石韦散加减汤联合输尿管软镜钬激光碎石治疗上尿路结石临床价值分析

Clinical value of Modified Shiweisan Decoction combined with flexible ureteroscopic lithotripsy in treatment of upper urinary tract calculi

目的观察石韦散加减汤联合输尿管软镜钬激光碎石治疗上尿路结石临床价值。方法将我院收治的上尿路结石患者80例随机分为观察组与对照组各40例,对照组采用输尿管软镜钬激光碎石术治疗,观察组在对照组的治疗基础上联合石韦散加减汤治疗,对比两组患者临床疗效、临床症状消失时间、C反应蛋白(CRP)、降钙素原(PCT)、尿白细胞(UWBC)、尿红细胞(URBC)以及结石排出率。结果治疗后,观察组患者临床治疗总有效率显著高于对照组(P<0.05);观察组小腹坠胀、发热、血尿、尿频、尿急、尿痛的症状消失时间显著短于对照组(P<0.05);两组CRP、PCT水平较治疗前降低,且观察组CRP、PCT水平均显著低于对照组(P<0.05);两组UWBC、URBC较治疗前降低,且观察组UWBC、URBC水平均显著低于对照组(P<0.05);观察组的结石排出率显著高于对照组(P<0.05);两组术后并发症发生率比较无明显差异(P>0.05)。结论石韦散加减汤联合输尿管软镜钬激光碎石治疗上尿路结石能够有效改善患者临床症状、炎症反应、UWBC和URBC水平,并促进碎石排除,且安全性较好。

Objective To observe the clinical value of Modified Shiweisan Decoction combined with flexible ureteroscopic lithotripsy in treatment of upper urinary tract calculi.Methods Eighty patients with upper urinary tract calculi were randomly divided into observation groupand control group,40 cases each.Control group underwent flexible ureteroscopic lithotripsy,while observation group was additionally treated with Modified Shiweisan Decoction.The disappearance time of clinical symptoms,C-reactive protein(CRP),procalcitonin(PCT),urine white blood cells(UWBC),urine red blood cells(URBC)and stone excretion rate were compared between the two groups.Results After treatment,the total effective rate in observation group was higher than that in control group(P<0.05);the disappearance time of clinical symptoms(abdominal distension,fever,hematuria,frequent urination,urgent urination,dysuria)in observation group was significantly shorter than that in control group(P<0.05);the levels of CRP and PCT in both groups decreased,which were significantly lower in observation group than control group(P<0.05);the levels of UWBC and URBC in both groups decreased,which were significantly lower in observation group than control group(P<0.05);the stone excretion rate in observation group was significantly higher than that in control group(P<0.05);the difference in the incidence of postoperative complications between the two groups was not statistically significant(P>0.05).Conclusion Modified Shiweisan Decoction combined with flexible ureteroscopic lithotripsy can effectively improve clinical symptoms,inflammatory response,UWBC and URBC levels,and promote stone excretion in patients with upper urinary tract calcuri with good safety.