三金排石汤辅助输尿管镜钬激光碎石术治疗输尿管结石临床研究

Clinical Study on Sanjin Paishi Decoction Assisting Ureteroscopic Holmium Laser Lithotripsy for Ureteral Calculi

目的:观察三金排石汤辅助输尿管镜钬激光碎石术治疗输尿管结石的排石效果。方法:将115例输尿管结石患者,按随机数字表法分为治疗组58例与对照组57例。对照组给予输尿管镜钬激光碎石术治疗,治疗组在输尿管镜钬激光碎石术后加用三金排石汤治疗。观察2组治疗后排石效果、炎症因子[肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)]水平、应激反应指标[超氧化物歧化酶(SOD)、过氧化氢酶(CAT)]水平及并发症。结果:治疗组结石残余率为5.17%,低于对照组19.30%,2组比较,差异有统计学意义(P<0.05);治疗组结石排尽率为94.83%,高于对照组80.70%,2组比较,差异有统计学意义(P<0.05)。治疗组结石排尽时间明显短于对照组、VAS评分明显低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组TNF-α、CRP水平比较,差异无统计学意义(P>0.05)。治疗后,2组TNF-α、CRP水平较治疗前降低(P<0.05);且治疗组TNF-α、CRP水平低于对照组(P<0.05)。治疗前,2组SOD、CAT水平比较,差异无统计学意义(P>0.05);治疗后,2组SOD、CAT水平均较治疗前降低(P<0.05),且治疗组SOD、CAT水平均低于对照组(P<0.05)。治疗组并发症发生率为3.45%,对照组为15.79%,2组比较,差异有统计学意义(P<0.05)。结论:输尿管镜钬激光碎石术联合三金排石汤治疗输尿管结石,有利于提高结石排尽率,缩短结石排尽时间,减轻疼痛及机体炎症反应,改善应激反应,且并发症发生率较低。

Objective: To observe the calculi-discharge effect of Sanjin Paishi Decoction assisting ureteroscopic holmium laser lithotripsy on ureteral calculi. Methods: A total of 115 patients with ureteral calculi were divided into the treatment group and the control group according to the random number table method,with 58 and 57 cases in each group. After treatment,the discharge effects of calculi,levels of inflammatory factors,including tumor necrosis factor-α(TNF-α) and C-reactive protein(CRP),levels of stress reactions, including superoxide dismutase(SOD) and catalase(CAT) and complications in both groups were observed. Results:The residual rate of calculi was 5.17% in the treatment group,lower than that of 19.30% in the control group,the difference being significant(P<0.05);the complete discharge rate of calculi was 94.83% in the treatment group, higher than that of 80.70% in the control group, the difference being significant(P<0.05). The complete discharge time of calculi in the treatment group was obviously shorter than that in the control group,and the VAS scores were significantly lower than those in the control group, differences being significant(P<0.05). Before treatment, there was no significant difference being found in the comparisons of levels of TNF-α and CRP between the two groups(P>0.05).After treatment, the levels of TNF-α and CRP in the two groups were increased when compared with those before treatment(P<0.05),and the CRP levels were decreased when compared with those before treatment(P<0.05);the TNF-α level in the treatment group was higher than that in the control group(P<0.05),the CRP level was lower than that in the control group(P<0.05). Before treatment,there was no significant difference being found in the comparisons of levels of SOD and CAT between the two groups(P>0.05);after treatment,the levels of SOD and CAT in the two groups were decreased when compared with those before treatment(P<0.05),and the above two levels in the treatment group were lower than those in the control group(P<0.05). The incidence of complications was 3.45% in the treatment group,lower than that of 15.79% in the control group, the difference being significant(P<0.05). Conclusion:Ureteroscopic holmium laser lithotripsy combined with Sanjin Paishi Decoction for ureteral calculi can help improve the complete discharge rate of calculi,shorten the complete discharge time of calculi,mitigate the pain and inflammatory responses of the body,reduce the stress reactions and decrease the incidence of complications.