[Clinical observation on the treatment of acute cholangitis of a severe type with endoscopic retrograde biliary drainage and qingjieling].
In order to find out an effective approach for the improvement of therapeutic results of acute cholangitis of severe type (ACST) and its therapeutic and pathophysiologic problems, clinical observation has been made. In clinical practice, 38 patients with ACST were treated with ERBD and herbs (n = 20) or operative drainage (n = 18). The results suggested that the pressure of bile duct in the patients was very high (20-35 cmH2O). There were high levels of endotoxin in bile and blood, and level of fibronectin in serum was just 25% compared to that of normal level. The value of C3 in serum was only a half of normal level of C3. However, a high level of C-reactive protein in serum was determined. Positive rate of E. coli in bile was 84%. From the significant differences in the series of parameters between the ERBD-herb group and the operative drainage group, it was suggested that the ERBD-herb therapy was more effective than the operative method in promoting immunologic ability, relieving symptoms of ACST, minimizing complications and decreasing mortality. Some new pathophysiologic and therapeutic concepts of ACST have been proposed.
Hu
J S
JS
Wu
X Z
XZ
Lu
H Z
HZ
D000208:Acute Disease; D000328:Adult; D000368:Aged; D001652:Bile Ducts; D002097:C-Reactive Protein / Q000378:metabolism; D002761:Cholangitis / Q000628:therapy*; D004322:Drainage / Q000379:methods; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D004724:Endoscopy; D004731:Endotoxins / Q000097:blood; D004926:Escherichia coli; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D004365:Drugs, Chinese Herbal; D004731:Endotoxins; D002097:C-Reactive Protein