients with intrahepatic bile duct stones who underwent CBDE with T tube drainage were randomly divided into experi mental group and control group. XYLDT were administrated at day 4 after surgery in experimental group(n=20), while none of medication were given in control group(n=20). 2 mL of bile was collected through T tube in both groups at day 1, 2, 3, 7, 14, and 21 postoperatively. Total bile acids(TBA), cholesterol(CHO), and phospholipids(PLIP) in bile were measured, and TBA/CHO ratio and PLIP/CHO ratio were calculated respectively. The results were statistical analyzed. Results The demographic data in both groups including age, gender, height, weight, preoperative concomitant diseases, operative time, postoperative complications, hospital stays, serum total bilirubin, direct bilirubin, alanine aminotransferase(ALT), aspartate aminotransferase(AST), and amylase were not significantly different(P > 0.05). The measurements of TBA, CHO, PLIP, and the ratio of TBA/CHO and PLIP/CHO in bile were not significant on day 1, 2, and 3 after surgery in both groups(P > 0.05). In experimental group, the TBA, CHO, and PLIP on day 7, 14, and 21 after surgery were significantly increased compared with the control group(P < 0.05). The ratio of TBA/CHO on day 7, 14, and 21 was 2.17±0.29, 2.29±0.44, and 2.59±0.58, the ratio of PLIP/CHO was 2.03±0.68, 2.84±0.64, and 2.86±0.77, respectively, which were also significantly increased compared with the control group(P < 0.05). Conclusions Oral XYLDT can increase the secretion of TBA, CHO, and PLIP, elevate the TBA/CHO and PLIP/CHO ratio, and change the bile composition which may increase the dissolution of cholesterol in the bile. Presumably, oral XYLDT may have preventive effects in the recurrence of intrahepatic bile duct stones.

Citation： LIUYang, CHENGNan-sheng, YEHui, LIFu-yu, CHENLi-ping, YOUZhen, ZHOURong-xing. The Effect of Oral Xiaoyan Lidan Tablets on The Bile Composition in Patients with Intrahepatic Bile Duct Stones. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(10): 1198-1202. doi: 10.7507/1007-9424.20140288 Copy

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26.	向陽, 項建斌, 馬保金, 等.膽寧片對膽石癥患者膽汁成分和成石趨勢的影響[J].上海醫學, 2008, 31(2):104-106.

1. 鄒聲泉.膽道病學[M].北京:人民衛生出版社, 2010:5-15.
2. Kratzer W, Mason RA, K?chele V. Prevalence of gallstones in sonographic surveys worldwide[J]. J Clin Ultrasound, 1999, 27(1):1-7.
3. Sandler RS, Everhart JE, Donowitz M, et al. The burden of selected digestive diseases in the United States[J]. Gastroenterology, 2002, 122(5):1500-1511.
4. Nervi F, Miquel JF, Alvarez M, et al. Gallbladder disease is associated with insulin resistance in a high risk Hispanic population[J]. J Hepatol, 2006, 45(2):299-305.
5. Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome[J]. Lancet, 2005, 365(9468):1415-1428.
6. 中華醫學會外科學分會膽道外科學組.肝膽管結石病診斷治療指南[J].中華消化外科雜志, 2007, 6(2):156-160.
7. 安新, 王利民, 李琳, 等.應用全自動生化分析儀測定人膽汁脂質成分[J].檢驗醫學, 2007, 22(4):422-424.
8. Dawson PA, Lan T, Rao A. Bile acid transporters[J]. J Lipid Res, 2009, 50(12):2340-2357.
9. 董家鴻, 田遠虎.肝膽管結石外科治療進展[J].中華普外科手術學雜志:電子版, 2012, 6(4):340-344.
10. 程南生.肝膽管結石并發癥的防治[J].中國普外基礎與臨床雜志, 2006, 13(4):380-381.
11. 蘇芬蓮, 陳小勛.術中超聲聯合膽道鏡治療肝內膽管結石的臨床意義[J].中國普通外科雜志, 2009, 18(2):121-123.
12. 黃德全, 胡先典.膽道鏡診治肝膽管結石的體會[J].中華普通外科雜志, 2009, 24(6):505-506.
13. 馬利林, 朱建偉, 陸麗萍, 等.經膽道鏡等離子體沖擊波碎石術的臨床應用[J].中國普外基礎與臨床雜志, 2010, 17(12):1275-1278.
14. 宋樹樓, 武楊.膽道手術中常規應用膽道鏡的臨床意義[J].中國普外基礎與臨床雜志, 2010, 17(4):368-371.
15. Campagnacci R, Baldoni A, Baldarelli M, et al. Is laparoscpic fiberoptic choledochoscopy for common bile duct stones a fine option or a mandatory step[J]. Surg Endosc, 2010, 24(3):547-553.
16. Sakpal SV, Babel N. Chamberlain RS. Surgical management of hepatolithiasis[J]. HPB (Oxford), 2009, 11(3):194-202.
17. 趙美峰, 龐來祥.利膽排石中藥復方的藥理與臨床研究近況[J].國醫論壇, 2010, 6(6):51-53.
18. 潘維, 周卓.金錢草藥用價值及研究[J].中國民族民間醫藥, 2010, 9:11-12.
19. 張毫, 徐滿卿, 丁舸.茵陳蒿湯中茵陳大黃的核心作用[J].長春中醫藥大學學報, 2013, 29(6):1112-1113.
20. 王憲齡, 周志.試探柴胡黃芩藥對清泄肝膽的配伍作用[J].中醫研究, 2009, 22(6):6-9.
21. Zhang Z, Li D, Blanchard DE, et al. Key regulatory oxysterols in liver:analysis as delta4-3-ketone derivatives by HPLC and response to physiological perturbations[J]. J Lipid Res, 2001, 42(4):649-658.
22. 張西波, 崔乃強.清熱利濕方防治兔膽色素結石形成的實驗研究[J].中國中西醫結合雜志, 2007, 27(3):241-243.
23. Méndez-Sanchez N, Zamora-Valdés D, Chavez-Tapia NC, et al. Role of diet in cholesterol gallstone formation[J]. Clin Chim Acta, 2007, 376(1-2):1-8.
24. 程南生, 付林, 肖路加.兔膽紅素鈣結石成石過程中血脂質變化的研究[J].華西醫科大學學報, 1994, 5(3):301-304.
25. Sunami Y, Tazuma S, Chayma K. Is a role of phospholipase A2 in cholesterol gallstone formation phospholipid species-dependent?[J]. Biochim Biophys Acta, 2001, 1532(1-2):51-59.
26. 向陽, 項建斌, 馬保金, 等.膽寧片對膽石癥患者膽汁成分和成石趨勢的影響[J].上海醫學, 2008, 31(2):104-106.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The Effect of Oral Xiaoyan Lidan Tablets on The Bile Composition in Patients with Intrahepatic Bile Duct Stones

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