广西医学

目的探讨四金化石汤加减治疗输尿管结石术后结石残留患者的临床效果，以及对患者β2微球蛋白、Tamm-Horsfall蛋白（THP）水平的影响。方法选取140例输尿管结石术后结石残留患者，随机分为对照组和观察组，每组70例。对照组服用盐酸坦索罗辛缓释胶囊治疗，观察组在对照组基础上加用四金化石汤加减治疗，两组均治疗4周。比较两组患者临床疗效、结石清除率和临床症状消失时间，以及治疗前后的中医证候积分和血清β2微球蛋白、尿THP水平，并统计患者治疗后6个月内的结石复发率。结果治疗后，观察组的疗效优于对照组，结石清除率高于对照组（P＜0.05）；两组中医证候总积分、血清β2微球蛋白和尿THP水平较治疗前降低，且观察组上述指标低于对照组（P＜0.05）。观察组的结石排净时间、疼痛消失时间、小便带血消失时间短于对照组（P＜0.05）。观察组的结石复发率稍低于对照组，但组间比较差异无统计学意义（P＞0.05）。结论在常规西药治疗基础上，采用四金化石汤加减治疗输尿管结石术后结石残留患者的疗效显著，可改善患者的中医证候，缩短结石排净时间，提高结石清除率，可能与联合用药更能降低血清β2微球蛋白水平和尿THP水平有关。

ObjectiveTo explore the clinical effect of modified Sijin Huashi Decoction for the treatment of patients with residual stone after ureteral calculi surgery, and its influence on patients′ β2 microglobulin and Tamm-Horsfall protein (THP) levels.MethodsA total of 140 patients with residual stones after ureteral calculi surgery were selected, and they were randomly divided into control group or observation group, with 70 cases in each group. The control group was administrated Tamsulosin Hydrochloride Sustained Release Capsule for treatment, based on which the observation group was additionally administrated modified Sijin Huashi Decoction for treatment. Both groups received continuous treatment for 4 weeks. The clinical efficacy, clearance rate of calculi, and disappeared time to clinical symptoms, as well as pre- and post-treatment Traditional Chinese Medicine syndromes score, and levels of serum β2 microglobulin, urine THP were compared between patients of the two groups; moreover, the recurrence rate of calculi within 6 months after treatment was analyzed in patients. ResultsAfter treatment, efficacy of the observation group was superior to that of the control group, and the clearance rate of calculi was higher than that of the control group (P＜0.05); in addition, the Traditional Chinese Medicine syndromes total score, and serum β2 microglobulin, urine THP levels in the two groups were decreased as compared with before treatment, and the observation group yielded lower aforementioned indices as compared with the control group (P＜0.05). Stone clearance time, pain removal time, and disappeared time to urine with blood in the observation group were shorter than those in the control group (P＜0.05). The recurrence rate of calculi in the observation group was slightly lower than that in the control group, but there was no statistically significant difference between the two groups (P＞0.05). ConclusionOn the basis of routine Western Medicine therapy, employing modified Sijin Huashi Decoction for the treatment of patients with residual stone after ureteral calculi surgery exerts a significant efficacy, which can ameliorate patients′ Traditional Chinese Medicine syndromes, shorten clearance time to remove calculi, improve the clearance rate of calculi, and it may be related to that the drug combination can more decrease levels of serum β2 microglobulin and urine THP.