摘要
目的:观察补肾祛瘀法治疗草酸钙结石经输尿管软镜碎石术后残石的临床疗效。方法:选取60例肾结石或输尿管上段结石经输尿管软镜碎石术后存在残石患者,结石成分为草酸钙,中医辨证为肾(阳)虚血瘀证,随机分为治疗组和对照组,每组30例。所有患者行输尿管软镜碎石术后常规抗生素预防感染、运动排石治疗,治疗组加用补肾祛瘀排石汤。术后2周、4周及6周各复诊1次或至结石排出,观察结石排出有效率、术后疼痛视觉模拟评分(visual analogue scale,VAS)、中医症状评分及术后并发症。结果:治疗组术后2周、4周及6周术后结石排出率均高于对照组,差异有统计学意义(P<0.05);治疗组在术后2周、4周VAS评分低于对照组,差异具有统计学意义(P<0.05);两组术后6周VAS评分比较,差异无统计学意义(P>0.05);治疗后治疗组腰酸、腰痛、尿急各中医症状积分均低于对照组,差异有统计学意义(P<0.05);治疗组术后并发症低于对照组,差异具有统计学意义(P<0.05)。结论:补肾祛瘀法能提高草酸钙结石输尿管软镜碎石术后残留结石清除率,缩短残石排出时间,减轻术后排石过程中的疼痛症状,减少并发症发生。
Objective:To observe the clinical effect of kidney-tonifying and blood-stasis-removing method for treating residual stones of calcium oxalate stone after ureteroscopic lithotripsy.Methods:60 patients with residual stones in kidney calculi or upper ureteral calculi after ureteroscopic lithotripsy were selected.The stone component was calcium oxalate stones,and the TCM syndrome differentiation was kidney(Yang)deficiency and blood stasis,and they were randomly divided into treatment group and control group,with 30 cases in each group.All patients were treated with conventional antibiotics to prevent infection and exercise to remove stones after ureteroscopic lithotripsy,while the treatment group was treated with Bushen Quyu Paishi Decoction,and the patients were followed up once every 2 weeks,4 weeks and 6 weeks after operation or until the stones were removed.The effective rate of stone removal,postoperative pain score(VAS),TCM symptom score and postoperative complications were observed.Results:The stone excretion rate in the treatment group was higher than that in the control group at 2 weeks,4 weeks and 6 weeks after operation,and the difference between the two groups was statistically significant(P<0.05).The VAS score in the treatment group was lower than that in the control group at 2 weeks and 4 weeks after operation,and the difference was statistically significant(P<0.05).There was no significant difference in VAS score after 6 weeks(P>0.05).After treatment,the scores of TCM symptoms of backache,lumbago and urgency in the treatment group were lower than those in the control group,with statistical significance(P<0.05).The postoperative complications in the treatment group were lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion:The method of tonifying kidney and removing blood stasis can improve the clearance rate of residual stones after ureteroscopic lithotripsy of calcium oxalate stones,shorten the discharge time of residual stones,alleviate the pain symptoms and reduce the occurrence of complications in the process of postoperative stone discharge.
作者
任安吉
张起新
任立江
于志勇
毕玉行
王永传
Ren Anji;ZHANG Qixin;REN Lijiang;YU Zhiyong;BI Yuhang;WANG Yongchuan(Weifang Chinese Medicine Hospital Affiliated to Weifang Medical College,Weifang Shandong China 261041;The People's Hospital of Weifang City,Weifang Shandong China 261041;Chinese Medicine Hospital of Shouguang City,Shouguang Shandong China 262700)
出处
《中医学报》
CAS
2023年第10期2209-2213,共5页
Acta Chinese Medicine
基金
山东省潍坊市科技发展计划项目(2022YX017)。
关键词
肾结石
草酸钙结石
补肾祛瘀法
输尿管软镜碎石
肾(阳)虚血瘀证
kidney calculi
calcium oxalate stone
tonifying Kidney and removing stasis method
ureteroscopic lithotripsy
Kidney(Yang)deficiency and blood stasis syndrome
作者简介
任安吉(1983-),男,山东枣庄人,医学硕士,主治医师,研究方向:中西医结合治疗泌尿外科疾病临床研究;通信作者:王永传(1974-),男,山东潍坊人,医学博士,主任医师,研究方向:中西医结合治疗泌尿外科疾病临床研究。E-mail:chinawyc@hotmail.com。
