艾灸对URL术后输尿管支架管综合征的影响

陈浩; 王赟; 王志民; 张誉; 赵润璞

doi:10.13703/j.0255-2930.20230422-k0001

您当前的位置：

首页 >

文章列表页 >

艾灸对URL术后输尿管支架管综合征的影响

临床研究2 | 更新时间：2024-06-03

- 艾灸对URL术后输尿管支架管综合征的影响
- Effect of moxibustion on ureteral stent-related symptoms after ureteroscopic lithotripsy
- 中国针灸 2023年43卷第11期页码：1251-1256
- 作者机构：
  
  1.河南中医药大学研究生院，郑州 450046
  2.河南中医药大学第一附属医院泌尿外科，郑州 450099
- 作者简介：
  
  赵润璞，主任医师、教授。E-mail：zhaorunpu1219@163.com
- 基金信息：
  
  河南省中医药科学研究专项课题(2023ZY2050)
- DOI：10.13703/j.0255-2930.20230422-k0001
  中图分类号： R 246.2
- 收稿：2023-04-22，
  
  网络首发：2023-08-04，
  
  纸质出版：2023-11-12
- 稿件说明：
移动端阅览
陈浩,王赟,王志民等.艾灸对URL术后输尿管支架管综合征的影响[J].中国针灸,2023,43(11):1251-1256.

CHEN Hao,WANG Yun,WANG Zhi-min,et al.Effect of moxibustion on ureteral stent-related symptoms after ureteroscopic lithotripsy[J].Chinese Acupuncture & Moxibustion,2023,43(11):1251-1256.
陈浩,王赟,王志民等.艾灸对URL术后输尿管支架管综合征的影响[J].中国针灸,2023,43(11):1251-1256. DOI： 10.13703/j.0255-2930.20230422-k0001.

CHEN Hao,WANG Yun,WANG Zhi-min,et al.Effect of moxibustion on ureteral stent-related symptoms after ureteroscopic lithotripsy[J].Chinese Acupuncture & Moxibustion,2023,43(11):1251-1256. DOI： 10.13703/j.0255-2930.20230422-k0001.

摘要

目的

观察艾灸联合西药治疗输尿管镜碎石术（URL）后输尿管支架管综合征（USS）的临床疗效。

方法

将150例URL术后置入输尿管支架管的上尿路结石患者随机分为艾灸组（50例，脱落1例）、安慰艾灸组（50例，脱落3例）和空白对照组（50例）。空白对照组不行任何干预。在口服盐酸坦索罗辛缓释胶囊（术后第1天开始，每次0.2 mg，每日1次，连续治疗4周）基础上，艾灸组艾灸关元、双侧肾俞，安慰艾灸组采用假艾灸相同穴位，均每次15 min，每日1次，每周6次，共治疗4周。比较各组患者治疗前及治疗1、2、4周后下尿路症状、身体疼痛情况、一般情况、工作能力、性生活满意度评分，比较各组治疗4周后结石清除率及尿路感染、口服止痛药情况。

结果

各组治疗1周后下尿路症状、身体疼痛情况、一般情况评分及治疗2、4周后下尿路症状、身体疼痛情况、一般情况、工作能力评分均较治疗前降低（

0.01）。艾灸组治疗1、2、4周后下尿路症状、身体疼痛情况评分低于空白对照组及安慰艾灸组（

0.01，

0.05）。艾灸组治疗1周后一般情况评分低于空白对照组（

0.01），治疗2、4周后低于空白对照组及安慰艾灸组（

0.01，

0.05）。艾灸组治疗1、2周后工作能力评分低于空白对照组（

0.05，

0.01），治疗4周后低于空白对照组及安慰艾灸组（

0.01，

0.05）。艾灸组结石清除率为95.9%（47/49），高于空白对照组的80.0%（40/50，

0.05）。艾灸组（28.6%，14/49）和安慰艾灸组（40.4%，19/47）口服止痛药比例低于空白对照组（76.0%，38/50，

0.01）。

结论

艾灸联合西药可缓解URL术后患者下尿路症状及身体疼痛，加快一般情况及工作能力恢复。

Abstract

Objective

To observe the clinical efficacy of moxibustion combined with western medication on ureteral stent-related symptoms after ureteroscopic lithotripsy (URL).

Methods

One hundred and fifty patients with upper urinary tract calculus implanted with ureteral stents after URL were randomly divided into a moxibustion group (50 cases

1 case dropped out)

a placebo moxibustion group (50 cases

3 cases dropped out) and a blank control group (50 cases). No intervention was performed in the blank control group. On the basis of oral administration with tamsulosin hydrochloride sustained release capsule (starting from the first day after surgery

once a day

0.2 mg each time

continuously for 4 weeks)

in the moxibustion group

moxibustion was operated at Guanyuan (CV 4) and bilateral Shenshu (BL 23); the sham-moxibustion was delivered at the same acupoints in the placebo moxibustion group

once daily

6 times a week

for 15 min in each treatment. The duration of treatment was 4 weeks. Before treatment

and after 1

2 and 4 weeks of treatment

the scores of lower urinary tract symptoms

body pain

general health

work performance and satisfaction of sexual matters were compared among the 3 groups. The tract calculus clearance rate

urinary infection and the oral administration of painkillers were compared after 4 weeks of treatment in the 3 groups.

Results

The scores of lower urinary tract symptoms

body pain and general health after 1 week of treatment

and the scores of lower urinary tract symptoms

body pain

general health and work performance after 2 and 4 weeks of treatment were lower than those before treatment in the 3 groups (

0.01). The scores of lower urinary tract symptoms and body pain in the moxibustion group after 1

2 and 4 weeks of treatment were lower than those in the blank control group and the placebo moxibustion group (

0.01

0.05) respectively. The score of general health in the moxibustion group was lower than that in the blank control group after 1 week of treatment (

0.01)

and lower than those of the blank control group and the placebo moxibustion group after 2 and 4 weeks of treatment (

0.01

0.05). Regarding the score of work performance

it was lower in the moxibustion group after 1 and 2 weeks of treatment compared with those in the blank control group (

0.05

0.01)

and lower than those of the blank control group and the placebo moxibustion group after 4 weeks of treatment (

0.01

0.05). The tract calculus clearance rate in the moxibustion group was 95.9% (47/49)

higher than that in the blank control group (80.0%

40/50

0.05). The proportion of oral administration of painkillers in the moxibustion group (28.6%

14/49) and the placebo moxibustion group (40.4%

19/47) was lower than that in the blank control group (76.0%

38/50

0.01) respectively.

Conclusion

Moxibustion combined with western medication relieves lower urinary tract symptoms and body pain

and accelerate the recovery of general health and work performance in the patients after URL.

关键词

Keywords

references

Türk C , Petřík A , Sarica K , et al . EAU guidelines on interventional treatment for urolithiasis [J ] . Eur Urol , 2016 , 69 ( 3 ): 475 - 482 .

Li H , Na WL , Li HY , et al . Percutaneous nephrolithotomy versus ureteroscopic lithotomy for large (>15 mm) impacted upper ureteral stones in different locations: is the upper border of the fourth lumbar vertebra a good indication for choice of management method? [J ] . J Endourol , 2013 , 27 ( 9 ): 1120 - 1125 .

Fischer KM , Louie M , Mucksavage P . Ureteral stent discomfort and its management [J ] . Curr Urol Rep , 2018 , 19 ( 8 ): 64 .

Joshi HB , Newns N , Stainthorpe A , et al . Ureteral stent symptom questionnaire: development and validation of a multidimensional quality of life measure [J ] . J Urol , 2003 , 169 ( 3 ): 1060 - 1064 .

Abdelaziz AS , Salama NM , Ghoneem AM . Mirabegron vs. solifenacin in control of endoscopically inserted ureteral stent-related symptoms [J ] . World J Urol , 2022 , 40 ( 8 ): 2113 - 2119 .

姜超 , 卢莉娜 . 电针结合艾灸治疗肾阳不足型中风后尿失禁的临床观察 [J ] . 针刺研究 , 2020 , 45 ( 7 ): 578 - 582 .

韦慧麟 , 任亚锋 , 张芝兰 , 等 . 电针和艾灸治疗脊髓损伤后神经源性膀胱疗效差异:随机对照试验 [J ] . 中国针灸 , 43 ( 9 ): 1036 - 1037 .

梁雪芳 , 冯淑仪 , 温丹婷 . 艾灸治疗术后疲劳综合征的随机对照研究 [J ] . 实用医学杂志 , 2013 , 29 ( 18 ): 3074 - 3075 .

Thomas K , Smith NC , Hegarty N , et al . The Guy's stone score-grading the complexity of percutaneous nephrolithotomy procedures [J ] . Urology , 2011 , 78 ( 2 ): 277 - 281 .

Koprowski C , Kim C , Modi PK , et al . Ureteral stent-associated pain: a review [J ] . J Endourol , 2016 , 30 ( 7 ): 744 - 753 .

付猛 , 胡卫国 , 李建兴 . 输尿管镜碎石取石术安全共识 [J ] . 现代泌尿外科杂志 , 2020 , 25 ( 5 ): 385 - 391 .

Ho CH , Tai HC , Chang HC , et al . Predictive factors for ureteral double-J-stent-related symptoms: a prospective, multivariate analysis [J ] . J Formos Med Assoc , 2010 , 109 ( 11 ): 848 - 856 .

Yavuz A , Kilinc MF , Aydin M , et al . Does tamsulosin or mirabegron improve ureteral stent-related symptoms? A prospective placebo-controlled study [J ] . Low Urin Tract Symptoms , 2021 , 13 ( 1 ): 17 - 21 .

谢超帆 , 韦堂墙 , 刘俊波 , 等 . 坦索罗辛单用或联合抗胆碱能药物治疗输尿管支架相关症状疗效的Meta分析 [J ] . 中国药房 , 2020 , 31 ( 13 ): 1633 - 1639 .

赖海标 . 泌尿系结石的中西医最新治疗 [M ] . 北京 : 中国中医药出版社 , 2010 : 162 - 165 .

陈志红 , 易无庸 , 卢建东 , 等 . 李顺民辨治泌尿系结石经验 [J ] . 广州中医药大学学报 , 2019 , 36 ( 10 ): 1638 - 1640 .

de Groat WC , Griffiths D , Yoshimura N . Neural control of the lower urinary tract [J ] . Compr Physiol , 2015 , 5 ( 1 ): 327 - 396 .

胡静 , 杨华元 . 艾灸刺激物理信号的传导途径及其作用 [J ] . 中国针灸 , 2021 , 41 ( 5 ): 577 - 581 .

李冰 , 王永福 , 任亚锋 , 等 . 艾灸对骶髓损伤后逼尿肌无反射型神经源性膀胱大鼠膀胱组织M2、P2X3受体的影响 [J ] . 中国针灸 , 2022 , 42 ( 3 ): 291 - 297 .

Kim KW , Park SH , Im G , et al . CFD study on vesicoureteral reflux in the urinary tract with double J stent [J ] . Comput Biol Med , 2022 , 145 : 105456 .

浏览量

下载量

CSCD

文章被引用时，请邮件提醒。

提交

工具集

关联资源

艾灸联合健脾温肾方治疗脾肾阳虚型癌性厌食：随机对照试验

艾灸治疗痰湿质中心性肥胖：随机对照试验

“标本配穴”艾灸治疗腹型肥胖的临床疗效及对脂质蓄积水平的影响

艾灸治疗肝肾亏虚型类风湿关节炎量效关系研究及对疲劳状态的影响：随机对照试验

穴位按摩、穴位贴敷联合艾灸治疗产后尿潴留：随机对照试验