排石汤联合冲击波碎石术治疗上段尿路结石临床研究

Curative effect of upper urinary calculi treated with Paishi decoction combined with extracorporeal shock wave lithotripsy

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。

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.