三金汤联合输尿管软镜碎石取石术治疗输尿管上段嵌顿性结石患者的排石情况和对SOD及炎性因子的影响

Sanjin decoction combined with flexible ureteroscopy lithotripsy for patients with upper ureteral incarcerated stones and its effect on SOD and inflammatory factors

目的 分析三金汤联合输尿管软镜碎石取石术治疗输尿管上段嵌顿性结石患者的排石情况和对超氧化物歧化酶(SOD)及炎性因子的影响。方法 选取邯郸市磁县人民医院2020年7月至2022年12月收治的输尿管上段嵌顿性结石患者96例,按照治疗方案分为单一手术组(输尿管软镜碎石取石术)46例及联合组(三金汤+输尿管软镜碎石取石术)50例。对比两组临床疗效、排石情况、氧化应激指标[SOD、丙二醛(MDA)]、炎性因子[白介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]。结果 联合组总有效率高于单一手术组,差异有统计学意义(P<0.05)。治疗1周、2周及3周后,两组残石滞留率均显著下降,且联合组残石滞留率显著低于单一手术组,差异有统计学意义(P<0.05)。联合组治疗后1周、2周SOD水平均高于单一手术组,且MDA水平低于单一手术组,差异有统计学意义(P<0.05)。两组治疗3周后SOD、MDA水平比较差异无统计学意义(P>0.05)。治疗1周、2周及3周后,两组IL-6、TNF-α、CRP水平均显著下降,且联合组IL-6、TNF-α、CRP水平下降幅度大于单一手术组,差异有统计学意义(P<0.05)。结论 三金汤联合输尿管软镜碎石取石术治疗输尿管上段嵌顿性结石患者效果确切,可显著降低患者的残石滞留率,有效改善患者的SOD、IL-6、TNF-α及CRP水平。

Objective To analyze the stone expulsion status and its effect on superoxide dismutase(SOD)and inflammatory factors in patients with upper ureteral incarcerated stones treated by Sanjin Decoction combined with flexible ureteroscope lithotripsy.Methods 96 cases of patients with incarcerated calculi in the upper ureter who were admitted to Ci County Peoples Hospital of Handan City from July 2020 to December 2022 were selected,and according to the treatment plan,they were divided into the single operation group(flex-ible ureteroscopy lithotripsy)of 46 cases and the combined group(Sanjin Decoction+Ureteroscopic lithotrip-sy)of 50 cases.The clinical efficacy,stone expulsion,oxidative stress indicators[SOD,malondialdehyde(MDA)],inflammatory factors[interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α),C reactive protein(CRP)]were compared between the two groups.Results The total effective rate of the combination group was higher than that of the single operation group,and the difference was statistically significant(P<0.05).After 1 week,2 weeks and 3 weeks of treatment,the residual stone retention rate in the two groups was signifi-cantly reduced and the residual stone retention rate in the combined group was significantly lower than that in the control group,and the difference was statistically significant(P<0.05).The SOD level in the combination group was higher than that in the control group at 1 week and 2 weeks after treatment,and the MDA level in the combination group was lower than that in the control group,the difference was statistically significant(P<0.05).There was no significant difference in the levels of SOD and MDA between the two groups after 3 weeks of treat-ment(P>0.05).After 1 week,2 weeks and 3 weeks of treatment,the levels of IL-6,TNF-αand CRP in the two groups decreased significantly,and the decrease in the levels of IL-6,TNF-αand CRP in the combined group was greater than that in the single operation group,and the difference was statistically significant(P<0.05).Conclusion The combination of Sanjin Tang and ureteroscopic lithotripsy for the treatment of upper ureteral in-carcerated stones has a definite effect,which can significantly reduce the retention rate of residual stones and effec-tively improve patientsSOD,IL-6,TNF-αand CRP level.