CAJ | 학술논문

目的：评价牛磺熊去氧胆酸（ TUDCA）与熊去氧胆酸（ UDCA）对保胆取石术后患者预防胆囊结石复发的差异性及其临床价值。方法2010年10月～2011年12月，我院内镜微创保胆手术成功的313例胆囊结石按病历号奇偶分为TUDCA组（n＝161）和UDCA组（n＝152），术后2周TUDCA组口服牛磺熊去氧胆酸胶囊（商品名：滔罗特，意大利贝斯迪大药厂生产，进口批文号：H20070200、H20110233）500 mg，每晚1次，连续服用5天后，停药10天，15天为一周期；UDCA组口服熊去氧胆酸胶囊（商品名：优思弗，德国Dr．Falk药厂生产，进口批文号H20050181）500 mg，每晚1次。两组服药疗程均为180天。两组术后护理、饮食等均相同。术后定期随访及复查B超，观察记录胆囊结石复发、胆囊壁厚度变化以及胆囊收缩率。结果2组随访时间12～30个月，TUDCA组和UDCA组2年胆囊结石复发率分别为3．7％和12．4％（log-rank χ2＝5．304，P＝0．021）。结论内镜微创保胆取石术后口服TUDCA预防胆囊结石的复发效果优于UDCA。
목적：평개우광웅거양담산（ TUDCA）여웅거양담산（ UDCA）대보담취석술후환자예방담낭결석복발적차이성급기림상개치。방법2010년10월～2011년12월，아원내경미창보담수술성공적313례담낭결석안병력호기우분위TUDCA조（n＝161）화UDCA조（n＝152），술후2주TUDCA조구복우광웅거양담산효낭（상품명：도라특，의대리패사적대약엄생산，진구비문호：H20070200、H20110233）500 mg，매만1차，련속복용5천후，정약10천，15천위일주기；UDCA조구복웅거양담산효낭（상품명：우사불，덕국Dr．Falk약엄생산，진구비문호H20050181）500 mg，매만1차。량조복약료정균위180천。량조술후호리、음식등균상동。술후정기수방급복사B초，관찰기록담낭결석복발、담낭벽후도변화이급담낭수축솔。결과2조수방시간12～30개월，TUDCA조화UDCA조2년담낭결석복발솔분별위3．7％화12．4％（log-rank χ2＝5．304，P＝0．021）。결론내경미창보담취석술후구복TUDCA예방담낭결석적복발효과우우UDCA。
Objective To evaluate the clinical effect between tauroursodeoxycholic acid ( TUDCA) and ursodeoxycholic acid ( UDCA) on preventing the relapse of cholelithiasis after gallbladder-preserving lithotomy via choledochoscope . Methods A total of 313 patients of cholecystolithiasis in Peking University Shougang Hospital undergoing gallbladder -preserving lithotomy via choledochoscope were divided into TUDCA and UDCA group by odd and even numbers of their medical record .The TUDCA group took 500 mg TUDCA (commodity name: Taurolite, Bruschettini S.r.l., Italy, import approval number: H20070200/H20110233) once per night, for 5 days consecutively, and withdrew the drug for 10 days, 15 days was considered a cycle;the UDCA group took 500 mg UDCA ( commodity name:Ursofalk, Dr.Falk Pharma GmbH, German, import approval number: H20050181) once per night .The total course of treatment of the two groups was 180 d.Nursing and diet therapies were the same in the two groups .The cases were checked at regular intervals after surgery with B ultrasonography and were followed up .The recurrence rate of calculi , the change of the thickness of gallbladder wall and the rate of gallbladder contraction were recorded . Results The two groups were followed up for 12-30 months.The 2-year recurrence rates of cholecystolithiasis were 3.7% and 12.4% respectively in the two groups ( log-rankχ2 =5.304, P =0.021 ). Conclusion The effect of TUDCA is better than that of UDCA in preventing the relapse of cholecystolithiasis for patients with gallbladder-preserving lithotomy via choledochoscope .