三金排石汤联合输尿管镜钬激光碎石术治疗肾输尿管结石的临床研究  

Clinical study on Sanjin Paishi decoction combined with ureteroscopic holmium laser lithotripsy in treating renal and ureteral calculi

作　　者：唐健荣 蔡雪贞 杜文灏 TANG Jian-rong;CAI Xue-zhen;DU Wen-hao(Department of Surgery,Sanshui Hospital of Foshan Municipal Hospital of Traditional Chinese Medicine,Foshan 528100,China)

机构地区：[1]佛山市中医院三水医院,佛山528100

出　　处：《中国中西医结合外科杂志》2025年第1期75-80,共6页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：佛山市自筹经费类科技创新项目(2220001005027)。

摘　　要：目的:探究三金排石汤联合输尿管镜钬激光碎石术用于肾输尿管结石患者治疗的临床价值。方法:选取2023年1月—2024年1月本院收治的肾输尿管结石患者102例,按照信封随机法分为三金组和常规组两组,每组各51例。三金组予以三金排石汤联合输尿管镜钬激光碎石术(UHLL)治疗,常规组予以UHLL治疗。比较两组肾输尿管结石患者术后恢复状态、治疗前后中医证候积分(主症:腰酸胀痛、小便淋沥不畅、尿色深红;次症:冷汗、恶心呕吐)、清石率及血肌酐含量、疼痛差异[视觉疼痛量表(VAS)]和并发症情况。结果:治疗后,三金组中医证候积分的主症和次症积分均低于常规组(P <0.05)。两组术后首次排气时间均无明显差异(P>0.05)。三金组下床活动时间、血尿改善时间和住院时间均短于常规组(P <0.05)。三金组清石率为(96.52±2.13)%,明显高于常规组的(90.47±3.56)%(P <0.05)。治疗后,三金组血肌酐水平为(95.67±4.28)μmol/L,明显低于常规组的(108.91±5.17)μmol/L,差异有统计学意义(P <0.05)。术后24 h、1周和治疗结束时,三金组VAS得分均低于常规组(P <0.05)。三金组患者并发症总发生率为1.96%,低于常规组的13.73%(P <0.05)。结论:三金排石汤联合输尿管镜钬激光碎石术能有效促进肾输尿管结石患者术后恢复,提高清石率,改善肾功能,缓解疼痛并降低并发症风险,有临床应用价值。Objective To explore the clinical value of Sanjin Paishi decoction combined with ureteroscopic holmium laser lithotripsy in the treatment of patients with renal and ureteral calculi.Methods 102 patients with renal and ureteral calculi who received treatment in the hospital were selected from January 2023 to January2024,and were divided into Sanjin group and conventional group according to the random envelope method.The Sanjin group was treated with Sanjin Paishi decoction combined with UHLL,while the conventional group was given UHLL,with 51 cases in each group.The postoperative recovery status,TCM syndromes scores(primary symptoms:waist soreness and pain,poor urination,dark red urine;secondary symptoms:cold sweating,nausea and vomiting),stone clearance rate,serum creatinine level and pain [Visual Analogue Scale(VAS)] before and after treatment and complications were compared.Results After treatment,the scores of TCM syndromes such as waist soreness and pain,poor urination,dark red urine,cold sweating,and nausea and vomiting in Sanjin group were lower than those in conventional group(P <0.05).There was no significant difference in the postoperative first exhaust time between the two groups(P >0.05).The out-of-bed activity time,hematuria improvement time and hospital stay in Sanjin group were shorter than those in conventional group(P <0.05).The stone clearance rate with(96.52 ±2.13)% in Sanjin group was significantly higher than(90.47 ±3.56)% in conventional group(P <0.05).The level of serum creatinine in Sanjin group after treatment with(95.67 ±4.28)μmol/L was obviously lower than(108.91 ±5.17)μmol/L in conventional group(P <0.05).The VAS scores in Sanjin group at 24 hours and 1 week after surgery and at the end of treatment were lower than those in conventional group(P <0.05).The total incidence rate of complications in Sanjin group was 1.96%,which was lower than 13.73% in conventional group(P <0.05).Conclusion Sanjin Paishi decoction combined with ureteroscopic holmium laser lithotripsy can effectively p

关 键 词：肾输尿管结石 三金排石汤 输尿管镜钬激光碎石术 术后恢复 肾功能 疼痛 并发症 

分 类 号：R692.4[医药卫生—泌尿科学]