药操联合疗法治疗湿热下注型上尿路结石的临床随机对照研究  

TCM drug-exercise combination therapy in the treatment of upper urinary tract calculi with syndrome of dampness-heat diffused downward: A randomized controlled clinical trial

作　　者：赵友康 曹宏文[1,2] 达骏 郁超[1,2,4] 何晓锋[1] 陈磊 龚华[1] 冯懿赓[1] 潘在丁 孙鹏[1] 张志航 ZHAO Youkang;CAO Hongwen;DA Jun;YU Chao;HE Xiaofeng;CHEN Lei;GONG Hua;FENG Yigeng;PAN Zaiding;SUN Peng;ZHANG Zhihang(First Department of Surgery,Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032,China;Zhou Zhiheng's Studioof Famous Chinese Medicine Physicians,Shanghai 200032,China;Ninth People's Hospital Affiliated to Jiao Tong University School of Medicine,Shanghai 200011,China;Shanghai Clinical Demonstration Base of Chinese Medical Urology,Shanghai 200032,China)

机构地区：[1]上海中医药大学附属龙华医院外一科,上海200032 [2]上海市周智恒名中医工作室,上海200032 [3]上海交通大学医学院附属第九人民医院,上海200011 [4]上海市中医泌尿男科临床示范基地,上海200032

出　　处：《上海中医药杂志》2018年第12期48-52,共5页Shanghai Journal of Traditional Chinese Medicine

基　　金：上海市科委医学引导项目(18401904400);上海市卫计委中医特色诊疗技术建设项目(TSJS2016023);上海市卫计委重点项目"上尿路结石排石治疗中西医结合规范化治疗方案探索"(ZHYY-ZXYJHZX-1-03);上海市卫计委海派中医流派传承人才培养项目(LPRC2017015);全国中医药高等教育学会临床教育研究会临床教学科研课题(2017062)

摘　　要：目的观察中医导引排石操联合周氏排石汤(药操联合疗法)治疗湿热下注型上尿路结石的临床疗效。方法将158例湿热下注型上尿路结石患者随机分为治疗组和对照组,每组79例。治疗组予周氏排石汤联合中医导引排石操(药操联合),对照组予周氏排石汤治疗。两组疗程均为1个月,观察临床疗效及用药安全性,比较中医证候积分及各症状评分的变化情况。结果 (1)最终150例患者完成研究,治疗组75例,对照组75例。(2)治疗组、对照组总有效率分别为68.0%、60.0%;组间临床疗效比较,治疗组明显优于对照组(P<0.05)。(3)治疗前后组内比较,两组中医证候总积分及各症状评分比较,差异均有统计学意义(P<0.05)。组间治疗后比较,治疗组中医证候总积分明显低于对照组(P<0.05);治疗组尿道灼热、尿频、尿急评分明显低于对照组(P<0.05),而腰痛、血尿、尿痛、少腹拘急评分组间差异无统计学意义(P>0.05)。结论中医导引排石操联合周氏排石汤(药操联合疗法)治疗湿热下注型上尿路结石,安全有效,疗效优于单纯中药治疗,可明显改善临床症状,促进结石排出,减轻患者痛苦。Objective To observe the clinical efficacy of Chinese medicine physical and breathing exercise for calculi removal combined with Zhou’s calculi removal decoction (drug-exercise combination therapy) in the treatment of upper urinary tract calculi with syndrome of dampness-heat diffused downward. Methods 158 patients of upper urinary tract calculi with syndrome of dampness-heat diffused downward were randomly divided into the treatment group and the control group,79 cases in each group. The treatment group was treated with Zhou’s calculi removal decoction combined with Chinese medicine physical and breathing exercise for calculi removal (drug-exercise combination therapy) ,and the control group was treated with Zhou’s calculi removal decoction,with a course of 1 month. The clinical efficacy and medication safety were observed,and the changes of TCM syndrome score and symptom scores were compared. Results ①Finally 150 patients completed the trial,among 75 cases in the treatment group and 75 cases in the control group. ②The total effective rates were 68.0% in the treatment group and 60.0% in the control group. The clinical efficacy of the treatment group was obviously better than that of the control group (P<0.05) . ③In both groups, there were statistically significant differences on the TCM syndrome score and symptom scores between treatment before and after (P<0.05 ) . After treatment,the TCM syndrome score in the treatment group was significantly lower than that in the control group (P<0.05 ) . The scores of urethral burning,frequent urination and urgent urination in the treatment group were significantly lower than those in the control group (P<0.05) . However,there were no statistically significant differences on the scores of lumbago, hematuresis,urination pain and lower abdominal pain between the two groups (P>0.05) . Conclusion Chinese medicine physical and breathing exercise for calculi removal combined with Zhou’s calculi removal decoction (drugexercise combination therapy) is safe and effecti

关 键 词：上尿路结石 石淋 湿热下注证 中医导引排石操 中药排石 体外排石 

分 类 号：R277.5[医药卫生—中医学]