中醫藥治療腎積水病例報告

A Case Report of Hydronephrosis Treated with Traditional Chinese Medicine

46 歲女性因右側輸尿管結石，接受輸尿管鏡雷射碎石術，併發右側輸 尿管狹窄，引起急性腎盂腎炎及敗血症，使用抗生素控制感染並置入雙 J 導 尿管，而後因雙 J 管導尿移位，又發生急性腎盂腎炎，住院控制感染及移除 右側雙 J 導尿管，隨後接受腎臟超音波檢查，顯示右側腎積水。 泌尿道部分阻塞常導致後續泌尿道感染及腎積水，造成腎臟損傷及末期 腎病變，損傷程度取決於阻塞的嚴重程度與持續時間，治療上以雙 J 導尿管 緩解輸尿管阻塞，患者因雙 J 導尿管移位，已移除雙 J 導尿管，服用補益腎 氣、理氣化瘀與清利濕熱之劑，使腎之陽氣充盈，則氣化有力，積水通利， 達到以中藥治療腎積水之效果。

A 46-year-old woman was diagnosed with ureteral stone and received ureteroscopic laser lithotripsy. Then, she suffered from right ureteral stricture causing acute pyelonephritis and sepsis. During hospitalization, antibiotics were prescribed to control infection and double J catheter was placed. Unfortunately due to double-J catheter dislodgement, acute pyelonephritis occurred again. She received antibiotics treatment and the double-J catheter was removed. At the same time, right hydronephrosis was still existed by renal ultrasound examination. Partial urinary tract obstruction often leads to subsequent urinary tract infection and hydronephrosis, causing kidney damage and end stage renal disease. The degree of injury depends on the severity and duration of the obstruction. Double-J catheter was often placed for relieving the ureteral obstruction and preventing kidney damage. This time, the Double-J catheter was removed for the patient due to the dislodgement of the catheter. Chinese herbs were prescribed to benefit kidney qi, regulate qi, dissipate blood stasis, disperse the damp and heat for the patient. When the qi of the kidney is filled, the gasification is powerful, the damp is clear and hydronephrosis will relieve. It is a successful case of hydronephrosis treated with traditional Chinese medicine.