益肾通淋排石汤联合运动疗法治疗肾石病临床疗效和炎症反应的研究

Clinical Effect and Inflammatory Reaction of Yishen Tonglin Paishi Decoction Combined with Kinesitherapy in the Treatment of Nephrolithiasis

目的:研究益肾通淋排石汤结合运动疗法对肾石病的临床疗效和炎症反应,为临床肾石病的医治提供一种新的思路与方法。方法:根据诊断标准选取80例肾石病患者,随机分为对照组和研究组,对照组30例,研究组50例,对照组治疗采用复方金钱草颗粒和盐酸坦索罗辛缓释胶囊,复方金钱草颗粒每次2袋(6 g),每日3次,共兑水900 mL,盐酸坦索罗辛缓释胶囊每天1粒(0.2 g),研究组治疗采用益肾通淋排石汤和盐酸坦索罗辛缓释胶囊,益肾通淋排石汤每日1剂,共煎水剂900 mL,分3次口服,盐酸坦索罗辛缓释胶囊每天1粒(0.2 g),直至结石排出后停止给药,在治疗前后分别复查肝功、肾功、超敏C反应蛋白、尿液分析、临床症状等检查和评估,常规每周复查泌尿系超声1次,在自觉有结石排出时复查泌尿系超声1次。结果:研究组的临床总有效率为96%(48/50)明显高于对照组的70%(21/30),P=0.001,研究组的治疗时间(11.56±5.49)d少于对照组的(18.08±8.57)d,P=0.000,研究组的复发率8.00%低于对照组的36.67%,研究组和对照组均能够有效的降低患者血超敏C反应蛋白含量、尿白细胞评分、尿红细胞评分和尿蛋白评分,治疗前后的P值均小于0.05,但是研究组治疗后的以上四项指标的评分值显著低于对照组治疗后的评分值,P分别为0.000、0.008、0.024和0.001,研究组和对照组对ALT和AST的变化无差别,研究组显著降低了患者的BUN和Cr值,P值均为0.000,但是对照组也降低患者的BUN和Cr值,但是P值分别为0.383和0.012,同时研究组治疗后和对照组治疗后比较,BUN和Cr的P值分别为0.011和0.006。结论:益肾通淋排石汤能够有效的治疗肾石病,缩短结石的治疗时间,有效地保护肾功能,抑制炎症反应,降低结石的复发率,临床疗效肯定,临床用药安全。

Objective:To observe the clinical effect and inflammatory reaction of Yishen Tonglin Paishi Decoction combined with kinesitherapy in the treatment of nephrolithiasis,thus to provide a new thought and method for clinical treatment of nephrolithiasis.Methods:According to the diagnostic criteria,80 cases of nephrolithiasis were randomly divided into the control group(n=30)and the study group(n=50).The control group was treated with Compound Jinqiancao Granules and Tamsulosin Hydrochloride Sustained Release Capsules,2 bags(6 g)of Compound Jinqiancao Granules each time,three times a day,900 ml of water in total,and 1 capsule(0.2 g)of Tamsulosin Hydrochloride Sustained Release Capsules every day.The study group was treated with Yishen Tonglin Paishi Decoction and Tamsulosin Hydrochloride Sustained Release Capsules,Yishen Tonglin Paishi Decoction once a day,with a total of 900 ml water decoction,were taken orally three times,Tamsulosin Hydrochloride Sustained Release Capsules was taken one capsule(0.2 g)every day until the stone was discharged.Before and after the treatment,liver function,kidney function and hypersensitive C-reactive protein were checked,and urinalysis,clinical symptoms and other examinations and evaluations were reviewed respectively.The urinary system ultra sound was reviewed once every week,in the consciousness of stone discharge,urinary ultrasound was double checked.Results:The total clinical effective rate of the study group was 96%(48/50),which was significantly higher than 70%(21/30)of the control group(P=0.001).The treatment time of the study group was(11.56±5.49)days,which was less than(18.08±8.57)days of the control group(P=0.000).The recurrence rate of the study group was 8.00%,which was lower than 36.67%of the control group.Both the study group and the control group were able to effectively decrease the content of blood hypersensitive C-reactive protein,urinary leukocyte score,urinary RBC score and the urine protein score after the treatment(P<0.05);of which the decreases in the study group were more significant(P=0.000,P=0.008,P=0.024,P=0.001).There were no statistical differences in ALT and AST between the study group and the control group(P>0.05).The study group significantly reduced the values of BUN and Cr(P=0.000),and the control group also reduced the values of BUN and Cr after the treatment(P=0.383,P=0.012);of which the improvements in the study group were more significant(P=0.011,P=0.006).Conclusion:Yishen Tonglin Paishi Decoction can effectively treat nephrolithiasis,it can shorten the treatment time of nephrolithiasis,effectively protect renal function,inhibit inflammatory reaction,reduce the recurrence rate of nephrolithiasis,with definite clinical effect and safe clinical medication.