张舰,李成英,姜源洁
ZHANG Jian,LI Chengying,JIANG Yuanjie

• 1:解放军第107医院泌尿外科
• 2:烟台市中医医院

摘要(Abstract)：

目的:研究体外冲击波碎石联合中药辅助排石治疗肾结石的临床效果。方法:80例肾结石患者均分对照组和治疗组,对照组在碎石治疗后仅给予常规处理,治疗组在对照组的基础上于术后次日起联合中药辅助排石,两组治疗均以14 d为1个疗程,共2个疗程;记录两组患者结石排尽时间、止痛时间、第1和第2个疗程结束时的排尽结石例数、结石复发数、排石率及总有效率;观察两组患者碎石术治疗前、治疗后第3、7及14天时的肾脏体积、尿红细胞数及血肌酐(SCr)和尿素氮(BUN)的变化。结果:在通过体外冲击波碎石联合辅助中药排石治疗后,治疗组患者的结石排尽时间、止痛时间和复发率明显低于对照组,排石率和总有效率明显高于对照组(P<0.05);治疗组第1个疗程结束时排尽结石患者所占比例显著高于对照组(P<0.05);两组患者治疗前平均肾脏体积大小、尿红细胞数及血SCr和BUN比较,差异无统计学意义(P>0.05);两组患者在碎石治疗后第3、7及14天的平均肾脏体积较治疗前显著降低,尿红细胞数较治疗前明显减少(P<0.05);与对应时间点相比,治疗组肾脏体积的缩小和尿红细胞数减少较对照组更为明显(P<0.05);碎石治疗后第3和7天时,两组血SCr和BUN含量较治疗前升高(P<0.05),碎石治疗后第14天时,治疗组血SCr和BUN含量与治疗前比较,差异无统计学意义(P>0.05),而对照组则仍高于治疗前(P<0.05)。结论:体外冲击波碎石次日联合中药辅助排石治疗肾结石效果优于单一体外冲击波碎石治疗。
Objective: To investigate the clinical effect of extracorporeal shock wave lithotripsy combined with traditional Chinese medicine on treating renal calculi. Methods: 80 cases of patients with kidney stones were randomly divided into control group and treatment group with equal numbers; control group after treatment were given conventional treatment; treatment group after the treatment were given combined traditional Chinese medicine treatment the following day of surgery. Both groups received 2 courses of treatment with 14 days each. Recording exhausting time of stone,pain stopping time,the average number of stone exhausted at the end of 1stand 2ndcourse of treatment,calculi recurrence rate,stone exhausting rate and overall response rate. Observing before and 3 d,7 d and 14 d after treatment of both groups concerning change of renal volume,SCr and BUN. Results: After combined therapy,stone exhausting time,pain stopping time and recurrence rate of treatment group were obviously lower than control group. Overall response rate and stone exhausting rate of treatment group were significantly higher than the control group(P < 0. 05). Stone exhausting time of treatment group after 1stcourse of treatment was significantly higher than the control group(P < 0. 05),and stone rowrate is significantly higher than control group(P < 0. 05); 3rd,7thand 14 thday after treatment of both groups,average renal volume,urine red blood cell count obviously decreased than before treatment(P< 0. 05); comparing with corresponding time,shrinking of renal volume and decreased urine red blood cell count of treatment group was more obvious than control group(P < 0. 05); 3rdand 7thday after treatment,SCr and BUN values of both groups increased more than before treatment(P < 0. 05); 14 th day after treatment,comparison of SCr and BUN values before and after treatment showed no statistical significance(P > 0. 05),while that of control group were still higher than before treatment(P <0. 05). Conclusion: extracorporeal shock wave lithotripsy treatment followed by combined therapy with Chinese medicine is proven better than mono extracorporeal shock wave lithotripsy treatment.

关键词(KeyWords)： 肾结石;中草药;体外冲击波碎石;血肌酐;尿素氮;复发
kidney stones;traditional Chinese medicine;extracorporeal shock wave lithotripsy;blood creatinine;urea nitrogen;recurrence

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 张舰,李成英,姜源洁
ZHANG Jian,LI Chengying,JIANG Yuanjie

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