通淋排石汤辅助治疗肾结石 ESWL 术后结石残留的临床研究

Clinical Effect of Tonglin Paishi Decoction in Adjuvant Treatment of Residual Kidney Stone after ESWL Operation

摘要:

〔摘 要〕 目的：探究通淋排石汤辅助治疗肾结石体外冲击波碎石（ESWL）术后结石残留的疗效及对尿白细胞 （WBC）、红细胞（RBC）水平的影响。 方法：选取 2020 年 1 月至 2021 年 12 月期间河南科技大学第一附属医院新 区医院收治的肾结石 ESWL 术后结石残留患者共 72 例，采用随机数表法将研究对象分为观察组（36 例）以及对照组 （36 例）。对照组患者接受常规去结石治疗，观察组患者在对照组基础上联合使用通淋排石汤辅助治疗；比较两组 患者治疗后结石清除时间、碎石直径、住院时间；治疗前后腰腹痛、尿频尿急、血尿中医证候积分、尿 WBC、RBC 水平；统计不良反应发生情况。 结果：治疗后观察组患者结石清除时间、总住院时间均短于对照组，碎石直径小于对 照组，差异具有统计学意义（P ＜ 0.05）。治疗后两组患者腰腹痛、尿频尿急、尿血的中医证候积分均有不同程度降 低，且治疗后观察组患者腰腹痛、尿频尿急、尿血的中医证候积分均低于对照组，差异具有统计学意义（P ＜ 0.05）。 术后（治疗前）两组患者尿 WBC、RBC 均有不同程度上升，治疗 14 d 后两组患者尿 WBC、RBC 均有不同程度下降， 且观察组患者尿 WBC、RBC 低于对照组，差异具有统计学意义（P ＜ 0.05）。两组患者治疗期间均未出现明显不良 反应。 结论：通淋排石汤能够有效帮助清除残余碎石、缓解临床症状、降低 ESWL 术后尿 WBC、RBC 水平，且不引 发明显不良反应。

Abstract:

〔Abstract〕 Objective To investigate the effect of Tonglin Paishi decoction in the adjuvant treatment of residual stone after extracorporeal shock wave lithotripsy (ESWL) and its influence on urinary white blood cell (WBC) and red blood cell (RBC) level. Methods A total of 72 patients with residual stone after ESWL in New District Hospital of the First Affiliated Hospital of Henan University of Science and Technology from January 2020 to December 2021 were selected, and the subjects were divided into an observation group (n = 36) and a control group (n = 36) by random number table method. The control group received routine calculus removal treatment, the observation group combined with Tonglin paishi decoction adjuvant treatment on the basis of the control group; The stone removal time, stone diameter and length of hospital stay were compared between the two groups. Before and after treatment, the traditional Chinese medical (TCM) syndrome score of lumbar and abdominal pain, frequent and urgent urination, hematuria, and the levels of urinary WBC and RBC were compared, the occurrence of adverse reactions were counted. Results After treatment, the stone removal time and total hospital stay in the observation group were shorter than those of the control group, and the gravel diameter was smaller than that of the control group, the differences were statistically significant (P < 0.05). After treatment, TCM syndrome scores of lumbar and abdominal pain, frequent urination and urgent urination, blood urination were reduced to varying degrees in the two groups, and after treatment, TCM syndrome scores of lumbago and abdominal pain, frequent urination and urgent urination and blood urination in the observation group were lower than those in the control group, with statistical significance (P < 0.05). After surgery (before treatment), the levels of urine WBC and RBC were increased to varying degrees in 2 groups, and after 14 days of treatment, the levels of urine WBC and RBC were decreased to varying degrees in 2 groups, and the levels of urine WBC and RBC in the observation group were lower than those of the control group, the differences were statistically significant (P < 0.05). There was no obvious adverse reaction in the two groups during treatment. Conclusion Tonglin Paishi Decoction can effectively help remove residual lithotripsy, relieve clinical symptoms, reduce the levels of urine WBC and RBC after ESWL, and does not cause obvious adverse reactions.