排石汤联合间苯三酚对湿热蕴结证肾结石钬激光碎石术后辅助治疗的临床效果

Clinical Effect of Paishi Decoction Combined with Phloroglucinol on Postoperative Adjuvant Treatment of Kidney Stones with Damp-heat Accumulation Syndrome after Holmium Laser Lithotripsy

目的探究排石汤联合间苯三酚对湿热蕴结证肾结石钬激光碎石术后辅助治疗的临床效果。方法前瞻性选取2020年5月—2022年5月行钬激光碎石术治疗的200例湿热蕴结证肾结石为研究对象,采用随机数字表法分为观察组1组、观察组2组、观察组3组和对照组,每组50例。对照组术后行常规治疗,在此基础上观察1组给予排石汤联合间苯三酚,观察2组给予排石汤,观察3组给予间苯三酚。比较4组结石清除效果,并比较治疗前后中医证候评分、肾主动脉血流动力学[收缩期间峰值流速(V_(max))、收缩期峰值流速(S)、舒张末期峰值流速(D)、阻力指数(RI)]、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)、过氧化脂质(LPO)]、舒适度(导尿管相关性症状评分)及不良反应。结果观察1组结石清除率和结石排净率高于观察2组、观察3组、对照组(P<0.05)。治疗第3、7天,观察1组各中医证候评分、导尿管相关性症状评分、RI以及血清MDA、LPO水平低于观察2组、观察3组、对照组,且观察2组、观察3组低于对照组(P<0.05)。治疗第3、7天,观察1组V_(max)、S/D及血清SOD水平高于观察2组、观察3组、对照组,且观察2组、观察3组高于对照组(P<0.05)。4组不良反应发生率比较差异无统计学意义(P>0.05)。结论湿热蕴结证肾结石行钬激光碎石术后给予排石汤联合间苯三酚能提高结石清除效果,改善肾脏血流动力学,减轻氧化应激反应,缓解患者症状并提高舒适度,且安全性较高。

Objective To explore the clinical effect of Paishi Decoction combined with Phloroglucinol on postoperative adjuvant treatment of kidney stones with damp-heat accumulation syndrome after holmium laser lithotripsy.Methods A total of 200 patients with kidney stones with damp-heat accumulation syndrome treated by holmium laser lithotripsy from May 2020 to May 2022 were prospectively selected as the research subjects,and were divided into observation group one,observation group two,observation group three and control group by random number table method,with 50 cases in each group.The control group received conventional treatment after operation.On this basis,observation group one was given Paishi decoction combined with Phloroglucinol,observation group two was given Paishi decoction and observation group three was given Phloroglucinol.The effect of stone clearance in the four groups was compared.TCM syndrome score,renal aorta hemodynamics[peak systolic velocity(V_(max)),systolic peak velocity(S),end-diastolic peak velocity(D),resistance index(RI)],oxidative stress index[superoxide dismutase(SOD),malondialdehyde(MDA),lipid peroxide(LPO)]and comfort level(catheter-related symptom scores)were compared before and after treatment.Results The stone clearance rate of observation group one was higher than that of observation group two,observation group three and control group(P<0.05).At 3 and 7 d after treatment,the TCM syndrome scores,catheter-related symptom scores,RI and serum MDA and LPO levels of observation group one were lower than those of observation group two,observation group three and control group,which were lower in observation group two and observation group three than in control group(P<0.05).At 3 and 7 d after treatment,the V_(max),S/D and serum SOD levels in observation group one were higher than those in observation group two,observation group three and control group,which were higher in observation group two and observation group three than in control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the four groups(P>0.05).Conclusion After holmium laser lithotripsy,Paishi decoction combined with Phloroglucinol given can improve the effect of stone clearance,improve renal hemodynamics,reduce oxidative stress reaction,relieve symptoms and improve comfort.