三金排石汤加减方在输尿管结石围手术期的疗效观察

Effect of Modified Sanjin Paishi Decoction on Ureteral Calculus in Perioperative Period

目的观察三金排石汤加减方在输尿管结石围手术期的临床疗效及1年后肾积水改善、结石复发情况。方法将所选取的135例患者完全随机分为综合治疗1组、综合治疗2组和手术组三组,均予以行输尿管镜碎石取石术、留置D-J管及术后对症治疗,而综合治疗1组间断服用中药半年,综合治疗2组仅术后服用中药半个月。观察3组治疗前后中医证候积分、术后住院时间及血尿清除时间、不良反应发生情况,1年后肾脏积水改善结石复发情况。结果治疗后综合治疗组、手术组均能明显改善输尿管结石症状,且综合治疗组的疗效明显优于手术组,差异具有统计学意义(P<0.05);综合治疗组在术后住院时间、血尿清除时间、不良反应发生情况上,均优于手术组,差异具有统计学意义(P<0.05);在1年后结石复发情况方面,综合治疗1组未见结石复发,与综合治疗2组、手术组比较,差异具有统计学意义(P<0.05)。结论在输尿管结石围手术期服用中药三金排石汤加减方能明显降低手术并发症、改善保留D-J管的不良反应及预防结石复发疗效确切,值得临床使用及深入研究。

Objective To observe the clinical effect of modified Sanjin Paishi decoction on ureteral calculus during perioperative period.Methods The 135 cases of patients were randomly divided into group I of comprehensive treatment,group II of comprehensive treatment and operation group.All groups were performed with ureteroscopic lithotripsy,indwelling D-J tube and postoperative symptomatic treatment.Patients in Group I were given Chinese medicine for half a year,patients in group II were treated with Chinese medicine for only half a month after the operation.The TCM syndrome scores,postoperative hospital stay,hematuresis clearing time and adverse reactions,and the improvement of hydronephrosis and recurrence of calculus after operating for one year in the three groups were observed.Results The symptoms of ureteral stones in comprehensive treatment groups and the operation group were siginificantly improved,and the efficacy of the comprehensive treatment groups was significantly better than the operation group(P<0.05).The time of hospitalization,hematuria clearing time and the incidence of adverse reactions in comprehensive groups were superior to the operation group,the difference was statistically significant(P<0.05).There was no recurrence of calculus in group I of the comprehensive treatment group after operating for one year,compared with the group II of comprehesive treatment group and the operation group,the difference was statistically significant(P<0.05).Conclusion Modified Sanjin Paishi decoction can significantly reduce the complications of surgery,improve the adverse reactions of D-J tube and prevent recurrence of calculus during the perioperative period of ureteral calculus.It is worthy of clinical use and further study.