八珍湯治療尿路結石之案例報告

A Case Report on Eight-treasure Decoction for the Treatment of Urolithiasis

腎結石盛行率全世界都有上升趨勢，以美國為例，從1976－1980年3.8%至2007－2010年8.4%；在臺灣尿路結石疾患，依健保局資料統分析計有7.38%，約有160萬人反覆為此病所困擾，治療失當或延誤治療可能形成更嚴重的腎臟病。尿路結石是泌尿系統常見疾病之一，其發病率僅次於泌尿系統感染，改變病患居住環境溫度，減少日照及某些飲料攝取，可大幅降低尿路結石罹患率。尿路結石於中醫辨證屬五淋中石淋證，分急慢性淋證，臨床上常見急性石淋證為濕熱下注膀胱，慢性石淋證較少見，且治療經久不癒。本文中探討一病例以八珍湯加減治療慢性石淋兼有血小板低下症且已腎水腫，服西藥排石藥近3個月未見改善，改服中藥一週後約6mm大的結石自體內排出，解除腎水腫危險，療效顯著；最後並探討造成尿路結石的高危險因子，建議尿路結石治療後的生活保健，以預防疾病的再復發。

The prevalence of urolithiasis has been increasing all over the world. Taking the U.S. for example, the prevalence of urolithiasis increased from 3.8% in 1976- 1980 to 8.4% in 2007-2010. According to the statistical analysis data of the National Health Insurance Administration (NHI), 7.38% of the total population (1.6 million people) are repeatedly struck by the disease. Malpractice or delayed treatment may lead to the formation of more serious kidney disease. Urolithiasis is one of the common diseases of the urinary system, and its incidence is only second to urinary system infections. The incidence of urolithiasis can be significantly reduced by changing the temperature of patients' living environment and reducing the intake of sunshine and certain drinks. In Chinese medicine, urolithiasis belongs to the stone stranguria of the five kinds of stranguria, and can be divided into acute and chronic stranguria. The common clinical acute strangula is humidity and heat-invaded bladder. Chronic strangula is uncommon, and cannot be cured by prolonged therapy. This study investigated a patient suffering from chronic stone strangula, thrombocytopenia, and hydronephrosis, whose disease did not improve after taking Ursodiol for nearly 3 months, and then received the treatment of the eight-treasure decoction. The 6mm size stone was removed after the patient changed to Chinese medicine to relieve the danger of hydronephrosis. The efficacy was significant. Moreover, this study investigated the high risk factors of urolithiasis. It is advised to pay attention to life care after the treatment of urolithiasis to prevent disease relapse.