清热解毒通淋汤对上尿路结石患者输尿管镜下钬激光碎石术后排石效果及炎症因子的影响OA
Effects of Qingre Jiedu Tonglin Decoction on Stone Clearance and Inflammatory Factors in Patients with Upper Urinary Tract Calculi After Ureteroscopic Holmium Laser Lithotripsy
目的:观察清热解毒通淋汤对上尿路结石患者输尿管镜下钬激光碎石术(URL)后排石效果及炎症因子的影响.方法:选取2021年1月—2024年12月德清县中医院收治的上尿路结石输尿管镜下钬激光碎石术患者98例,按照随机数字表法分为观察组和对照组各49例.对照组行URL治疗,观察组URL术后加用清热解毒通淋汤口服.比较2组术前、术后24 h和72 h炎症因子[C-反应蛋白(CRP)、降钙素原(PCT)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]水平,术前与术后24 h肾功能指标[血肌酐(SCr)、血尿素氮(BUN)]以及2组结石清除率术后72 h、不良反应发生情况,比较2组围手术期实验室指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、白蛋白(Alb)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)]水平变化.结果:术后72 h,观察组结石清除率为85.71%(42/49),对照组为67.35%(33/49),2组比较,差异有统计学意义(P＜0.05).术前,2组血清CRP、PCT、IL-6、TNF-α水平比较,差异均无统计学意义(P＞0.05).术后24 h,观察组CRP、PCT、IL-6、TNF-α水平均低于对照组,差异有统计学意义(P＜0.05);术后72 h,2组CRP、PCT、IL-6、TNF-α水平比较,差异均无统计学意义(P＞0.05).术前及术后24 h、术后72 h,2组SCr、BUN水平比较,差异均无统计学意义(P＞0.05).术前及术后72 h,2组ALT、AST、ALP、Alb、TG、TC、LDL-C水平比较,差异均无统计学意义(P＞0.05).治疗期间,2组患者在均未发生明显不良反应.结论:清热解毒通淋汤可有效抑制输尿管镜术后早期炎症反应,有效提高结石清除率,且安全性良好.
Objective:To observe the effects of Qingre Jiedu Tonglin Decoction on stone clearance and inflammatory factors in patients with upper urinary tract calculi after ureteroscopic holmium laser lithotripsy(URL).Methods:A total of 98 patients with upper urinary tract calculi who underwent URL in Deqing County Hospital of Traditional Chinese Medicine from January 2021 to December 2024 were selected and divided into the observation group and the control group using the random number table method,with 49 cases in each group.The control group was treated with URL,while the observation group was additionally treated with oral Qingre Jiedu Tonglin Decoction after URL.The levels of inflammatory factors[C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)]were compared between the two groups before surgery,and at 24 hours and 72 hours after surgery.Renal function markers[serum creatinine(SCr)and blood urea nitrogen(BUN)]were compared before surgery and at 24 hours after surgery.The stone clearance rate 72 hours after surgery and the incidence of adverse reactions were compared between the two groups.Perioperative laboratory indicators[alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),albumin(Alb),triglycerides(TG),total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C)]were compared between the two groups.Results:At 72 hours after surgery,the stone clearance rate was 85.71%(42/49)in the observation group and 67.35%(33/49)in the control group,and the difference between the two groups was statistically significant(P＜0.05).Before surgery,there were no statistically significant differences in the levels of CRP,PCT,IL-6,and TNF-α between the two groups(P＞0.05).At 24 hours after surgery,the levels of CRP,PCT,IL-6,and TNF-α in the observation group were lower than those in the control group,with statistically significant differences(P＜0.05).At 72 hours after surgery,there were no statistically significant differences in the levels of CRP,PCT,IL-6,and TNF-α between the two groups(P＞0.05).Before surgery,and at 24 hours and 72 hours after surgery,there were no statistically significant differences in SCr and BUN levels between the two groups(P＞0.05).Before surgery and at 72 hours after surgery,there were no statistically significant differences in the levels of ALT,AST,ALP,Alb,TG,TC,and LDL-C between the two groups(P＞0.05).During treatment,no significant adverse reactions occurred in either group.Conclusion:Qingre Jiedu Tonglin Decoction can effectively inhibit the early inflammatory response after ureteroscopic lithotripsy,effectively improve the stone clearance rate,and has a good safety profile.
姚金良;胡志琛
德清县中医院,浙江 德清 313000浙江中医药大学附属杭州西溪医院/杭州市西溪医院,浙江 杭州 310023
医药卫生
上尿路结石输尿管镜下钬激光碎石术清热解毒通淋汤炎症因子结石清除率
Upper urinary tract calculiUreteroscopic holmium laser lithotripsyQingre Jiedu Tonglin DecoctionInflammatory factorsStone clearance rate
《新中医》 2026 (12)
34-39,6
湖州市科学技术公益性应用研究项目(2021GY53)
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