Background

Endoscopic surgery of Western medicine has developed rapidly in treating ureteral calculi while traditional Chinese medicine (TCM) therapy also has its advantage, thus the integrated traditional Chinese and Western medicine therapy may have an even better efficacy in dealing with this problem.
Objective

To observe the clinical effects of sequential therapy of Quantong Recipe, a compound traditional Chinese herbal medicine, combined with ureteroscopic laser lithotripsy on ureteral calculi.
Design, setting, participants and interventions

A total of 151 patients with ureteral calculi (stone diameter of 3 to 21 mm) from Department of Urology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine were included, of which 106 patients with stone diameter of 3 to 10 mm were treated with Quantong Recipe for the first two weeks. Twenty patients with unexpelled stones and 45 patients with stone diameter of more than 10 mm were treated with ureteroscopic laser lithotripsy. The 65 patients except one open operation were divided into regular treatment group (32 cases) and regular treatment combined with Quantong Recipe group (32 cases) after lithotripsy. The efficacy was assessed after one week.
Main outcome measures

Cure rate in the patients with stone diameter of less than 10 mm after two-week Quantong Recipe treatment was calculated, and clearance rate in the patients with residual stone for ureteroscopic laser lithotripsy after one-week Quantong Recipe treatment was also observed.
Results

After taking Quantong Recipe for two weeks, the stones in 86 patients were completely discharged, and the stones in 6 patients were not completely discharged, but the unexpelled stones had moved down more than one segment of ureteral stenosis; the total response rate was 86.79% (92/106). The 64 patients with stones unexpelled or with stone diameter of more than 10 mm were treated with ureteroscopic laser lithotripsy, and the clearance rate of residual stone was 93.8% in regular treatment combined with Quantong Recipe group, and was 71.9% in regular treatment group, and there was a significant difference between the two groups (P<0.05).
Conclusion

Sequential therapy of Quantong Recipe integrated with ureteroscopic laser lithotripsy demonstrates a significant advantage of integrated traditional Chinese and Western medicine therapy in treating ureteral calculi.

Key words: Ureteral calculi, Chinese herbal drug, Ureteroscopic surgical procedure, Lithotripsy