| Objective:To observe the efficacy and safety of Paishi Decoction combined with tamsulosin in the treatment of upper urinary tract calculi after operation,and to explore its improvement in the efficiency of promoting excretion,creatinine,uric acid,urine occult blood,TCM symptom scores and recurrence of stones,so as to explore an effective and safe therapeutic method for the combination of traditional Chinese and western medicine to promote the excretion of residual stones.Methods:93 patients who underwent surgery for upper urinary tract stones in the Department of Urology,Ruikang Hospital affiliated to Guangxi University of Traditional Chinese Medicine from October 2021 to October 2022 were selected as the study subjects.They were divided into three groups,A,B and C,by random number table.Group A was treated with tamsulosin on the first day after operation,Group B was treated with our own Paishi Decoction on the first day after operation,and Group C was treated with Paishi Decoction and tamsulosin on the first day after operation.Two weeks were one course of treatment,a total of two courses.Observe and record the changes of blood creatinine,blood uric acid,urine occult blood,white blood cells,TCM syndrome score,pain score,recurrence of stones and other aspects of the three groups of patients before surgery and after take medication,recording the occurrence of adverse events,analyzing and dealing with them through SPSS26.0 to evaluate the efficacy and safety of different intervention measures.Results:A total of 93 patients were included in this study,2 person lost follow-up and 4 people refused to continue taking Chinese medicine,and 90 cases finally completed the trial.The specific results are as follows:1.Comparison of observation indicators before treatment: There was no statistically significant difference in gender,age,surgical choice,the longest diameter and location of stones among the three groups(P>0.05),and there was no statistically significant difference in the efficacy indicators such as creatinine,uric acid,and TCM syndrome score(P>0.05),which was comparable.2.The analysis of stone composition indicates that the main component of stones in this area is calcium oxalate stone,and the mixed component accounts for the highest proportion.3.Comparison of serum creatinine level: After 3 days of treatment,there was no significant change in the creatinine level of patients in the three groups(P>0.05).After 4 weeks of treatment,the level of serum creatinine in the three groups was significantly lower than that before(P<0.05);The curative effect of group C was better than that of group A and B(P<0.05),The curative effect between groups B and C was similar(P>0.05).4.Comparison of blood uric acid level: There was no significant change in uric acid in the three groups after treatment for 3 days and 4 weeks(P>0.05).5.Comparison of blood white blood cells: After 3 days of treatment,the level of blood white blood cells in the three groups was significantly higher than that before operation,and the difference was statistically significant(P<0.05),there was no statistically significant difference in the overall comparison groups(P>0.05).After 4 weeks of treatment,the white blood cells in the three groups decreased compared with those in the third day of treatment(P<0.01);After comparison between groups,it was found that the decline level of Group C was better than that of Group A and Group B(P<0.05),and there was no significant difference between Group A and Group B(P>0.05).6.Comparison of urine occult blood: After 2 weeks of treatment,the improvement of urine occult blood between the three groups was statistically significant(P<0.05).The curative effect between groups B and C was similar(P>0.05),and the score of group B and C was better than group A(P<0.05).After 4 weeks of treatment,the improvement of urine occult blood between the three groups was not statistically significant(P>0.05).7.Comparison of TCM syndrome score: There were statistically significant differences between 2 weeks of treatment and preoperative treatment and between 4 weeks of treatment and 2 weeks of treatment(P<0.05);The curative effect between groups B and C was similar(P>0.05),and the score of group B and C was better than that of group A(P<0.05).8.Comparison of pain score: There was no statistically significant difference between the groups after 3 days of treatment(P>0.05).There was statistically significant difference between two weeks of treatment and three days of treatment(P<0.05);There was a significant difference in the overall comparison among the three groups(P<0.01).The pain score of group B and C was better than group A(P>0.05),The curative effect between groups B and C was similar(P>0.05).Compared with 2 weeks of treatment,the difference between groups A and C was statistically significant(P<0.05),and there was no difference in group B(P>0.05).There was a significant difference in the overall comparison between the three groups(P<0.01),The curative effect of group C was better than that of group A and B(P<0.05).9.Comparison of stone expulsion efficacy: The overall stone expulsion effect of group C was better than that of group A and B(P<0.05),and the efficacy of stone expulsion in group A and B was comparable(P>0.05).10.Comparison of stone recurrence: There was no significant difference in stone recurrence between the three groups after 3 months(P>0.05).Conclusions:1.Paishi decoction combined with tamsulosin is superior to traditional Chinese medicine or western medicine in promoting creatinine recovery,improving hematuria symptoms,reducing inflammatory indicators and alleviating pain after upper urinary tract stone lithotripsy;2.Paishi Decoction can improve the score of TCM symptoms after operation,and relieve the symptoms of waist and abdomen pain,dripping and astringent pain in urination,hematuria and dysuria to a certain extent;3.The effect of stone expulsion decoction combined with tamsulosin after upper urinary tract stone lithotripsy was better than that of the traditional Chinese medicine group or the western medicine group alone,and has no obvious adverse reactions and good safety.It can be used for clinical promotion and enhance the effect of stone removal. |
PDF Full Text Request