3种从肝治胆方对胆石症模型豚鼠的防治作用

目的 观察疏肝理气法、养肝柔肝法和清肝利湿法治疗胆囊结石的疗效。方法 将75只豚鼠随机分为正常组和模型组、疏肝组、养肝组和清肝组，采用喂食高脂致石性饲料和少量蔬菜的方法复制胆石症模型，疏肝组灌服十二味疏肝利胆颗粒，养肝组灌服一贯煎颗粒，清肝组灌服龙胆泻肝颗粒，正常组和模型组均灌胃生理盐水。8周后检测各组豚鼠胆囊结石形成率，结石主要成分，血清丙氨酸氨基转移酶（alanine aminotransferase，ALT）、天冬氨酸氨基转移酶（aspartate aminotransferase，AST）、总胆固醇（total cholesterol，TC）水平，以及胆汁总胆红素（total bilirubin，TBIL）和Ca2+浓度，观察胆囊病理变化。结果 疏肝组、养肝组和清肝组豚鼠胆囊结石形成率较模型组明显降低（P<0.05），结石主要成分为胆固醇； 与模型组比较，疏肝组、养肝组和清肝组豚鼠胆囊病理变化均明显改善，血清ALT、AST、TC水平均明显降低（P＜0.05），胆汁TBIL浓度无明显变化（P>0.05），仅清肝组Ca2+浓度明显下降（P<0.05）；养肝柔肝法降低AST的作用最优（P<0.05），疏肝理气法降低TC的作用最优（P<0.05），清肝利湿法降低胆汁Ca2+的作用最优（P<0.05）。结论 疏肝理气法、养肝柔肝法和清肝利湿法均可防治豚鼠胆囊结石形成，3种中医治法的作用存在差异。

Therapeutic Effects of Soothing the Liver and Regulating Qi, Nourishing and Softening the Liver, and Clearing Liver Fire and Removing Dampness in Quinea Pig Model of Cholelithiasis

Objective To observe the efficacy of soothing the liver and regulating qi, nourishing and softening the liver, and clearing liver fire and removing dampness in the treatment of cholelithiasis. Methods A total of 75 guinea pigs were randomly divided into normal group, model group, liver soothing group, liver nourishing group, and liver-fire clearing group. All guinea pigs, except those in the normal group, were fed with high-fat feed (for inducing cholelithiasis) and a small amount of vegetable to establish a cholelithiasis model. The liver soothing group was given Twelve-Flavour Shugan Lidan Granule by gavage, the liver nourishing group was given Yiguanjian Granule by gavage, the liver-fire clearing group was given Longdan Xiegan Granule, and the normal group and model group were given normal saline by gavage. Eight weeks later, the rate of gallstone formation, main components of gallstones, serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total cholesterol (TC), and the concentrations of total bilirubin (TBIL) and Ca2+ in bile were determined, and the pathological changes of the gallbladder were evaluated. Results Compared with the model group, the liver soothing group, liver nourishing group, and liver-fire clearing group had a significantly reduced rate of gallstone formation (P<0.05), with cholesterol as the main component of gallstones, as well as significantly reduced pathological changes of the gallbladder and significantly decreased serum ALT, AST, and TC (P<0.05). The three groups showed no significant changes in the concentration of TBIL in bile compared with the model group (P>0.05). A significant reduction in Ca2+ concentration was seen only in the liver-fire clearing group (P<0.05). AST reduction was greatest with the method of nourishing and softening the liver (P<0.05); TC reduction was greatest with the method of soothing the liver and regulating qi (P<0.05); bile Ca2+ reduction was greatest with the method of clearing liver fire and removing dampness (P<0.05). Conclusion The method of soothing the liver and regulating qi, method of nourishing and softening the liver, and method of clearing liver fire and removing dampness are effective in treating cholelithiasis in guinea pigs, but they have different effects.