清热通淋排石方联合钬激光碎石术治疗湿热蕴结型输尿管结石患者临床疗效观察

Clinical study on Qingre Tonglin Paishi recipe combined with holmium laser lithotripsy in the treatment of damp and heat ureteral calculi

目的:观察清热通淋排石方联合钬激光碎石术治疗湿热蕴结型输尿管结石患者临床疗效和安全性。方法:选取湿热蕴结证输尿管结石患者60例,随机分为观察组与对照组各30例。对照组给予输尿管镜下钬激光碎石手术治疗,观察组在输尿管镜下钬激光碎石手术治疗基础上加用清热通淋排石方汤剂口服,连续服用2周。观察治疗后两组患者症状,记录的结石排净情况、结石排出时间以及不良反应发生情况,采用视觉模拟量表(Visual Analog Score,VAS)进行疼痛程度评分,评定临床疗效。结果:观察组治愈24例,治愈率80.0%(24/30),好转5例,好转率16.7%(5/30),无效1例,无效率3.3%(1/30),总有效29例,总有效率96.7%(29/30);对照组治愈22例,治愈率73.3%(22/30),好转6例,好转率20.0%(6/30),无效1例,无效率3.3%(1/30),总有效28例,总有效率93.3%(28/30)。观察组的治愈率高于对照组(P<0.05)。观察组结石排净率93.3%(28/30)显著高于对照组80.0%(24/30)(P<0.05);观察组平均结石排出时间5.23 d显著短于对照组9.57 d(P<0.05)。观察组VAS评分均值1.67分低于对照组3.73分(P<0.05)。观察组与对照组均未见严重不良反应。结论:清热通淋排石方联合钬激光碎石术治疗湿热蕴结证输尿管结石临床疗效显著、安全可靠。

Objective:To observe the clinical efficacy and safety of Qingre Tonglin Paishi recipe(清热通淋排石方)combined with holmium laser lithotripsy in the treatment of damp and heat ureteral calculi.Methods:60 cases of ureteral calculi were randomly divided into the observation group and the control group,with 30 cases in each group.The control group was treated with holmium laser lithotripsy under ureteroscope.The observation group was treated with holmium laser lithotripsy under ureteroscope on the basis of the surgical treatment,and was given orally Qingre Tonglin Paishi recipe for 2 consecutive weeks.After treatment,the symptoms of the two groups of patients were observed.The stone excretion,stone excretion time and adverse reactions were recorded.Visual Analog Score(VAS)was used to score the pain degree and evaluate the clinical efficacy.Results:In the observation group,the cure rate was 80.0%(24/30)in 24 cases,16.7%(5/30)in 5 cases,3.3%(3/30)in 1 case and 96.7%(29/30)in 29 cases.In the control group,the cure rate was 73.3%(22/30)in 22 cases,20.0%(6/30)in 6 cases,3.3%(1/30)in 1 case and 93.3%(28/30)in 28 cases.The cure rate of the observation group was higher than that of thecontrol group(P<0.05).The stone excreted net rate of 93.3%(28/30)in the observation group was significantly higher than 80.0%(24/30)in the control group(P<0.05).The average stone excretion time in the observation group was significantly shorter than that in the control group(5.23 days,P<0.05).The mean VAS score of 1.67 in the observation group was lower than that of 3.73 in the control group(P<0.05).No serious adverse reactions were observed in the observation group and the control group.Conclusion:Combined Tonglin Paishi recipe with holmium laser lithotripsy is effective,safe and reliable in the treatment of ureteral calculi with dampness-heat accumulation.