坦索罗辛联合三金排石汤对上尿路结石体外冲击波碎石术后疗效和血清学指标的影响

Effects of Tamsulosin Combined with Sanjin Paishi Decoction on Postoperative Effect and Serological Parameters of Extracorporeal Shock Wave Lithotripsy for Upper Urinary Tract Calculi

目的:探讨坦索罗辛联合三金排石汤对上尿路结石体外冲击波碎石术后疗效和血清学指标的影响。方法:选取2020年5月—2021年5月菏泽市牡丹人民医院泌尿外科收治的70例上尿路结石患者,按随机数字表法分为对照组(n=35)和联合组(n=35)。对照组在体外冲击波碎石术后给予坦索罗辛治疗,联合组在体外冲击波碎石术后给予坦索罗辛联合三金排石汤治疗。比较两组临床疗效,结石排净时间,腰痛减轻时间,肉眼血尿消失时间,中医症候积分,炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)],以及肾功能[血肌酐(Scr)、胱抑素C(Cyc C)、β_(2)微球蛋白(β_(2)-MG)]。结果:联合组总有效率为94.29%,高于对照组的77.14%,差异有统计学意义(P<0.05);联合组结石排净时间、腰痛减轻时间和肉眼血尿消失时间均较对照组缩短,差异均有统计学意义(P<0.05);治疗后,两组尿频、腰痛、血尿、淋漓不尽评分均低于治疗前,且联合组均低于对照组,差异均有统计学意义(P<0.05);治疗后,两组TNF-α、IL-6、IL-1β、Scr、Cyc C、β_(2)-MG均低于治疗前,且联合组均低于对照组,差异均有统计学意义(P<0.05)。结论:上尿路结石体外冲击波碎石术后采用坦索罗辛联合三金排石汤治疗可提高效果,缩短排石时间,减轻炎症反应和改善肾功能。

Objective:To investigate the effects of Tamsulosin combined with Sanjin Paishi Decoction on postoperative effect and serological parameters of extracorporeal shock wave lithotripsy for upper urinary tract calculi.Method:A total of 70 patients with upper urinary tract calculi who were treated in the Department of Urology of Heze Mudan People's Hospital from May 2020 to May 2021 were selected and divided into control group(n=35)and united group(n=35)according to random number table method.The control group was treated with Tamsulosin after extracorporeal shock wave lithotripsy,the united group was treated with Tamsulosin combined with Sanjin Paishi Decoction after extracorporeal shock wave lithotripsy.The clinical efficacy,the stone excretion time,the relief time of low back,the disappearance time of hematuria,the TCM syndromes scores,the inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-1β(IL-1β)]and the renal function[serum creatinine(Scr),cystatin C(Cyc C),β_(2)-microglobulin(β_(2)-MG)]were compared.Result:The total effective rate of the treatment in united group was 94.29%,which was higher than 77.14% in the control group,with a statistically significant difference(P<0.05).The stone excretion time,the relief time of low back and the disappearance time of hematuria in the united group were significantly shorter than those in the control group,the differences were statistically significant(P<0.05).After treatment,frequency of urination,low back pain,hematuria and endless dripping scores of the two groups were lower than those before treatment,and those of the united group were lower than those of the control group,the differences were statistically significant(P<0.05).After treatment,the TNF-α,IL-6,IL-1β,Scr,Cyc C and β_(2)-MG of the two groups were lower than those before treatment,and those of the united group were lower than those of the control group,with statistically significant differences(P<0.05).Conclusion:After extracorporeal shock wave lithotripsy for upper urinary tract calculi,Tamsulosin combined with Sanjin Paishi Decoction can improve the therapeutic effect,shorten the stone excretion time,reduce inflammation and improve renal function.