To Observe The Effect On Bleeding Volume And Time Of Benign Prostatic Hyperplasia Patients Using Removing Heat And Cooling Blood Decotion After Transurethral Plasmakkinetic Bipolar Vaporization

Objective To observe the effect on bleeding volume and time of benign prostatichyperplasia(BPH) patients using removing heat and cooling blood decotion aftertransurethral plasmakkinetic bipolar vaporization(TUPK), and approach its mechanism ofaction, so as to provide some approaching ways to the combination of TCM with Westernmedicine therapies for the bleeding of BPH patients after TUPK.Methods To collect 41 cases of BPH in-patients who accept therapies in the urologydepartment of Jiangsu Provincial hospital of TCM. Divide them into two groupsrandomly, curing group of 21persons and control group of 20 persons. Both groups acceptTUPK, with the same resectoscope and the same surgeon. The operation adopt epidural andlumbar anesthesia, patients take the lithotomy position, the resectoscope is inserted underTV monitoring, then the left, right and central lobus of the prostate are resected along to thesurgical capsule, stop bleeding thoroughly, wash out the prostatic chips, detain the F22trifoveolate urethral catheter. After the resection, keep bladder washout with Nitrofural forthree days, pull out the catheter in the 5th day. Both two groups take anti-infectiontreatment, fluid replacement and supportive treatment regularly. Besides the regulartreatment, the curing group take the removing heat and cooling blood decotion in the 1stday after TUPK, one decotion per day, taken separately in the morning and evening, 7 daysin all. Observe the colour and volume of BW fluid in the 3rd day after TUPK, take the24-hour quantitative examination of urine HB in the 4th day and 6th day, and calculate thebleeding volume. Observe the urination and symptoms of the patients without the catheters,collect the data and do statistic and comparison. Qualitation take chi-square test andrank-sum test, quantitation take t-test. P≤0.05 stands for statistical significance, and P≤0.01 stands for highly statistical significance.Results After analyzing the therapeutic effect of curing group and control group, itindicates that in curing group, the 24-hour mean urine bleeding volume (X±S) in the 4thday after TUPK is 5.32±4.52ml, the control group is 7.88±6.46ml, no significant statisticdifferences within two groups (t-test, P=0.153). The 24-hour urine bleeding volume(X±S)in day 6, in curing group is 2.70±3.22ml, in control group is 5.22±4.03ml. The bleedingvolume of curing group is less than that of control group, as well as it has significantstatistic differences (P=0.028).The secondary index: in day 7 after TUPK, in urine regular test, the positive rate ofWBC in curing group is 38.1％, less than that of 70％in control group,There aresignificant statistic differences. Constipation occurred in curing group is 14.28％(3/21),in control group is 45％(9/20), statistic differences present. Cystospasm is 14.28％incuring group and 40％in control group, post-operation, and statistic difference is seen byX2-test (P=0.05). Urine retention and secondary hemorrhage are seen in both two groups, each of one case, also no statistic differences.Results To use removing heat and cooling blood decotion in BPH patients afterTUPK can reduce post-operation hemorrhage, and lower the incidence rate of cystospasmand constipation. Coagulation function is not disordered meanwhile hemostasis acts,incidence rate of thrombus does not increase. It carries out the result: the removing heat andcooling blood decotion can be used in BPH patients after TUPK.