Clinical Observation On The Improvement Of Double J Tube Symptoms After Ureteroscopic Lithotripsy With Traditional Chinese Medicine

Background: ureteral stent is a kind of hollow tubular stent.The double-j tube with double-end pigtail structure is the most common and widely used in urology.With the development and popularization of endoscopic urological surgery,ureteroscopy lithotripsy for the treatment of upper urinary tract stones has become the mainstream of surgical treatment.As an important part of ureteroscopic lithotripsy,the indwelling ureteral stent has the effect of supporting,draining and improving the clearance rate of urinary calculi.However,with the indwelling of the double J stent,the symptoms of the indwelling of the double J sent,including urinary frequency,urgency,urination pain,urinary incontinence and other symptoms of the lower urinary tract,the pain symptoms including lumbar and abdominal,and hematuria,have greatly affected quality of life.Western medicine has conducted a systematic studies on the symptoms related to double-j tube indwelling,and put forward measures to alleviate the symptoms,such as improveting in stent designs and oral medication,but no consensus has been reached.Traditional Chinese medicine has unique advantages in the treatment of urinary calculi.According to years of clinical practice,professor Zhang Yaosheng has rich experience in the treatment of urinary calculi,and believes that the complication of ureteral stent after calculi surgery still belong to the urolithic stranguria,the mechanism is damp heat and stannant qi and dlood satsis,and the prescription of the method of damp heat removing,qi regulating and blood stasis removing is used as the auxiliary treatment after calculi surgery.Based on the traditional advantages of traditional Chinese medicine surgery to urolithic stranguria,combined with the understanding of the mechanism evolution of urolithic stranguria under the conditions of modern surgery,the combination of traditional Chinese medicine and modern surgery technology,in order to reduce adverse reactions and improve the quality of life,is one of the directions of to treatment urolithiasis with integrated Chinese and western medicine.Objective: By treating patients indwelled double J stent after ureteroscopic lithotripsy with traditional Chinese medicine prescription of damp heat removing,qi regulating and blood stasis removing,to observe the urination and pain condition when removing double J tube,and to evaluate the therapeutic effect of the methed of damp heat removing,qi regulating and blood stasis removing on the urination symptoms and pain symptoms caused by double J tube indwelling.Methods: 40 patients who underwent ureteroscopy lithotripsy were randomly divided into two groups.Postoperative anti-inflammatory and analgesic basic treatment was given,postoperative Chinese medicine group was given oral Chinese medicine granules,one dose a day,a total of 14 days,the control group without drug intervention.Double J tubes were removed 14 days after surgery in both groups.Both groups completed ureteral stent symptom questionnaires before,after and during catheter extubation.SPSS software was used for statistical analysis of the results,and P<0.05 was considered statistically significant.Results:After indwelling doublt-j stent,both of the tow groups,scores of urination symptoms and pain symptoms were significantly increased than before(P<0.05).After 2 weeks,when the double J tube was removed,the scores of urination symptoms and pain symptoms of the traditional Chinese medicine group were lower than those of the control group,and the difference was statistically significant(P<0.05).For specific evaluation of urination symptoms and pain symptoms,there were significant differences in urination symptoms between the Chinese medicine group and the control group(P < 0.05)in urgency of urination,urethral burning and incomplete voiding,and no significant differences in frequency of urination and hematuria between the two groups(P > 0.05).In terms of pain symptoms,there were significant differences in VAS and urination pain symptoms between the traditional Chinese medicine group and the control group(P < 0.05),and no significant differences in pain of activity and back pain of urinating symptoms between the two groups(P > 0.05).Conclusion: Indeweling ureteral stent-j stent after ureteroscopic lithotripsy can cause obvious urination and pain symptoms.According to the basic understanding that the symptom of double J stent indwelling belongs to urolithic stranguria and its mechanism is damp heat and stannant qi and dlood satsis,the application of traditional Chinese medicine method of damp heat removing,qi regulating and blood stasis removing as the basic treatment method can improve the urination symptoms and pain symptoms caused by double J stent indwelling.Ureteral stent symptoms is one of the problems existing in the lumen lithotripsy,this study is the preliminary observation of traditional Chinese medicine applied to ureteroscopy lithotripsy postoperative symptoms of double J stent,as well as the exploration of traditional Chinese medicine to be used to lumen lithotripsy,proving that traditional Chinese medicine still has a broad application space under the condition of modern minimally invasive surgery.The application of traditional Chinese medicine in ureteroscopy for the treatment of urinary calculi is of practical clinical significance and has the value of further research and exploration.