排石颗粒对肾结石患者FURS后疼痛程度及炎症指标的影响

Effect of Paishi granules on pain and inflammatory indexes in patients with renal calculi after FURS

目的 观察排石颗粒对肾结石患者进行输尿管软镜钬激光碎石术(FURS)后疼痛程度及炎症指标的影响。方法 采用随机数字表法将2022年4月至2023年4月江西省宜春市中医院泌尿外科收治的86例肾结石患者分为观察组与对照组,每组43例。两组均进行FURS治疗,对照组术后口服盐酸坦索罗辛缓释胶囊,观察组在对照组基础上服用排石颗粒,两组均连续治疗2周。比较两组结石清除率、结石清除时间、血尿持续时间、住院时间;比较两组术后第1、3、7天疼痛程度[视觉模拟评分法(VAS评分)];比较两组治疗前后血清白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)水平。结果 观察组的结石清除率高于对照组,结石排净时间、血尿持续时间、住院时间均短于对照组,差异均有统计学意义(P<0.05)。重复测量方差分析显示,VAS评分存在时间效应及交互效应(P<0.05),两组术后第3、7天VAS评分均低于术后第1天,且术后第7天VAS评分均低于术后第3天(P<0.05)。观察组术后第1、3、7天VAS评分均低于对照组,差异均有统计学意义(P<0.05)。两组治疗后IL-6、CRP、TNF-α水平均低于治疗前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。结论 运用排石颗粒辅助治疗可降低肾结石患者FURS后炎症反应,缓解术后疼痛程度,缩短血尿时间及结石清除时间,提高结石清除率。

Objective To observe the effect of Paishi granules on pain and inflammatory indexes in patients with renal calculi after ureteroscopic holmium laser lithotripsy(FURS).Methods A total of 86 patients with renal calculi admitted to the Department of Urology,Yichun Hospital of Traditional Chinese Medicine in Jiangxi Province from April 2022 to April 2023 were randomly divided into observation group and control group,with 43 cases in each group.Both groups were treated with FURS,the control group was treated with tamsulosin hydrochloride sustained-release capsules,and the observation group was treated with Paishi granules on the basis of control group.Both groups were treated for 2 weeks.The stone clearance rate,stone clearance time,hematuria duration and hospitalization time were compared between the two groups.The degree of pain[visual analogue scale(VAS) score] at 1 d,3 d and 7 d after operation was compared between the two groups.The serum levels of interleukin-6(IL-6),C-reactive protein(CRP) and tumor necrosis factor-α(TNF-α) were compared between the two groups before and after treatment.Results The stone clearance rate of the observation group was higher than that of the control group,and the stone clearance time,hematuria duration and hospitalization time were shorter than those of the control group,and the differences were statistically significant(P<0.05).Repeated measurement analysis of variance showed that there were time effects and interaction effects in VAS score(P< 0.05).The VAS scores in the two groups at 3 d and 7 d after operation were lower than those at 1 d after operation,and the VAS scores at 7 d after operation were lower than those at 3 d after operation(P<0.05).The VAS scores of the observation group were lower than those of the control group at 1 d,3 d and 7 d after operation,and the differences were statistically significant(P<0.05).After treatment,the levels of IL-6,CRP and TNF-α in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion The use of Paishi granule as adjuvant therapy can reduce the inflammatory reaction,relieve the postoperative pain,shorten the hematuria time and stone clearance time,and improve the stone clearance rate in patients with renal calculi after FURS.