补肾清热排石汤防治肾虚湿热型感染性肾结石的疗效观察

Efficacy of Bushen Qingre Paishi Decoction for Prevention and Treatment of Renal Deficiency and Humid Heat Type Infectious Renal Calculus

目的：观察补肾清热排石汤对肾虚湿热型感染性肾结石术后患者消除残余结石和防治复发的疗效。方法：将70例患者随机分为治疗组和对照组,各35例,治疗组予经方八正散结合肾气丸加减而成的补肾清热排石汤口服,对照组予左氧氟沙星、头孢唑肟分散片及氯化铵口服。分别治疗4周后观察结石有无复发及服药前后尿培养阴性率,尿液pH,24 h尿液生化,血钙,血磷,血肌酐变化情况。结果：服用补肾清热排石汤的治疗组总有效率为88.6%,明显高于对照组的68.6%（P〈0.05）。治疗组患者服药后在提高24 h尿枸橼酸,降低24 h尿磷含量方面明显优于对照组（P〈0.05）,且在控制感染、提高尿培养阴性率、降低尿液pH方面与对照组无明显差异。两组患者在服药后检测24 h尿草酸,24 h尿钙,血磷,血钙,血肌酐方面无统计学差异。结论：补肾清热排石汤对肾虚湿热型感染性肾结石术后患者的治疗效果确切,且有预防感染性肾结石复发的作用,可以为治疗肾虚湿热型感染性肾结石提供新的思路,有很好的研究前景。

Objective： To observe the efficacy of Bushen Qingre Paishi decoction for the post-operative prevention and treatment of the renal deficiency and humid heat type infectious renal calculus. Method： Totally 70 patients were randomly divided into two groups： treatment group and control group,35 cases in each group. The treatment group orally took Bushen Qingre Paishi decoction that was modified from Bazhengsan and Shenqiwan,while the control group orally took levofloxacin,ceftizoxime and ammonium chloride. Calculus recurrence and changes in negative rate of urine culture,urine pH value,24 h urine biochemical analysis,serum calcium,serum phosphorus,serum creatinine were observed 4 weeks after treatment. Result： The total effective rate of the treatment group was 88. 6%,which was significantly higher than 68. 6% of control group（ P 0. 05）. The improvement in 24 h urine citric acid and the reduction in 24 h urine phosphorus of control group were more significant than those of control group after administration（ P 0. 05）,but with no obvious difference in infection control and reduction of urine pH value between two groups. The two groups showed no statistically significant difference in 24 h urine oxalate,24 h urine calcium and serum calcium,serum phosphorus,serum creatinine after administration. Conclusion： Bushen Qingre Paishi decoction has a satisfactory effect for the post-operative treatment of renal deficiency and humid heat type infectious renal calculus,and can also prevent the recurrence of infectious renal calculus and provide new ideas for treating infectious kidney stones,with a good study prospect.