目的 探討羥甲煙胺聯(lián)合氨芐西林治療慢性膽囊炎的臨床效果。方法 選取2017年4月—2018年10月南陽醫(yī)學高等?？茖W校第一附屬醫(yī)院收治的100例慢性膽囊炎患者，以隨機數(shù)字表法將研究對象分為對照組（n=50例）和治療組（n=50例）。對照組口服氨芐西林膠囊，0.75 g/次，3次/d。治療組在對照組基礎(chǔ)上口服羥甲煙胺片，1.0 g/次，3次/d，飯前服用，連服3 d后調(diào)整為0.5 g/次，3次/d。兩組均連續(xù)治療4周。對比兩組臨床療效及主要癥狀緩解時間；觀察兩組治療前后膽囊收縮功能、膽囊壁厚度及血清白細胞介素（IL）-6、IL-8、腫瘤壞死因子（TNF）-α、瘦素（LEP）、一氧化氮（NO）和超氧化物歧化酶（SOD）水平變化。結(jié)果 治療組總有效率為94.0%，顯著高于對照組80.0%（P<0.05）。治療組主要癥狀（右上腹疼痛、惡心、腹脹）的緩解時間均顯著短于對照組（P<0.05）。兩組治療后膽囊收縮率均較本組治療前顯著提高，但空腹膽囊容積、餐后殘余容積及膽囊壁厚度均較本組治療前顯著降低（P<0.05）；且治療后，治療組對膽囊收縮功能及膽囊壁厚度的改善效果均顯著優(yōu)于對照組（P<0.05）。兩組治療后血清IL-6、IL-8、TNF-α、LEP、NO水平均較本組治療前顯著降低，血清SOD水平則均較本組治療前顯著上升（P<0.05）；但治療后，治療組比對照組對血清IL-6、IL-8、TNF-α、LEP、NO水平的降低作用及對血清SOD水平的升高作用更顯著（P<0.05）。結(jié)論 羥甲煙胺聯(lián)合氨芐西林治療慢性膽囊炎的整體療效確切，能安全有效地緩解患者主要癥狀，改善膽囊功能，進一步抑制機體炎癥反應與氧化應激反應，值得推廣應用。

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

南陽醫(yī)學高等?？茖W?？萍加媱濏椖浚?186518）