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目的:观察三金排石汤联合α-受体阻滞剂坦索罗辛治疗输尿管下段结石的疗效。方法:将128例确诊为输尿管下段结石患者按比例随机分成三组,A组(联合治疗)患者每天7点和18点各服中药汤剂200ml,随后饮水1 000ml,19点服用坦索罗辛0.2mg;B组(单用α-受体阻滞剂)患者除每天饮水2 000ml外,19点服用坦索罗辛0.2mg;C组(单用中药治疗)患者每天7点和18点各服中药汤剂200ml,随后饮水1 000ml。鼓励患者多做运动,疗程2周,每3d复诊了解排石情况,复查腹部B超,记录排石时间、是否出现绞痛及使用镇痛药情况,观察药物有无副作用。结果:2周后,A组、B组、C组的结石排出率分别为81.3%、47.5%、66.7%,其中A组的结石排出率显著高于B组(P<0.01),也优于C组(P<0.05),三组平均排石时间分别为(5.1±2.3)、(11.1±1.2)、(9.2±3.8)d,A组患者排石平均时间显著快于另两组(P<0.01)。三组患者镇痛剂使用总量分别为1 200、1 500、2 500mg,经过统计比较,A、B组患者镇痛剂使用量显著少于C组(P<0.01)。结论:运用中药联合α-受体阻滞剂的治疗方法可以明显提高输尿管远端结石患者的排石率,缩短排石时间,减轻和减少治疗期间肾绞痛的发作次数和镇痛剂的使用量。
Objective: To observe the curative effect of Sanjin Paishi Decoction combined with α-blocker tamsulosin on lower ureteral calculi. Methods: 128 patients diagnosed as lower ureteral calculi were randomly divided into three groups. Group A (combined treatment) received 200ml of Chinese medicine decoction at 7 o’clock and 18 o’clock each day, then they drank 1 000ml and taken tamsulosin at 19 o’clock 0.2mg; group B (α-blocker alone) patients in addition to daily drinking water 2 000ml, 19:00 tamsulosin 0.2mg; C group (single Chinese medicine treatment) patients at 7:00 and 18 points each Chinese medicine decoction 200ml, followed by drinking 1000ml. Encourage patients to do more exercise, treatment 2 weeks, referral every three days to understand the row of stone, review the abdomen B ultrasound, record row of stone time, whether there is angina pectoris and use of analgesics, the observation of drugs with or without side effects. Results: After 2 weeks, the rate of stone excretion in group A, group B and group C was 81.3%, 47.5% and 66.7%, respectively. The rate of stone excretion in group A was significantly higher than that in group B (P <0.01) (5.1 ± 2.3), (11.1 ± 1.2) and (9.2 ± 3.8) days respectively in group C (P <0.05). The average time for discharging stone in group A was significantly faster than that in other two groups (P <0.01). The total amount of analgesics used in the three groups was 1 200,1 500 and 2 500 mg, respectively. After statistical comparison, the use of analgesics in group A and group B was significantly less than that of group C (P <0.01). Conclusion: The treatment of traditional Chinese medicine combined with α-blockers can significantly improve the rate of stone removal in patients with distal ureteral calculi, shorten the row of stone row time, reduce and reduce the number of attacks of renal colic during treatment and the use of analgesics the amount.