排石冲剂对大鼠草酸钙结石生成的干预效果及其机制研究

Effects and Mechanism of Paishi Granule on Renal Calcium Oxalate Stone Formation in Rats

目的探讨排石冲剂防治草酸钙结石形成的机制,为其临床治疗尿路结石提供依据。方法将SPF级健康雄性Wistar大鼠(48只)应用随机数字表法分为正常组、模型组、枸橼酸钾组、排石冲剂组,每组12只。采用1%乙二醇自由饮水和2%氯化铵灌胃建立大鼠草酸钙肾结石模型,同时各组给予相应药物,观察各组大鼠体质量、24 h尿量、尿草酸、Ca2+、P3+、Mg2+水平及血清BUN、Cr、Ca2+、P3+、Mg2+水平;显微镜下观察肾组织切片中草酸钙结晶沉积及病理变化。结果大鼠24 h尿量比较,枸橼酸钾组和排石冲剂组均高于正常组和模型组(P<0.05);枸橼酸钾组与排石冲剂组比较,差异无统计学意义(P>0.05)。4组大鼠24 h尿草酸、Ca2+、P3+水平两两比较,差异均有统计学意义(P<0.05);大鼠尿Mg2+水平比较,模型组、枸橼酸钾组与排石冲剂组均低于正常组,均高于模型组(P<0.05);枸橼酸钾组与排石冲剂组尿Mg2+水平比较,差异无统计学意义(P>0.05)。4组大鼠血清Mg2+和P3+水平比较,差异无统计学意义(P>0.05);BUN、Ca2+水平比较,枸橼酸钾组与排石冲剂组均高于正常组,均低于模型组(P<0.05);枸橼酸钾组与排石冲剂组BUN、Ca2+水平比较,差异无统计学意义(P>0.05);4组Cr水平两两比较,差异均有统计学意义(P<0.05)。枸橼酸钾组和排石冲剂组草酸钙结晶评分均高于正常组,低于模型组(P<0.05);排石冲剂组结晶评分低于枸橼酸钾组(P<0.05)。结论排石冲剂可降低尿草酸、血Ca2+等促肾结石形成物质的水平,促进肾结石溶解,明显抑制尿中和肾组织中草酸钙晶体的形成及减轻肾功能损伤程度,保护肾脏。

Objective To investigate the effects and possible mechanism of Paishi granule on renal calcium oxalate stone formation in rats,and provide the basis for the clinical therapy for urinary calculi. Methods A total of 48 SPF level healthy male Wistar rats were separated into 4 groups by random number table method,including normal group,model group,Potassium citrate - treated group,and Paishi granule - treated group（n = 12 for each）. The rat model of renal calcium oxalate stone was induced by intragastrically administrated 2% ammonium chloride（ AC）,together with 1% ethylene glycol（ EG）for free drink. At the same time,each group was treated with corresponding drug. Individual weight and urine volume were recorded;24 h urine was collected for the evaluations of urinary oxalate（ Ox）,calcium（ Ca2 ＋ ）,phosphate（ P3 ＋ ）and magnesium （Mg2 ＋ ） levels. The serum urea nitrogen（ BUN）,creatinine（ Cr）,Ca2 ＋ ,P3 ＋ ,Mg2 ＋ levels were determined in each animal. The paraffin sections of kidney were prepared for observing the calcium oxalate deposit and pathological changes under the microscope. Results The 24 h urine volumes in Potassium citrate - treated group and Paishi granule - treated group were significantly higher than those in normal group and model group（ P 0. 05）. The levels of 24 h urinary oxalate,Ca2 ＋ and P3 ＋ showed significant differences between any two groups from the four groups（P 0. 05）. The serum BUN and Ca2 ＋ levels in the two treated groups were significantly higher than those in normal group,but lower than in model group（P 0. 05）. The serum Cr level demonstrated significant difference between any two groups（P 〈 0. 05）. The scores of calcium oxalate crystallization in the two treated groups were significantly higher than in normal group,conversely,lower than model group（ P 〈 0. 05）. Furthermore,the score in Paishi granule - treated group was lower than in Potassium citrate - treated group（P 〈 0. 05）. Conclusion The Paishi granule can significantly decrease the levels of urinary oxalate and serum Ca2 ＋ which facilitate renal calculus formation,while accelerate renal calculus dissolution, consequently,inhibiting the formation of calcium oxalate crystals in urine and renal tissues,thus,protecting the kidneys.