中药排石汤联合体外震波碎石术对肾结石患者肾功能、尿液代谢的影响

Effects of Chinese Medicine Paishi Decoction Combined with Extracorporeal Shock Wave Lithotripsy on the Renal Function and Urine Metabolism of Patients with Renal Calculus

目的:探讨中药排石汤联合体外震波碎石术(ESWL)对肾结石患者肾功能、尿液代谢的影响。方法:选取2014年5月至2017年2月成都市龙泉驿区中医医院收治的肾结石患者138例为研究对象,按照随机数字表法分为观察组和对照组,每组69例,2组均行ESWL治疗,术后对照组采用常规药物治疗,观察组在对照组的基础上采用中药排石汤治疗,2组治疗时间均为2周。比较2组患者临床疗效及中医证候改善情况;统计手术前后2组患者肾功能及尿液代谢状况。结果:术后观察组总有效率为94. 20%,显著高于对照组的78. 26%(P <0. 05);与术前比较,2组患者中医证候积分均下降,且观察组低于对照组(P <0. 05);与术前比较,术后3～14 d 2组血清血肌酐(SCr)、尿素氮(BUN)、半胱氨酸蛋白酶抑制剂(Cys-C)、中性粒细胞明胶酶相关载脂蛋白(NGAL)水平均呈先升高后降低趋势,且各时间点观察组均低于对照组(P <0. 05);术后14 d观察组与术前比较,差异无统计学意义(P> 0. 05),对照组仍高于术前(P <0. 05);与术前比较,术后2周内2组患者高尿钙症、高草酸尿症、高尿酸尿症、低尿量及低镁尿症等尿液代谢异常发生率下降(P <0. 05),且观察组低于对照组(P <0. 05)。结论:中药排石汤联合ESWL治疗肾结石可保护患者肾功能,降低尿液代谢异常状况发生率,临床疗效显著。

Objective:To explore the influence of Chinese medicine Paishi Decoction combined with extracorporeal shock wave lithotripsy (ESWL) on the renal function and urine metabolism of patients with renal calculus.Methods:A total of 138 cases of patients with renal calculus from May 2014 to February 2017 were selected as study objects and were randomly divided into observation group (n=69) and control group (n=69).The 2 groups were treated with ESWL,control group was treated with routine drugs,and the observation group was treated with Paishi Decoction on the basis of control group.The 2 groups were treated for 2 weeks.The clinical efficacy and the improvement of Traditional Chinese Medicine syndrome of 2 groups were compared:the renal function index and urine metabolism condition of 2 groups were detected before and after operation.Results:The total effective rate of observation group reached up to 94.20% after operation,which was higher than that 78.26% of control group (P<0.01):Compared with before operation,the Traditional Chinese Medicine syndrome integral of 2 groups decreased after operation,and observation group were lower than control group (P<0.01):Compared with before operation,the levels of serum SCr,BUN,NGAL,Cys-C of 2 groups from 3 days to 14 days after operation increased firstly and then decreased,and observation group was lower than control group at each time point (P<0.01):There was no difference between 14 days after operation and before operation of observation group (P>0.05),but the control group was higher than those before operation (P<0.01).Compared with before operation,the incidence of urinary metabolic abnormalities such as high urinary calcium,phenylketonuria,hyperuricemia,low urine output and low magnesium decreased within 2 weeks after operation (P<0.05 or P<0.01),and observation group were lower than control group (P<0.01).Conclusion:Chinese medicine Paishi Decoction combined with ESWL in the treatment of renal calculus can protect the renal function of patients,reduce the incidence of urinary metabolic abnormalities,the clinical efficacy is remarkable.