化瘀清石汤治疗上输尿管软镜碎石术后上尿路结石患者随机对照研究

Effect of Huayu Qingshi Decoction on Patients with Upper Urinary Tract Stones after RetrogradeIntrarenal Surgery:A Randomized Controlled Trial

目的 观察化瘀清石汤对上尿路结石患者行输尿管软镜碎石术(RIRS)后残石排出及并发症的临床疗效。方法 选取上尿路结石接受RIRS治疗的130例患者,随机分为对照组和中药组,每组65例。对照组患者术后常规给与左氧氟沙星抗感染+饮水运动指导,中药组患者在对照组基础上给与化瘀清石汤治疗,持续4周。比较两组患者的排石情况、腰痛减轻及肉眼血尿消失时间;比较两组术后发热、肉眼血尿、肾绞痛、尿频以及附壁结石等并发症的发生情况。结果 所有患者均完成研究。与对照组比较,中药组患者腰痛减轻、肉眼血尿消失时间缩短(P<0.01),术后1、2、4周结石排出、排净率升高(P<0.05,P<0.01),术后发热、肉眼血尿、附壁结石及并发症总发生率降低(P<0.05,P<0.01)。两组患者均未出现不良反应。结论 化瘀清石汤可促进残石的清除,减少术后并发症的发生。

Objective To observe the clinical effect of Huayu Qingshi Decoction on residual stone removal and complications after retrograde intrarenal surgery(RIRS)in patients with upper urinary tract stones.Methods A total of 130 patients with upper urinary tract stones who received RIRS treatment were randomly assigned to control group and Chinese medicine group,with 65 cases in each group.Patients in the control group were routinely given levofloxacin postoperatively for anti-infection+water and exercise instruction,while patients in the Chinese medicine group were treated with Huayu Qingshi Decoction on the basis of the control group for 4 weeks.The time of stone discharge,relief of backache and disappearance of gross hematuria were compared between the 2 groups.The incidence of postoperative complications such as fever,gross hematuria,renal colic,urinary frequency and mural stone were compared between the 2 groups.Results All patients completed the study.Compared with the control group,the time of stone discharge,relief of backache and disappearance of gross hematuria was shortened in the Chinese medicine group(P<0.01),the rate of stone discharge and clearance increased in 1,2 and 4 week after surgery(P<0.05,P<0.01),and the incidence of postoperative fever,gross hematuria,mural stones and complications decreased after surgery(P<0.05,P<0.01).Meanwhile,no adverse reactions were reported in both groups.Conclusion Huayu Qingshi Decoction could promote stone clearance and reduce the occurrence of postoperative complications.