导滞排石方对单纯性肾阳性结石患者24h尿THP及尿钙水平影响的研究

Effect of Daozhi Paishi Decoction on 24 Hours Urinary Tamm-Horsfall Protein and Calcium in Simple Kidney Radiopaque Calculus Formers

目的:观察复方导滞排石方对单纯性肾阳性结石患者24 h尿THP(Tamm-Horsfall蛋白)及尿钙水平的影响。方法:120例单纯性肾阳性结石患者采用区组随机观察化方法分配到G1组、G2组、G3组和G4组。所有入选患者均在充分术前准备的情况下根据结石实际情况施行体外冲击波碎石(ESWL)或经皮肾镜下气压弹道碎石术或二者结合治疗。术后G4组按西医常规治疗,其它3组则在西医常规治疗的基础上配合口服导滞排石方。G1组每天3次,每次200 mL温服;G2组每天2次,每次200 mL温服;G3组每天1次,每次200 mL温服。用药7 d为1个疗程,共4个疗程。所有患者分别于术后第1天、第5天、第7天按《外科术后康复评价量表》进行评分,并运用双抗体夹心酶联免疫吸附法(ELISA)及全自动生化分析仪对所有患者治疗前后的24 h尿THP及尿钙进行测定。结果:治疗前4组间基线特征均衡性良好(P>0.05);治疗后G1、G2和G3组中所有患者24 h尿THP水平显著升高,尿钙水平明显下降,其中G1组效果最佳(P<0.05);而G4组中所有患者治疗前后24 h尿THP及尿钙水平变化不大(P>0.05)。治疗后所有患者按《外科术后康复评价量表》进行评分,发现G1组中患者外科术后康复评分情况要明显优于其他3组(P<0.05)。结论:复方导滞排石方不仅能够显著影响患者24 h尿THP(Tamm-Horsfall蛋白)及尿钙水平,还可提高患者术后康复评分,改善症状,促进术后恢复。

Objective： To observe the clinical effect of Daozhi Paishi Decoction on the 24 hours urinary tamm-horsfall protein and calcium in simple kidney radiopaque calculus formers. Method： Adopting block random observation method, the 120 patients with simple kidney radiopaque calculus formers were assigned to the G1 group, G2 group, G3 group, G4 group.Accordance with the actual situation of the stones, all the patitents were treated with extracorporeal shock wave lithotripsy （ ESWL ） or percutaneous nephrolithotomy pneumatic ballistic lithotripsy or in combination of the both therapy.After the surgery, G4 group received western medicine only.The other three groups were treated with combination of western medicine and Daozhi Paishi Decoction in different doses.G1 group took 200 mL Decoction each time and three times a day; G2 group took 200 mL Decoction each time and twice a day; G3 group took 200 mL Decoction per day.The research observed a total of four therapeutic courses, and 7 clays as a course.All the participants were respectively scored according to Assessment of Postoperative Recovery Scale at the first day, five days, and seven days after surgery.The double-antibody sandwich enzyme-linked immunosorbent assay （ ELISA ） method and automatic biochemical analyzer were used to determine the 24 h urinary THP calcium in all patients before and after treatment. Resuh： Baseline characteristics were well balanced between the treatment of the 4 groups （ P〉0.05 ） .All the participants in G1, G2 and G3 groups had significant increase in 24 hours urinary THP （ Tamm-Horsfall Protein ） and decrease in urinary calcium.The G1 group represents best efficiency （ P〈0.05 ）; there was little change in the 24 h urinary THP and urinary calcium levels before and after treatment in the G4 groups （ P〉0.05 ） .After all the therapeutic courses, participants were scored by postoperative rehabilitation Assessment Scale Score, and postoperative rehabilitation in the G1 group was significantly better than that in the other three groups （ P〈0.05 ）. Conclusion ： Compound Daozhi Paishi Decoction can significantly affect patients＇ 24 h urine THP （ Tamm-Horsfall protein ） and urinary calcium levels, and improve the scores in assessment of postoperative recovery scale, and clinical symptoms.