清热活血排石汤治疗湿热瘀滞型输尿管结石的临床观察

Clinical Observation on Qingre Huoxue Paishi Decoction for the Treatment of Ureteral Calculi of Damp-Heat and Blood Stasis with Qi Stagnation Type

【目的】观察清热活血排石汤(由鸡内金、海金沙、金钱草、牡丹皮、瞿麦、滑石、车前草、醋延胡索、五灵脂、蒲黄等组成)治疗湿热瘀滞型输尿管结石(石淋)患者的临床疗效。【方法】将66例湿热瘀滞型输尿管结石患者随机分成对照组和治疗组,每组各33例。2组患者均给予泌尿结石的常规治疗,在此基础上,对照组给予通淋排石合剂(由广金钱草、车前草、姜厚朴、玉米须、牛膝等组成)治疗,治疗组给予清热活血排石汤加减治疗,疗程为2周。观察2组患者治疗前后中医证候积分的变化情况,并评价2组患者的临床疗效和安全性。【结果】(1)研究过程中,共有3例患者因各种原因未能按照课题设计进行治疗和随访而脱落,最终共有63例患者纳入统计分析,其中,对照组32例,治疗组31例。(2)治疗2周后,治疗组的总有效率为93.55%(29/31),对照组为78.13%(25/32),组间比较,治疗组的疗效明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者的中医证候积分均较治疗前明显降低(P<0.05),且治疗组的降低作用明显优于对照组,组间治疗后及差值比较,差异均有统计学意义(P<0.05)。(4)治疗组在服药第1周出现2例腹泻患者,对照组在服药第2周出现1例腹泻患者和1例下肢水肿患者,其余未出现不良反应。【结论】清热活血排石汤治疗湿热瘀滞型输尿管结石患者疗效确切,可有效改善临床症状,且无明显不良反应。

Objective To observe the clinical efficacy of Qingre Huoxue Paishi Decoction(composed of Galli Gigerii Endothelium Corneum,Lygodii Spora,Desmodii Styracifolii Herba,Moutan Cortex,Dianthi Herba,Talcum,Plantaginis Herba,vinegar-prepared Corydalis Rhizoma,Trogopterori Faeces,Typhae Pollen,etc.)in treating patients with ureteral calculi(urolithiasis)of damp-heat and blood stasis with qi stagnation type.Methods Sixty-six patients with ureteral calculi of damp-heat and blood stasis with qi stagnation type were randomly divided into the control group and the treatment group,with 33 patients in each group.Both groups of patients were given the conventional treatment for urinary calculi.Additionally,the control group was given oral use of Tonglin Paishi Mixture(composed of Desmodii Styracifolii Herba,Plantaginis Herba,ginger-prepared Magnoliae Officinalis Cortex,Stigma Maydis,Achyranthis Bidentatae Radix,etc.),and the treatment group was given oral use of modified Qingre Huoxue Paishi Decoction.Both groups were treated for 2 weeks.Before and after treatment,the scores of traditional Chinese medicine(TCM)syndrome in the two groups were observed.After treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1)During the trial,3 patients fell off for failing in completing the treatment and follow-up according to the subject design for various reasons.A total of 63 patients were finally included in the statistical analysis,of which 32 were in the control group and 31 were in the treatment group.(2)After 2 weeks of treatment,the overall effective rate of the treatment group was 93.55%(29/31)and that of the control group was 78.13%(25/32).The intergroup comparison showed that the efficacy of the treatment group was significantly superior to that of the control group,and the difference was statistically significant(P<0.05).(3)After treatment,TCM syndrome scores of the patients in both groups were significantly decreased compared with those before treatment(P<0.05).The effect on lowering the TCM syndrome scores in the treatment group was significantly superior to that in the control group,and statistically significant difference was shown in the post-treatment scores between the two groups and in the pre-and post-treatment difference of scores between the two groups(P<0.05).(4)In the treatment group,there were 2 cases of diarrhea in the first week of treatment,and in the control group,there was one case of diarrhea and one case of lower limb edema in the second week of treatment,but the rest patients did not show any adverse effects.Conclusion Qingre Huoxue Paishi Decoction exerts certain effect in treating patients with ureteral calculi of damp-heat and blood stasis with qi stagnation type,and the decoction is effective on relieving clinical symptoms without significant adverse effects.