自拟排石汤联合针刺减轻上尿路结石术后炎性反应的临床研究

Clinical Study on the Self-Made Paishi Decoction Combined with Acupuncture for Relieving the Postoperative Inflammatory Reaction of Upper Urinary Calculi

目的观察自拟排石汤联合针刺缓解上尿路结石术后炎性反应的临床疗效。方法 120例接受上尿路结石手术患者随机分为治疗组与对照组各60例,治疗组采用自拟排石汤联合针刺治疗,对照组采用盐酸坦洛新缓释片口服治疗,术后4周评价2组临床治疗效果,完成输尿管支架症状问卷调查整体生活质量(USSQ)评分并检测2组血清炎症因子超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)及尿草酸、尿钙、尿葡胺聚糖、尿柠檬酸水平。结果术后4周治疗组中医症状积分明显低于对照组(P<0.05~0.01);治疗组USSQ评分、hs-CRP、IL-6、TNF-α、尿草酸、尿钙水平均明显低于对照组(P<0.01),尿柠檬酸水平高于对照组(P<0.01);术后3月治疗组58例、对照组52例完全排出残留结石(P<0.05)。结论自拟排石汤联合针刺能有效改善上尿路结石术后炎性反应,排石治疗效果显著,值得临床进一步应用。

OBJECTIVE To observe the clinical effect of self made Paishi Decoction combined with acupuncture for relieving the postoperative inflammatory reaction of upper urinary calculi.METHODS 60 patients who have received upper urinary calculi operation were randomly divided into the experimental group and the control group,60 cases in each group.The experimental group was treated with self made Paishi Decoction combined with acupuncture,and the control group was treated with western medicine.After four weeks of operation,the clinical effect of both groups were evaluated,the Urinary Stent Symptom Questionnaire(USSQ)were completed and the levels of serum inflammatory factor hypersensitivity C reactive protein(hs CRP),interleukin 6(IL 6),tumor necrosis factor alpha(TNFα),urine oxalic acid,urinary calcium,urinary glucan and urine citric acid levels in both groups were detected.RESULTS Four weeks after the operation,TCM symptom score of the experimental group was significantly lower than that in the control group(P<0.05).Scores of the urinary tract symptoms,body aches and USSQ,levels of hs CRP,IL 6,TNFα,urine oxalic acid and urinary calcium levels in the experimental group were obviously lower than those in the control group(P<0.01),urine citric acid level was higher than that in the control group(P<0.05).Three moths after the operation,there were 58 cases and 52 cases in the experimental and the control group respectively completely discharged the residual stones(P<0.05).CONCLUSIONS Self made Paishi Decoction combined with acupuncture can effectively improve the postoperative inflammatory reaction of upper urinary calculi.This treatment method has obvious effect for discharging the residual stones,which is worth further clinical application.