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：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

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

1.	邹声泉.胆道病学[M].北京:人民卫生出版社, 2010:5-15.
2.	Kratzer W, Mason RA, Kächele 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.	中华医学会外科学分会胆道外科学组.肝胆管结石病诊断治疗指南[J].中华消化外科杂志, 2007, 6(2):156-160.
7.	安新, 王利民, 李琳, 等.应用全自动生化分析仪测定人胆汁脂质成分[J].检验医学, 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.	董家鸿, 田远虎.肝胆管结石外科治疗进展[J].中华普外科手术学杂志:电子版, 2012, 6(4):340-344.
10.	程南生.肝胆管结石并发症的防治[J].中国普外基础与临床杂志, 2006, 13(4):380-381.
11.	苏芬莲, 陈小勋.术中超声联合胆道镜治疗肝内胆管结石的临床意义[J].中国普通外科杂志, 2009, 18(2):121-123.
12.	黄德全, 胡先典.胆道镜诊治肝胆管结石的体会[J].中华普通外科杂志, 2009, 24(6):505-506.
13.	马利林, 朱建伟, 陆丽萍, 等.经胆道镜等离子体冲击波碎石术的临床应用[J].中国普外基础与临床杂志, 2010, 17(12):1275-1278.
14.	宋树楼, 武杨.胆道手术中常规应用胆道镜的临床意义[J].中国普外基础与临床杂志, 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.	赵美峰, 庞来祥.利胆排石中药复方的药理与临床研究近况[J].国医论坛, 2010, 6(6):51-53.
18.	潘维, 周卓.金钱草药用价值及研究[J].中国民族民间医药, 2010, 9:11-12.
19.	张毫, 徐满卿, 丁舸.茵陈蒿汤中茵陈大黄的核心作用[J].长春中医药大学学报, 2013, 29(6):1112-1113.
20.	王宪龄, 周志.试探柴胡黄芩药对清泄肝胆的配伍作用[J].中医研究, 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.	张西波, 崔乃强.清热利湿方防治兔胆色素结石形成的实验研究[J].中国中西医结合杂志, 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.兔胆红素钙结石成石过程中血脂质变化的研究[J].华西医科大学学报, 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.	向阳, 项建斌, 马保金, 等.胆宁片对胆石症患者胆汁成分和成石趋势的影响[J].上海医学, 2008, 31(2):104-106.

1. 邹声泉.胆道病学[M].北京:人民卫生出版社, 2010:5-15.
2. Kratzer W, Mason RA, Kächele 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. 中华医学会外科学分会胆道外科学组.肝胆管结石病诊断治疗指南[J].中华消化外科杂志, 2007, 6(2):156-160.
7. 安新, 王利民, 李琳, 等.应用全自动生化分析仪测定人胆汁脂质成分[J].检验医学, 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. 董家鸿, 田远虎.肝胆管结石外科治疗进展[J].中华普外科手术学杂志:电子版, 2012, 6(4):340-344.
10. 程南生.肝胆管结石并发症的防治[J].中国普外基础与临床杂志, 2006, 13(4):380-381.
11. 苏芬莲, 陈小勋.术中超声联合胆道镜治疗肝内胆管结石的临床意义[J].中国普通外科杂志, 2009, 18(2):121-123.
12. 黄德全, 胡先典.胆道镜诊治肝胆管结石的体会[J].中华普通外科杂志, 2009, 24(6):505-506.
13. 马利林, 朱建伟, 陆丽萍, 等.经胆道镜等离子体冲击波碎石术的临床应用[J].中国普外基础与临床杂志, 2010, 17(12):1275-1278.
14. 宋树楼, 武杨.胆道手术中常规应用胆道镜的临床意义[J].中国普外基础与临床杂志, 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. 赵美峰, 庞来祥.利胆排石中药复方的药理与临床研究近况[J].国医论坛, 2010, 6(6):51-53.
18. 潘维, 周卓.金钱草药用价值及研究[J].中国民族民间医药, 2010, 9:11-12.
19. 张毫, 徐满卿, 丁舸.茵陈蒿汤中茵陈大黄的核心作用[J].长春中医药大学学报, 2013, 29(6):1112-1113.
20. 王宪龄, 周志.试探柴胡黄芩药对清泄肝胆的配伍作用[J].中医研究, 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. 张西波, 崔乃强.清热利湿方防治兔胆色素结石形成的实验研究[J].中国中西医结合杂志, 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.兔胆红素钙结石成石过程中血脂质变化的研究[J].华西医科大学学报, 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. 向阳, 项建斌, 马保金, 等.胆宁片对胆石症患者胆汁成分和成石趋势的影响[J].上海医学, 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

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content