泽泻水煎剂对尿草酸钙结石影响的临床与实验研究

Study on Effect of Aqueous Extract from Alisma Orientatis on Urinary Oxalate Calcium Stone Formation

目的:探讨泽泻水煎剂对肾及输尿管草酸钙结石患者结石形成和排出的影响及其作用机制。方法:将60例肾和输尿管小结石(直径<0.8 cm)患者随机均分为2组,A组给予泽泻水煎剂(6 g,bid);B组给予多饮水。2组均治疗4周。检测2组治疗前后血生化、24 h尿草酸(Ox)、Ca^(2+)、M^(2+)分泌量变化;复查泌尿系平片(KUB)片以确定结石大小变化、位移情况;应用标准种晶技术分别在不同时间评价2组患者治疗期间新鲜晨尿对草酸钙结晶生长的抑制作用;人工肾盂结石生长模型体外检测结石的生长情况。结果:A组患者排石率高于B组(P<0.05),且A组血BUN、Cr水平明显低于B组;而两组间血Ca^(2+)、Mg^(2+)、P浓度差异无统计学意义(P>0.05);24 h尿Ox、Ca^(2+)和M^(2+)分泌量差异也无统计学意义(P>0.05)。种晶技术显示,泽泻水煎剂对草酸钙结晶生长有明显的抑制作用;A组尿液体外抑制成石作用明显强于B组。结论:泽泻水煎剂能有效减少草酸钙晶体的生长,从而抑制肾、输尿管结石形成,并通过利尿作用促进排石。

Objective： To investigate the effect of Alisma Orientatis, a chinese herbal medicine, on upper urinary tract oxalate calcium （CaOx） stone formation. Method： Sixty cases with kidney and ureter calculi were divided into 2 groups （A and B ） randomely. The group A was given aqueous extract from Alisma Orientaties （TAq-ext） 6 g bid and the group B was given water only. Therapy course was 4 week. The inhibiting index （I. I） on CaOx crystal growth was observed by seeded crystalization technique. The serum BUN ,Cr,Ca^2＋ ,P, the 24 h urinary excretion Ca^2＋ , Oxalate（ Ox）, Mg^2＋ and the renal tissue Ca^2＋ , Mg^2＋ were detected before and after therapy. Result： In group A,the stone expulsion rate was higher than group B （P 〈0. 05） ,BUN and Cr were significantly lower than group B （P 〈0. 05）; Blood Ca^2＋ ,Mg^2＋ ,P,as well as Ox,Ca^2＋ and Mg^2＋ in 24 h urine were similar in the group A and group B （P 〉0. 05）. The I. I between group A and groups B was compared that the difference was significantly. In group A, the voiding of stone was higher than in group B. Conclusion： Aqueous extract from Alisma Orientaties （TAq-ext） could inhibit significantly calcium oxalate crystal formation in vitro ,inhibited urinary oxalate calcium calculus formation in vivo and it promoted to remove of urinary calculus.