[1]李瑞国,王占有,李汉智.排石汤联合冲击波碎石术治疗上段尿路结石临床研究*[J].陕西中医,2019,(5):641-644.
 LI Ruiguo,WANG Zhanyou,LI Hanzhi..Curative effect of upper urinary calculi treated with Paishi decoction combined with extracorporeal shock wave lithotripsy[J].,2019,(5):641-644.
点击复制

排石汤联合冲击波碎石术治疗上段尿路结石临床研究*
分享到:

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2019年5期
页码:
641-644
栏目:
临床研究
出版日期:
2019-05-05

文章信息/Info

Title:
Curative effect of upper urinary calculi treated with Paishi decoction combined with extracorporeal shock wave lithotripsy
文章编号:
DOI:〖HT5K〗10.3969/j.issn.1000-7369.2019.05.028
作者:
李瑞国 1 王占有 1 李汉智
1.河南中医药大学第三附属医院针灸科 (郑州450008); 2.南阳医学高等专科学校第一附属医院普外科(南阳473000)
Author(s):
LI Ruiguo WANG ZhanyouLI Hanzhi.
Department of Acupuncture, the Third Affiliated Hospital of Henan University of Traditional Chinese Medicine(Zhengzhou 450008)
关键词:
体外冲击波碎石术上段尿路结石排石汤结石排出时间血尿持续时间结石排净率
Keywords:
Extracorporeal shock wave lithotripsy Upper urinary calculi Paishi decoction Stone exclusion time Hematuria duration Stone exclusion rate
分类号:
R691.4
文献标志码:
A
摘要:
摘 要 目的:观察排石汤联合体外冲击波碎石术(ESWL)对于上段尿路结石的治疗效果以及相关临床指标的影响。方法:选取98例上段尿路结石患者作为观察对象,将全部入组病例均分后分别纳入对照组与研究组,对照组采取常规ESWL治疗,研究组在对照组的基础上联合应用自拟排石汤治疗,观察两组术前7 d、术后1 d时肾功能指标的变化情况;术后3个月评估对比两组患者的临床疗效,统计患者术后结石排出时间、血尿持续时间、结石排净率、肾绞痛发生率;随访1年对比两组结石复发率。结果:术前7 d时两组Scr、NGAL、Cys-C、GFR均无统计学差异(P>0.05);术后1 d时两组NGAL、Cys-C均较前升高,GFR较前降低,组内对比差异具有统计学意义;术后1 d时研究组NGAL、Cys-C、GFR均较对照组理想(P<0.05)。术后3个月,研究组总有效率为95.92%,对照组总有效率为85.71%,研究组临床疗效较对照组良好(P<0.05)。研究组结石排出时间与血尿持续时间均少于对照组( P<0.05)。研究组结石排净率高于对照组,肾绞痛发生率与1年结石复发率均低于对照组(P<0.05)。结论:排石汤能够提高体外冲击波碎石术对于上段尿路结石的临床疗效,提高结石排净率,降低术后并发症发生率,减轻肾损伤。
Abstract:
Abstract Objective:To observe the curative effect of upper urinary calculi treated with Paishi decoction combined with extracorporeal shock wave lithotripsy (ESWL), and influence on clinical indicators. Methods:Clinical data of 98 patients with upper urinary calculi were enrolled . All patients were divided into control group and research group. The control group were treated with ESWL, and the research group were treated with Paishi decoction on the basis of the control group. Renal function indexes were observed at 7 days before operation and 1 day after operation. Stone exclusion time, hematuria duration, stone exclusion rate, renal colic incidence were compared in 2 groups at 3 months after operation. Stone recurrence rate were compared in 2 groups at 1 year after operation. Results: There was no significant differences in Scr, NGAL, Cys-C, and GFR between 2 groups at 7 days before operation (P>0.05). One day after operation, the NGAL and Cys-C were higher than those before operation, while GFR was lower than that before operation in 2 groups (P<0.05), and the NGAL, Cys-C, GFR of the research group were significantly improved compared with the control group (P<0.05). Three months after operation, the total effective rate was 95.92% in the control group, and was 85.71% in the research group, respectively (P<0.05). The stone exclusion time and hematuria duration of the research group were less than those of the control group (P<0.05). The stone exclusion rate of the research group was higher than that in the control group, and the renal colic incidence and stone recurrence rate of the research group were lower than those of the control group (all P<0.05). Conclusion:Paishi decoction can improve the curative effect of ESWL for upper urinary tract calculi, improve the stone exclusion rate, reduce the incidence of complications after operation and renal injury.

参考文献/References:

[1] 李海昌.排石汤辅助体外震波碎石术治疗泌尿系统结石疗效观察 [J].陕西中医,2017,38(4):503-504.
[2] Lidén M,Thunberg P,Broxvall M,et al.Two-and three-dimensional CT measurements of urinary calculi length and width: a comparativestudy [J].Acta Radiol,2015,56(4):487-492.
[3] Li FX,Li Y. Modified Bazhengsan combined with Tamsu-losin after ESWL [J].Information on Traditional Chinese Medicine,2015,32(4):111-113.
[4] 翁 超,沈明康,陆 毅,等.泌尿系结石患者应用体外冲击波碎石联合泌尿排石汤及健康教育的影响研究 [J].河北医药,2017,39(1):81-83.
[5] 赵 军,幸世龙.体外冲击波碎石治疗泌尿结石的临床疗效观察 [J].陕西医学杂志,2017,46(5):633-634.
[6] Liu CL,Qu Y,Zhang JS,et al.Tamsulosin combined with ESWL in treating ureterovesical junction stones [J].Chin Pharm,2016,25(14):38-40.
[7] 张 舰,李成英,姜源洁.体外冲击波碎石联合中药辅助排石治疗肾结石的效果 [J].贵州医科大学学报,2017,42(5):600-603.
[8] Wang ZY,Yang JJ,Wei JX. Incidence of rinary tractinfection in patients with lower ureteral calculi: flexible ureteroscopyvs [J].ESWL,2016,21(7):529-532.
[9] Huang Z,Lin SH. Study of protective effect of edaravonein treating renal injury caused by extracorporeal shock wave lithotripsyin renal calculi [J].Clinical Medication Journal,2015,13(6):34-37.
[10] Bao J,Yuan J. Clinical study on extracorporeal shock wavelithotripsy combined with Sanjin Paishi decoction for treating urinarycalculi [J]. J Sichuan Tradit Chin Med,2015,33(7): 129-131.
[11] Hafez MH,El-Mougy FA.Detection of an earlier tubulopathy in diabetic nephropathy among children with normoalbuminuria [J].Iran JKidney Dis,2015,9(2):126-131.
[12] Zhu Z,Jin Y,Xu TZ,et al.Curative effect on meridianflap combined with point massage in the treatment of ureteral calculiafter extracorporeal shock wave lithotripsy platoon stone [J].China Medical Herald,2016,13(31):158-161.
[13] 江世雄.排石颗粒与坦索罗辛治疗体外冲击波碎石后输尿管结石的疗效 [J].中国药物经济学,2017,12(12):42-44.
[14] Ren AJ,Zhang QX,Wang YC. Treatment of nephrolithwith TCM and electronic flexible ureteroscopy holmium laserlithotrips [J].Acta Chinese Medicine,2016,31(7):1059-1062.
[15] 李少芳,叶伟南.59例肺结核合并糖尿病治疗引起肾损害临床分析 [J].辽宁医学杂志,2017,31(2):12-13.

备注/Memo

备注/Memo:
*河南省科技攻关计划项目(132102310175)
更新日期/Last Update: 2019-05-07