三金汤在肾结石患者输尿管软镜术后的应用  

Application of Golden Three Decoction in Patients with Renal Calculi After Ureteroscopy

作　　者：周玲 李毓镕 肖先芸 张慧铭 ZHOU Ling;LI Yu-rong;XIAO Xian-yun;ZHANG Hui-ming(Dayu County People's Hospital,Dayu,Jiangxi,China,341500)

机构地区：[1]大余县人民医院,江西大余341500

出　　处：《河南中医》2022年第10期1569-1573,共5页Henan Traditional Chinese Medicine

基　　金：赣州市指导性科技计划项目(GZ2020ZSF506)。

摘　　要：目的:观察三金汤在肾结石患者输尿管软镜术后的应用效果。方法:选取大余县人民医院2019年1月至2021年12月治疗的肾结石患者82例,随机分为对照组和治疗组,每组41例。两组患者均行输尿管软镜术治疗,对照组术后给予甲磺酸左氧氟沙星片口服治疗,治疗组在对照组治疗的基础上给予三金汤治疗。观察两组临床症状、临床疗效、结石清除效果、炎性指标[白细胞介素(interleukin,IL)-2、IL-6、肿瘤坏死因子(tumor necrosis factor,TNF)-α]、C反应蛋白(C reactive protein,CRP)、降钙素原(procalcitonin,PCT)、全血白细胞(white blood cell,WBC)计数、尿WBC计数、肾功能[肌酐(serum creatinine,SCr)、尿素氮(blood urea nitrogen,BUN)、半胱氨酸蛋白酶抑制剂(cysteine protease inhibitor,Cys-C)]变化情况以及尿代谢异常的发生情况。结果:治疗组结石排净时间、疼痛消失时间以及小便带血消失时间均短于对照组,差异有统计学意义(P<0.05);治疗组有效率为95.12%,对照组有效率为84.09%,治疗组有效率高于对照组,差异有统计学意义(P<0.05);治疗组手术后2周、4周血清IL-2、IL-6、TNF-α、CRP、PCT、尿WBC计数、全血WBC计数、SCr、BUN、Cys-C水平均低于对照组,差异有统计学意义(P<0.05);治疗组结石清除率为95.12%,对照组结石清除率为84.09%,治疗组高于对照组,差异有统计学意义(P<0.05);治疗组石街形成率、二次手术清石率分别为2.44%、2.44%,对照组石街形成率、二次手术清石率分别为14.63%、14.63%,治疗组低于对照组,差异有统计学意义(P<0.05);治疗组尿液代谢异常率为4.88%,对照组尿液代谢异常率为19.51%(P<0.05),治疗组低于对照组,差异有统计学意义(P<0.05)。结论:三金汤可提高肾结石患者输尿管软镜术后结石清除率及结石排出效果,降低术后形成石街的概率,缩短结石排净时间,保护患者肾功能,降低尿液代谢异常发生率。Objective:To observe the clinical application efficacy of Golden Three Decoction on patients with renal calculi after ure-teroscopy.Methods:A total of 82 patients with renal calculi treated in Dayu County People's Hospital from January 2019 to Decem-ber 2021 were randomly divided into the control group and the treatment group,with 41 cases in each group.Both groups were trea-ted with ureteroscopy.Then the control group was additionally treated with Levofloxacin Mesylate Tablets orally after operation,while the treatment group was additionally treated with Golden Three Decoction on the basis of the treatment of the control group.The changes of the clinical symptoms,clinical efficacy,calculus removal effect,inflammatory indexes[including interleukin(IL)-2,IL-6,tumor necrosis factor(TNF)-α],C reactive protein(CRP),procalcitonin(PCT),white blood cell(WBC)count,urinary WBC count,renal function[including serum creatinine(SCr),blood urea nitrogen(BUN),cysteine protease inhibitor(Cys-C)]and the occurrence of abnormal urinary metabolismwere observed in the two groups.Results:The calculus removal time,pain disap-pearance time and urine blood disappearance time in the treatment group were shorter than those in the control group,and all the differences were statistically significant(P<0.05).The effective rate of the treatment group was 95.12%,which was higher than that of the control group:84.09%,and the difference was statistically significant(P<0.05).At the 2nd and 4th week respective-ly after operation,serum IL-2,IL-6 and TNF-α,CRP,PCT,urine WBC count,whole blood WBC count,SCr,BUN,and Cys-C levels in the treatment group were all lower than those in the control group,and all the differences were statistically significant(P<0.05).The calculus clearance rate of the treatment group was 95.12%,which was higher than that of the control group:84.09%,and the difference was statistically significant(P<0.05).The calculus formation rate and the second operation calculus removal rate in the treatment group were 2.44%and 2.44%respec

关 键 词：肾结石 输尿管软镜术 三金汤 中西医结合疗法 

分 类 号：R256.52[医药卫生—中医内科学]