三金排石汤辅助体外冲击波碎石术治疗输尿管上段结石临床研究

Clinical Study on Sanjin Paishi Decoction Assisted Extracorporeal Shock Wave Lithotripsy for Proximal Ureteral Stones

目的:观察三金排石汤辅助体外冲击波碎石术(ESWL)治疗下焦湿热兼瘀滞型输尿管上段结石的临床疗效。方法:选取98例下焦湿热兼瘀滞型输尿管上段结石患者,按照随机数字表法分成观察组和对照组,每组49例。2组均行ESWL治疗,对照组术后给予常规治疗与护理,观察组在对照组基础上采用三金排石汤治疗,2组均治疗4周。比较2组临床疗效、视觉模拟评分法(VAS)评分、血尿消失时间、结石排出时间及并发症发生率。结果:术后4周,观察组临床疗效总有效率95.92%,对照组临床疗效总有效率83.67%,观察组临床疗效优于对照组(P<0.05)。术后1 d、14 d、28 d,2组VAS评分均较术前降低(P<0.05),观察组VAS评分均低于同期对照组(P<0.05)。观察组血尿消失、结石排出时间均短于对照组(P<0.05)。观察组并发症发生率4.08%,与对照组6.12%比较,差异无统计学意义(P>0.05)。结论:三金排石汤辅助ESWL治疗下焦湿热兼瘀滞型输尿管上段结石,可有效缓解患者疼痛,缩短血尿消失与结石排出时间。

Objective:To observe the clinical effect of Sanjin Paishi Decoction assisted extracorporeal shock wave lithotripsy(ESWL)for proximal ureteral stones of lower energizer damp-heat and blood stasis types.Methods:A total of 98 cases of patients with proximal ureteral stones of lower energizer damp-heat and blood stasis types were selected and divided into the observation group and the control group,with 49 cases in each group.Both groups were treated with ESWL.After ESWL,the control group was treated with routine treatment and nursing,and the observation group was additionally treated with Sanjin Paishi Decoction based on the treatment of the control group.Both groups were treated for 4 weeks.The clinical effects,the scores of Visual Analogue Scale(VAS),the time of hematuria disappearance,the time of stone excretion,and the incidence of complications were compared between the two groups.Results:Four weeks after surgery,the total clinical effective rate was 95.92%in the observation group and 83.67%in the control group,the clinical efficacy of the observation group was better than that of the control group(P<0.05).The VAS scores at 1 day,14 days and 28 days after ESWL in the two groups were decreased when compared with those before treatment(P<0.05),and the VAS scores in the observation group were lower than those in the control group in the same period(P<0.05).The time of hematuria disappearance and the time of stone excretion in the observation group were shorter than those in the control group(P<0.05).The incidence of complications was 4.08% in the observation group and 6.12% in the control group,therebeing no significance in the difference (P>0.05). Conclusion: Sanjin Paishi Decoction assisted ESWL forproximal ureteral stones of lower energizer damp- heat and blood stasis types can effectively relieve painand shorten the time of hematuria disappearance and the time of stone excretion.