彭英克

【摘 要】 目的：探討中西医结合在老年良性前列腺增生合并膀胱结石术后的应用。方法：选取老年良性前列腺增生（BPH）合并膀胱结石患者80例，随机分为观察组和对照组，每组各40例。两组患者均采取钬激光碎石术治疗膀胱结石，采用药物方法治疗BPH。术后对照组给药坦索罗辛，观察组在对照组的基础上加服石淋通片，两组均治疗2周。观察治疗前、后在国际前列腺症状评分（IPSS）、生活质量评分（QOL）、膀胱过度活动症评分（OABSS）、最大尿流率（Qmax）、残余尿量（PVR）、日间排尿次数、夜间排尿次数、尿急次数等指标的水平变化差异以及术后并发症情况。结果：两组治疗后，在IPSS、QOL、OABSS、Qmax、PVR、日间排尿次数、夜间排尿次数、尿急次数等指标方面水平均优于治疗前（P<0.05），且观察组显著优于对照组（P<0.05）；两组治疗后，观察组总治愈率95%显著高于对照组的80%，差异有统计学意义（P<0.05）。结论：中西医联合用药可有效改善老年良性前列腺增生合并膀胱结石患者术后的临床症状，其效果显著优于单纯西药联合手术对该合并病症的治疗效果，值得临床推广使用。

【关键词】 中西医结合；碎石术；良性前列腺增生；膀胱结石

【中图分类号】R697+3 【文献标志码】 A【文章编号】1007-8517（2018）13-0069-04

Abstract：Objective To explore the application of Chinese and western medicine in the postoperative treatment of benign prostatic hyperplasia combined with bladder calculi in the elderly.Methods Selected 80 patients with benign prostatic hyperplasia （BPH） combined with bladder calculi， and randomly divided into observation group and control group， with 40 cases in each group. Both groups were treated with holmium laser lithotripsy for bladder calculi， and the BPH was treated with drug therapy. After operation， the control group was administered to tansoloxin， and the observation group was treated with stone tablets on the basis of the control group， and the two groups were taken for 2 weeks. Observe patients before treatment， after the international prostate symptom score （IPSS）， quality of life score （QOL）， bladder excessive activity score （OABSS）， maximum urinary flow rate （Qmax）， residual urine volume （PVR）， daytime micturition number number， number of night urination， urgency and other indicators of level difference and postoperative complications.Result Two groups of patients treatment in IPSS， QOL and OABSS， Qmax， PVR， daytime micturition number number， number of night urination， urgency and so on level indicators are better than that of before treatment （P<0.05）， and the observation group was significantly better than the control group （P<0.05）.After treatment， the total cure rate of the observation group was 95%， which was significantly higher than that in the control group （P<0.05）.The data difference of each group was statistically significant. （P<0.05）. Conclusion he combination of Chinese and western medicine can effectively improve the clinical symptoms after benign prostatic hyperplasia combined with bladder calculi，， the effect significantly better than pure western medicine combined treatment effect of the combined condition， worth clinical promotion.

Keywords：Combination of Traditional Chinese and Western Medicine；Lithotripsy； Benign Prostatic Hyperplasia； Bladder Calculi

良性前列腺增生（benign prostatic hyperplasia，BPH）是泌尿科常见的疾病，也是困扰老年男性的顽症之一，其发病率逐年增高且与年龄的增长呈线性关系[1]。尿频、尿急、尿失禁、夜尿增多、排尿困难及尿不尽等症状是该病的主要临床表现[2-3]。研究表明，造成膀胱出口梗阻（bladder outlet obstruction，BOO）的直接原因就是BPH[4]，而BOO是诱发膀胱结石形成的重要因素[5]。目前临床上对BPH主要采取经尿道前列腺电切术（transurethral resection of the prostate，TURP）治疗，而对于膀胱结石主要采取钬激光碎石治疗。鉴于BPH合并膀胱结石的患者多为中老年人且身体状况较差，部分患者还伴有心脑血管等手术高危因素，加之可耐受手术时间有限，故临床上很难同時完成两种疾病的手术治疗。……