泌尿排石方治疗肾结石输尿管软镜碎石术后残石  

Efficacy of urinary stone removal formula in the treatment of residual stones after kidney stone flexible ureteroscopy lithotripsy

作　　者：陈勇[1] 周绍文 陈兴林 付正伟 CHEN Yong;ZHOU Shaowen;CHEN Xinglin;FU Zhengwei(The Second Department of Surgery,Jianyang Hospital of Traditional Chinese Medicine,Jianyang 641400,China)

机构地区：[1]简阳市中医医院外二科,四川简阳641400

出　　处：《长春中医药大学学报》2024年第12期1355-1359,共5页Journal of Changchun University of Chinese Medicine

基　　金：四川省中医药信息科研项目(20200119)。

摘　　要：目的探讨泌尿排石方治疗肾结石输尿管软镜(FURL)术后残石的排石疗效。方法选择肾结石患者86例,按照随机数字表法分成观察组与对照组,各43例。对照组在输尿管软镜碎石术后予坦索罗辛治疗,观察组在对照组基础上联合泌尿排石方2组均治疗4周。比较2组临床疗效,治疗前后湿热下注证候积分、血肌酐(Scr)、胱抑素C(Cys-C)、尿素氮(BUN)、β_(2)微球蛋白(β_(2)-MG)、白介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)及不良反应和结石复发率。结果2组治疗后湿热下注证候积分、BUN、Scr、β_(2)-MG、Cys-C指标,IL-6、IL-1β、TNF-α、CRP指标均降低(均P<0.05),且观察组低于对照组(均P<0.05);观察组结石排净率(95.35%,41/43)明显高于对照组(76.74%,33/43)(P<0.05);观察组总有效率高于对照组[(95.35%,41/43)比(74.42%,32/43),P<0.05];2组不良反应比较,差异无统计学意义(P>0.05);观察组结石复发率(4.65%,2/43)低于对照组(18.60%,8/43)(P<0.05)。结论泌尿排石方配合坦索罗辛能够促进输尿管软镜术后残石排出,缓解患者临床症状,减轻炎症反应,保护肾功能,提高净石率。Objective To explore the therapeutic effect of urinary stone removal formula on residual stones after flexible ureteroscopy lithotripsy(FURL)for kidney stones.Methods 86 patients with kidney stones were selected and divided into the control group and the observation group according to random number table method,with 43 cases in each group.The control group was treated with tamsulosin after FURL,while the observation group received the combination of urinary stone removal formula treatment on the basis of the treatment of the control group.Both groups were treated for 4 weeks.Clinical efficacy,the score of syndrome of dampness-heat diffusing downward before and after treatment,the levels of serum creatinine(Scr),cystatin C(Cys-C),blood urea nitrogen(BUN),β_(2)-microglobulin(β_(2)-MG),interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β),and adverse reactions and the recurrence rate of stones in both groups were compared.Results After treatment,the score of syndrome of dampness-heat diffusing downward,and the levels of BUN,Scr,β_(2)-MG,Cys-C,IL-6,IL-1β,TNF-α,and CRP were all reduced in both groups(P<0.05),and the observation group was lower than the control group(P<0.05);The stone clearance rate of the observation group was significantly higher than that of the control group[95.35%(41/43)vs.76.74%(33/43),P<0.05];The total effective rate of the observation group was higher than that of the control group[95.35%(41/43)vs.74.42%(32/43),P<0.05];There was no statistically significant difference in adverse reactions between two groups(P>0.05);The recurrence rate of stones in the observation group was lower than that in the control group[4.65%(2/43)vs.18.60%(8/43),P<0.05].Conclusion The combination of urinary stone removal formula and tamsulosin can promote the removal of residual stones after FURL,alleviate clinical symptoms,reduce inflammatory reactions in the body,protect renal function,and improve stone clearance rate.

关 键 词：肾结石 输尿管软镜碎石术 泌尿排石方 坦索罗辛 肾功能 结石排净率 炎症反应 

分 类 号：R45[医药卫生—治疗学]