利水通淋、活血化瘀法对TRPV5在含钙肾结石患者肾组织中表达的影响

The Influence of Promoting Diuresis and Activating Blood Circulation to Remove Stasis on the Expression of TRPV5 in Renal Tissue of Patients with Calcium Nephrolithiasis

目的:探讨利水通淋、活血化瘀法对新型钙离子通道TRPV5在含钙肾结石患者肾组织中表达的影响。方法:将80例肾结石患者随机分为含钙消瘀化石合剂组、含钙结石组、非含钙消瘀化石合剂组及非含钙结石组,每组各20例,并选取同期因其他非肾结石原因接受肾脏切除的20例患者为对照组进行对比研究。含钙消瘀化石合剂组术前服用消瘀化石合剂,含钙结石组术前未服用消瘀化石合剂,非含钙消瘀化石合剂组术前服用消瘀化石合剂,非含钙结石组术前未服用消瘀化石合剂。检测所有患者24 h尿钙含量,免疫组织化学法检测肾组织TRPV5含量。结果:含钙消瘀化石合剂组24 h尿钙为(6.26±1.76)mmol,含钙结石组的24 h尿钙为(8.50±2.35)mmol,两组比较,差异具有统计学意义(P<0.05);非含钙消瘀化石合剂组为(6.11±1.72)mmol,非含钙结石组为(6.26±1.76)mmol,对照组为(9.62±2.32)mmol,三组组间比较,差异具有统计学意义(P<0.05)。免疫组化检测含钙消瘀化石合剂组肾组织中TRPV5强表达3例、中表达7例、低表达10例;含钙结石组肾组织中TRPV5强表达1例、中表达5例、低表达14例;非含钙消瘀化石合剂组中TRPV5强表达12例、中表达5例、低表达3例;非含钙结石组肾组织中TRPV5强表达9例、中表达7例、低表达4例;对照组肾组织中TRPV5强表达9例、中表达6例、低表达5例,含钙消瘀化石合剂组与含钙结石组,非含钙消瘀化石合剂组与非含钙结石组及对照组肾组织TRPV5的表达比较,差异均有统计学意义(P<0.05)。结论:利水通淋、活血化瘀法抑制肾结石形成的机制可能是通过上调肾组织中TRPV5的表达,以减少高钙尿及含钙结石的发生。

Objective： To explore the influence of promoting diuresis and activating blood circulation to remove stasis on the expression of novel calcium channel TRPV5 in renal tissue of patients with calcium nephrolithiasis. Methods： Eighty patients with kidney stone were randomly divided into the group of Hangai Xiaoyu Huashi Mixture,the group of Hangai Jieshi,the group of Feihangai Xiaoyu Huashi Mixture,the group of Feihangai Jieshi,with 20 cases in each group; The other 20 cases who received nephrectomy for other reasons except kidney stone at the same period were also selected for comparison research. The ones in the group of Hangai Xiaoyu Huashi Mixture took Hangai Xiaoyu Huashi Mixture before the operation,while the ones in the group of Hangai Jieshi didn＇t take it; The ones in the group of Feihangai Xiaoyu Huashi Mixture took Xiaoyu Huashi Mixture before the operation,while the ones in the group of Feihangai Jieshi didn＇t take it. The 24 hours＇ urine calcium contents of patients were detected,and the TRPV5 content in kidney tissue was detected by immunohistochemistry. Results： The 24 hours＇ urine calcium content in the the group of Hangai Xiaoyu Huashi Mixture was（ 6. 26 ± 1. 76） mmol,while that of the group of Hangai Jieshi was（ 8. 50 ± 2. 3）5mmol,and the difference was statistically significant（ P〈0. 05）. The content of Feihangai Xiaoyu Huashi Mixture was（ 6. 11 ±1. 72） mmol,while that of the group of Feihangai Jieshi was（ 6. 26 ± 1. 76） mmol,while that of the control group was（ 9. 62 ±2. 32） mmol,and the difference between the three groups was statistically significant（ P〈0. 05）. By using immunohistochemistry,in the group of Hangai Xiaoyu Huashi Mixture,TRPV5 in kidney tissues was strongly expressed in 3 cases,7 cases were moderately expressed,and low expression was found in 10 cases. In the group of Hangai Jieshi,TRPV5 in kidney tissues was strongly expressed in1 case,5 cases were moderately expressed,and low expression was found in 14 cases. In the group of Feihangai Xiaoyu Huashi Mixture,TRPV5 in kidney tissues was strongly expressed in 12 cases,5 cases were moderately expressed,and low expression was found in 3 cases. In the group of Feihangai Jieshi,TRPV5 in kidney tissues was strongly expressed in 9 cases,7 cases were moderately expressed,and low expression was found in 4 cases. In the control group,TRPV5 in kidney tissues was strongly expressed in 9 cases,6 cases were moderately expressed,and low expression was found in 5 cases. Conclusion： Promoting dieresis and activating blood circulation to dissipate blood stasis can inhibit the formation of kidney stone,and the mechanism may be to reduce the occurrence of high calcium urine and calcium containing stones by regulating up the expression of TRPV5 in renal tissues.