益气固肾排石方对输尿管软镜术后排石的临床观察

发布时间：2018-05-05 15:30

本文选题：肾结石 + 输尿管软镜　；参考：《广州中医药大学》2016年硕士论文

【摘要】：目的对于泌尿系结石,特别是肾结石,其发病率是逐渐上升的,随着微创技术的发展,治疗肾结石大多以微创为主,输尿管软镜钬激光碎石术是微创方法之一,是一种安全有效、创伤小、结石排净率高、并发症低的治疗方法,但输尿管软镜碎石术后可能出现腰痛、血尿等症状,术后残石碎末仍需依靠大量饮水及增加运动促进排石；因此,如何减轻临床症状及促进术后残石碎末排出成为泌尿外科医生关注的问题之一。中药益气固肾排石方已在临床使用多年,但缺少相关疗效方面的临床研究,本研究观察益气固肾排石方对输尿管软镜钬激光术后结石排出的疗效及其临床症状。方法本课题病例均来自从2015年6月至2016年2月在广东省中医院二沙泌尿外科的输尿管软镜钬激光碎石术后的住院病人,我们纳入了40例符合纳入标准的患者,随机分为益气固肾排石方组及热淋清颗粒组,其中益气固肾排石方组20例,热淋清颗粒组20例,治疗周期为术后4周,观察术后4周患者的临床症状(包括疼痛及血尿)、结石排出有效率及是否配合体外冲击波碎石术治疗来评价临床疗效,并记录4周内不良反应。最后通过SPSS17.0统计和分析收集的数据。结果1.两组病例的基本资料通过统计分析,差异无统计学意义(P＞0.05),如性别、年龄、结石位置、术前结石大小、术后结石大小及CT值等方面。2.益气固肾排石方组与热淋清颗粒组结石排出有效率比较,益气固肾排石方组结石排出有效率明显高于热淋清颗粒组,差异有统计学意义(P＜0.05)；同时益气固肾排石方组在VAS疼痛评分及血尿情况方面明显低于热淋清颗粒组,差异有统计学意义(P＜0.05)；4周后行体外冲击波碎石方面,益气固肾排石方组行体外碎石的比例低于热淋清颗粒组,但是差异无统计学意义(P＞0.05)3.安全研究方面,益气固肾排石方是安全的,在治疗期间均未出现不良反应及毒副作用。结论益气固肾排石方是安全有效的,无副作用；能有效促进输尿管软镜碎石术后结石排出,提高结石排出率,并能减少腰痛及血尿,改善患者生活质量。
[Abstract]:Objective to increase the incidence of urinary calculi, especially renal calculi. With the development of minimally invasive technique, the treatment of renal calculi is mostly minimally invasive, and ureteral soft endoscopy holmium laser lithotripsy is one of the minimally invasive methods. It is a safe and effective treatment method with small trauma, high stone removal rate and low complications. However, low back pain, hematuria and other symptoms may occur after ureteroscopic lithotripsy. The residual stone fragments still need to rely on a large amount of drinking water and increase exercise to promote the removal of stone. Therefore, how to reduce clinical symptoms and promote the excretion of residual stone has become one of the problems that urologers pay attention to. Yiqi Gu Shen Pai Shi Fang has been used in clinic for many years, but there is no related clinical research. This study is to observe the curative effect and clinical symptoms of Yiqi Gu Shen Pai Shi Fang on stone excretion after ureteral soft endoscope Ho: YAG laser. Methods from June 2015 to February 2016, all the patients were hospitalized after ureteral soft endoscope holmium: YAG laser lithotripsy in Disha Urology Department, Guangdong Provincial Hospital of traditional Chinese Medicine. We included 40 patients who met the inclusion criteria. The patients were randomly divided into two groups: Yiqi Gushen Pai Shi Fang group and Rilinqing granule group, including 20 cases in Yiqi Gushen Pai Shi Fang group and 20 cases in RL Qing granule group. The treatment period was 4 weeks after operation. The clinical symptoms (including pain, hematuria, effective rate of stone removal and ESWL) were observed and the adverse reactions were recorded in 4 weeks after operation. Finally, through SPSS17.0 statistics and analysis of the data collected. Result 1. There was no significant difference in the basic data of the two groups by statistical analysis (P > 0.05), such as sex, age, stone location, stone size before operation, stone size after operation and CT value. The effective rate of stone excretion in Yiqi Gushen Pai Shi Fang group was significantly higher than that in Rilinqing granule group, and the effective rate of stone excretion in Yiqi Gu Shen Pai Shi Fang group was significantly higher than that in RL Qing granule group. The difference was statistically significant (P < 0.05), at the same time, the VAS pain score and hematuria in Yiqi Gushen Pai Shi Fang group were significantly lower than those in RL Qing granule group (P < 0.05) and the extracorporeal shock wave lithotripsy was performed after 4 weeks. The proportion of extracorporeal lithotripsy in Yiqi Gushen Pai Shi Fang group was lower than that in Rilinqing granule group, but the difference was not statistically significant (P > 0.05). In safety research, Yiqi Gushen Pai Shi Fang was safe, no adverse reactions and side effects occurred during the treatment. Conclusion Yiqi Gu Shen Shi Fang is safe and effective with no side effects, it can effectively promote stone excretion after ureteral soft lithotripsy, increase stone excretion rate, reduce low back pain and hematuria, and improve the quality of life of patients with ureteral soft lithotripsy.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.5

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