泉通方联合经尿道输尿管镜激光碎石序贯疗法治疗输尿管结石  

Quantong Recipe integrated with ureteroscopic laser lithotripsy for ureteral calculi

作　　者：彭煜[1] 胡晓华[1] 李翔[1] 周桂平[1] 

机构地区：[1]上海中医药大学岳阳中西医结合医院泌尿外科,上海200437

出　　处：《中西医结合学报》2010年第6期530-534,共5页Journal of Chinese Integrative Medicine

基　　金：上海市中医药发展办公室中西医结合科研专项计划资助项目(No.2009ZXY010)

摘　　要：背景:外科腔镜技术在治疗输尿管结石方面发展迅速,而中医药治疗该病也有其独到的特色,将两者有机结合能更好地发挥中西医结合的优势。目的:观察中药泉通方和经尿道输尿管镜激光碎石联合应用的序贯疗法治疗输尿管结石的临床疗效。设计、场所、对象和干预措施:151例输尿管结石患者(结石直径3～21mm)均来自上海中医药大学岳阳中西医结合医院泌尿外科。其中结石直径3～10mm患者106例,先以中药治疗2周;结石未排出者(20例)以及结石直径>10mm的患者(45例)进行经尿道输尿管镜激光碎石,术后64例(1例改行开放手术)患者被分为常规治疗和加用泉通方两组,1周后评估疗效。主要结局指标:观察服用泉通方2周后,输尿管结石直径≤10mm患者的排石有效率,以及经尿道输尿管镜激光碎石后服用泉通方1周的残石排净率。结果:结石直径3～10mm的106例患者服用泉通方2周后,86例结石完全排出,6例结石虽未排出但下移1个狭窄段以上;两者合并总有效率为86.79%(92/106)。结石未排出者以及结石直径大于10mm的64例患者进行经尿道输尿管镜激光碎石,加用泉通方组1周后残石排净率为93.8%,常规治疗组为71.9%,两组比较,差异有统计学意义(P<0.05)。结论:中药泉通方和经尿道输尿管镜激光碎石联合应用的序贯疗法治疗输尿管结石体现了中西医结合治疗的优势。Background： Endoscopic surgery of Western medicine has developed rapidly in treating ureteral calculi while traditional Chinese medicine （TCM） therapy also has its advantage, thus the integrated traditional Chinese and Western medicine therapy may have an even better efficacy in dealing with this problem. Objective： To observe the clinical effects of sequential therapy of Quantong Recipe, a compound traditional Chinese herbal medicine, combined with ureteroscopic laser lithotripsy on ureteral calculi. Design, setting, participants and interventions： A total of 151 patients with ureteral calculi （stone diameter of 3 to 21 mm） from Department of Urology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine were included, of which 106 patients with stone diameter of 3 to 10 mm were treated with Quantong Recipe for the first two weeks. Twenty patients with unexpelled stones and 45 patients with stone diameter of more than 10 mm were treated with ureteroscopic laser lithotripsy. The 65 patients except one open operation were divided into regular treatment group （32 cases） and regular treatment combined with Quantong Recipe group （32 cases） after lithotripsy. The efficacy was assessed after one week. Main outcome measures： Cure rate in the patients with stone diameter of less than 10 mm after two-week Quantong Recipe treatment was calculated, and clearance rate in the patients with residual stone for ureteroscopic laser lithotripsy after one-week Quantong Recipe treatment was also observed. Results： After taking Quantong Recipe for two weeks, the stones in 86 patients were completely discharged, and the stones in 6 patients were not completely discharged, but the unexpelled stones had moved down more than one segment of ureteral stenosis; the total response rate was 86.79% （92/106）. The 64 patients with stones unexpelled or with stone diameter of more than 10 mm were treated with ureteroscopic laser lithotripsy, an

关 键 词：输尿管结石 中药 输尿管镜外科手术 碎石术 

分 类 号：R693.4[医药卫生—泌尿科学]