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[清淋方联合输尿管镜钬激光碎石术治疗输尿管结石]

[Quantong Recipe integrated with ureteroscopic laser lithotripsy for ureteral calculi].

作者信息

Peng Yu, Hu Xiao-Hua, Li Xiang, Zhou Gui-Ping

机构信息

Department of Urology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China.

出版信息

Zhong Xi Yi Jie He Xue Bao. 2010 Jun;8(6):530-4. doi: 10.3736/jcim20100604.

Abstract

BACKGROUND

Endoscopic surgery of Western medicine has developed rapidly in treating ureteral calculi while traditional Chinese medicine (TCM) therapy also has its advantage, thus the integrated traditional Chinese and Western medicine therapy may have an even better efficacy in dealing with this problem.

OBJECTIVE

To observe the clinical effects of sequential therapy of Quantong Recipe, a compound traditional Chinese herbal medicine, combined with ureteroscopic laser lithotripsy on ureteral calculi.

DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: A total of 151 patients with ureteral calculi (stone diameter of 3 to 21 mm) from Department of Urology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine were included, of which 106 patients with stone diameter of 3 to 10 mm were treated with Quantong Recipe for the first two weeks. Twenty patients with unexpelled stones and 45 patients with stone diameter of more than 10 mm were treated with ureteroscopic laser lithotripsy. The 65 patients except one open operation were divided into regular treatment group (32 cases) and regular treatment combined with Quantong Recipe group (32 cases) after lithotripsy. The efficacy was assessed after one week.

MAIN OUTCOME MEASURES

Cure rate in the patients with stone diameter of less than 10 mm after two-week Quantong Recipe treatment was calculated, and clearance rate in the patients with residual stone for ureteroscopic laser lithotripsy after one-week Quantong Recipe treatment was also observed.

RESULTS

After taking Quantong Recipe for two weeks, the stones in 86 patients were completely discharged, and the stones in 6 patients were not completely discharged, but the unexpelled stones had moved down more than one segment of ureteral stenosis; the total response rate was 86.79% (92/106). The 64 patients with stones unexpelled or with stone diameter of more than 10 mm were treated with ureteroscopic laser lithotripsy, and the clearance rate of residual stone was 93.8% in regular treatment combined with Quantong Recipe group, and was 71.9% in regular treatment group, and there was a significant difference between the two groups (P<0.05).

CONCLUSION

Sequential therapy of Quantong Recipe integrated with ureteroscopic laser lithotripsy demonstrates a significant advantage of integrated traditional Chinese and Western medicine therapy in treating ureteral calculi.

摘要

背景

西医内镜手术在输尿管结石治疗中发展迅速,而中医治疗也有其优势,中西医结合治疗可能对此问题有更好疗效。

目的

观察中药复方通淋方序贯联合输尿管镜激光碎石术治疗输尿管结石的临床疗效。

设计、地点、参与者和干预措施:纳入上海中医药大学附属岳阳中西医结合医院泌尿外科151例输尿管结石患者(结石直径3~21mm),其中结石直径3~10mm的106例患者先服用通淋方2周。20例结石未排出患者及45例结石直径大于10mm患者接受输尿管镜激光碎石术。65例除1例开放手术外的患者碎石术后分为常规治疗组(32例)和常规治疗联合通淋方组(32例)。1周后评估疗效。

主要观察指标

计算通淋方治疗2周后结石直径小于10mm患者的治愈率,观察通淋方治疗1周后输尿管镜激光碎石术后残留结石患者的清石率。

结果

服用通淋方2周后,86例患者结石完全排出,6例患者结石未完全排出,但未排出结石下移超过1个输尿管狭窄段;总有效率为86.79%(92/106)。64例结石未排出或结石直径大于10mm患者接受输尿管镜激光碎石术,常规治疗联合通淋方组残留结石清石率为93.8%,常规治疗组为71.9%,两组比较差异有统计学意义(P<0.05)。

结论

通淋方序贯联合输尿管镜激光碎石术体现了中西医结合治疗输尿管结石的显著优势。

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