中医在输尿管软镜钬激光碎石术后残石排出中的效果及对患者结石排净时间的影响

Effect of Traditional Chinese Medicine on Residual Calculus Elimination after Flexible Ureteroscope Holmium Laser Lithotripsy and Its Influence on Stone Clearance Time of Patients

目的:探讨中医疗法在输尿管软镜钬激光碎石术后残石排出中的效果及对患者结石排净时间的影响。方法:选取2023年1—4月于贵溪市中医院接受输尿管软镜钬激光碎石术治疗的患者68例为研究对象,根据随机数字表法将患者分为对照组和观察组,各34例。对照组术后给予常规治疗,在此基础上,观察组给予耳穴贴压磁珠联合石韦散加减治疗。比较两组治疗前及治疗2周后腹痛、尿频尿急、血尿、恶心呕吐积分,以及血清肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、血尿素氮(BUN)、血肌酐(Scr)水平,比较两组治疗1周后的无石率、结石排净时间与不良反应发生率。结果:治疗前,两组腹痛、尿频尿急、血尿、恶心呕吐积分,TNF-α、hs-CRP、IL-6、ALT、AST、BUN、Scr水平比较,差异均无统计学意义(P>0.05);治疗2周后,两组上述中医症候积分及TNF-α、hs-CRP、IL-6、BUN、Scr水平均低于治疗前(P<0.05);治疗2周后,观察组上述中医症候积分及TNF-α、hs-CRP、IL-6、BUN、Scr水平均低于对照组,差异均有统计学意义(P<0.05);治疗2周后,两组ALT、AST水平比较,差异均无统计学意义(P>0.05);观察组治疗1周后的无石率高于对照组、结石排净所需时间短于对照组,差异均有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:耳穴贴压磁珠联合石韦散可促进输尿管软镜钬激光碎石术后残石排出,降低炎症因子水平,改善肾功能,排石效果显著,安全性高。

Objective:To explore the effect of traditional Chinese medicine therapy on residual calculus elimination after flexible ureteroscope holmium laser lithotripsy and its influence on stone clearance time of patients.Method:A total of 68 patients who received flexible ureteroscope holmium laser lithotripsy in Guixi Hospital of Traditional Chinese Medicine from January to April 2023 were selected as the study objects.According to random number table method,the patients were divided into control group and observation group,with 34 cases in each group.The control group was given conventional treatment after operation,on the basis of which,the observation group was given ear acupoint pressing magnetic bead combined with modified Shiwei Powder treatment.The integrals of abdominal pain,frequent urination and urgent urination,nausea and vomiting,and the levels of serum tumor necrosis factor-α(TNF-α),hypersensitive C reactive protein(hs-CRP),interleukin-6(IL-6),alanine aminotransferase(ALT),aspartate aminotransferase(AST),blood urea nitrogen(BUN),and serum creatinine(Scr)were compared between the two groups before treatment and 2 weeks after treatment.The stone-free rate after 1 week of treatment,stone clearance time and the incidence of adverse reactions were compared between the two groups.Result:Before treatment,there were no significant differences in abdominal pain,frequent urination and urgent urination,nausea and vomiting scores,TNF-α,hs-CRP,IL-6,ALT,AST,BUN and Scr levels between two groups(P>0.05).After 2 weeks of treatment,the above TCM syndrome scores and the levels of TNF-α,hs-CRP,IL-6,BUN and Scr in both groups were lower than those before treatment(P<0.05).After 2 weeks of treatment,the above TCM syndrome scores and the levels of TNF-α,hs-CRP,IL-6,BUN and Scr in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).After 2 weeks of treatment,there were no significant differences in ALT and AST levels between the two groups(P>0.05).The stone-free rate after 1 week of treatment in the observation group was higher than that in the control group,the time required for stone clearance in the observation group was shorter than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in the comparsion of the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Ear acupoint pressing magnetic bead combined with Shiwei Powder can promote residual calculus elimination after flexible ureteroscope holmium laser lithotripsy,reduce the levels of inflammatory factors,improve renal function,stone removal effect is significant,high safety.