中医平衡阴阳法治疗尿路结石的临床研究

[目的]观察中医平衡阴阳法对尿路结石的疗效。[方法]在补肾利水、溶石排石的基础上,配合酸甘化阴或甘温成扶阳中药治疗尿路结石患者100例,并与西药对照组100例做疗效比较。[结果]治疗组治愈85例,好转10例,无效5例,治愈率85％,总有效率95％;对照组治愈24例,好转70例,无效6例,治愈率24％,总有效率为94％。两组比较总有效率差异无显著性(P>0.05),但治愈率差异有显著性(P<0.001)。[结论]中医平衡阴阳法治疗尿路结石,可使结石加速溶解,具有一定的疗效。

温肾化石汤防治含钙尿石复发的临床研究

【目的】通过观察温肾化石汤对含钙尿石形成相关指标的影响,探讨该方防治含钙尿石复发的机理。【方法】选择尿石症患者40例,随机分为治疗组和对照组各20例。治疗组给予口服温肾化石汤(主要由熟地、山药、制附子、茯苓、金钱草、茜草等组成)治疗,对照组给予口服西药双氢克尿噻治疗。两组均以14 d为1个疗程,观察治疗前后各相关指标的变化。【结果】温肾化石汤可以降低新鲜晨尿pH值及尿中钙、磷、草酸等尿石形成促进物的浓度,升高24 h总尿量和尿中镁、柠檬酸、葡胺聚糖(GAGs)含量等尿石形成抑制物的浓度(P<0.05)。【结论】温肾化石汤既可降低尿石形成促进物的浓度,又能提高尿石形成抑制物的浓度,可能是其防治含钙尿石形成与复发的重要作用机制之一。

Indications and contraindications for shock wave lithotripsy and how to improve outcomes

For over 35 years shock wave lithotripsy has proven to be an effective,safe and truly minimally invasive option for the treatment of nephrolithiasis.Various technical factors as well as patient selection can impact the success of the procedure.We used published work focusing on outcomes of shock wave lithotripsy,risk of complications,and strategies for improving stone fragmentation to create this review.Multiple patient and technical factors have been found to impact success of treatment.Skin to stone distance,stone density and composition,size and location of the stone within the urinary system all influence stone free rates.A slower rate with a gradual increasing voltage,precise targeting,proper coupling will improve stone fragmentation and decrease risk of complications.The selection of appropriate patients through a shared decision making process and attention to the technical factors that improve stone free rates is key to providing an effective treatment and patient satisfaction.

石淋清化汤治疗泌尿系结石的临床观察

【目的】观察石淋清化汤治疗泌尿系结石的临床疗效。【方法】将200例泌尿系结石患者按完全随机法分为治疗组和对照组各100例。治疗组给予口服石淋清化汤（由金钱草、鸡内金、白芍、滑石、威灵仙、茯苓、王不留行、车前草、篇蓄、瞿麦、琥珀末等组成），对照组给予口服消石素。2组均以20d为1个疗程，根据病情可连续服用1-3个疗程，治疗2个月后统计疗效。【结果】治疗组总有效率为96．0％，对照组总有效率为81．0％，2组比较差异有显著性意义（P〈0．01）。治疗组结石排出或消失率为64．4％，排出或消失时间为（7．35±3．05）d；对照组结石排出或消失率为54．3％，排出或消失时间为（13．28±3．52）d。2组比较差异有显着性意义（P〈0．05）。【结论】石淋清化汤治疗泌尿系结石具有良好的治疗效果，其疗效优于单纯西药治疗，而且排石率高、排出时间缩短。

Clinical Study on the Treatment of Renal Colic by Body and Auricular Acupuncture

Objective： To evaluate the clinical effects of combined acupuncture and ear-puncture in treating renal colic. Methods： Sixty subjects were randomized into an acupuncture group and a medication group, 30 in each, to receive acupuncture and Western medicine respectively. The analgesic effects and pain relief time were measured in both groups. Results： Both of the two groups got pain relieved or reduced. The total effective rate was 89.7% in the acupuncture group, significantly superior to 77.4% in the medication group （P〈0.05）. Conclusion： Combined body and auricular acupuncture is efficient in relieving pain in treating renal colic, and its effective rate was higher compared with medication treatment.