八正化石胶囊用于输尿管壁内段结石微创经皮肾输尿管镜碎石术术后的价值及对肾功能的影响

Application Value of BazhengHuashi CapsulesAfter Minimally Invasive Percutaneous Nephrolithotomyfor Ureteral Calculi and Their Effect on Renal Function

目的研究八正化石胶囊对输尿管壁内段结石患者微创经皮肾输尿管镜碎石术(Minimally Invasive Percutaneous Nephrolithotomy,MPCNL)术后肾功能的影响。方法选取2020年1月—2021年1月期间河北省沧州中西医结合医院心内二科收治的93例择期拟行MPCNL术治疗的输尿管壁内段结石患者为研究对象,最终入组90例,按照随机数表法分为观察组和对照组,每组各45例。所有患者均行MPCNL术治疗,对照组术后予以盐酸坦洛新缓释片辅助治疗,观察组在对照组基础上予以八正化石胶囊联合治疗。两组患者均持续治疗7 d后,观察比较两组患者结石排出时间、血尿持续时间及结石排净率。比较两组患者治疗前后腰痛、尿频尿急、血尿症候积分及肝肾功能指标[包括半胱氨酸蛋白酶抑制剂C(Cystatin C,Cys-C)、β_(2)-微球蛋白(β_(2)-Microglobulin,β_(2)-MG)、中性粒细胞明胶酶相关脂质运载蛋白(Neutrophil Gelatinase-Associated Lipocalin,NGAL)],观察两组患者术后并发症发生情况。结果观察组结石排净率95.56%(43/45)明显高于对照组82.22%(37/45),差异有统计学意义(P<0.05)。观察组结石排出时间、血尿持续时间均明显短于对照组,差异有统计学意义(P<0.05)。两组患者治疗后腰痛、尿频尿急、血尿症候积分均明显低于治疗前,差异有统计学意义(P<0.05),且观察组治疗后上述积分均明显低于对照组,差异有统计学意义(P<0.05)。治疗前两组患者Cys-C、NGAL、β_(2)-MG水平比较,差异无统计学意义(P>0.05)。两组治疗后Cys-C、NGAL、β_(2)-MG水平明显高于治疗前,差异有统计学意义(P<0.05),观察组治疗后Cys-C、NGAL、β_(2)-MG水平明显低于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率为20.00%(9/45),对照组并发症发生率为24.44%(11/45),两组患者并发症发生率比较,差异无统计学意义(P>0.05)。结论八正化石胶囊用于输尿管壁内段结石患者MPCNL术后,对促进残留结石排出、改善肾功能具有临床价值。

Objective To investigate the effect of BazhengHuashi Capsules on the renal function of patients with ureteral calculi after minimally invasive percutaneous nephrolithotomy(MPCNL).Methods Ninety-three patients with ureteral calculi scheduled for MPCNL in the Second Department of Cardiology,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicinefrom January 2020 to January 2021 were selected as the research objects.Ninety patients were finally enrolled and divided into an observation group(n=45)and a control group(n=45)according to a random number table.All patients were subject to MPCNL and treated withtamsulosin hydrochloride sustained-release tablets after the operation,and those in the observation group received additionalBazhengHuashi Capsules.Both groups were treated for 7 days.The stone excretion time,hematuria duration,and stone excretion rate were compared between the two groups.The scores of symptoms(low back pain,frequent micturition,urgent urination,and hematuria)and indexes of liver and kidneyfunctions[including cysteine protease inhibitor C(Cys-C),β_(2)-microglobulin(β_(2)-MG),and neutrophil gelatinase-associated lipocalin(NGAL)]were compared between the two groups before and after treatment.The postoperative complications of the two groups were observed.Results The stone excretion rate of the observation group was 95.56%(43/45),higher than 82.22%(37/45)of the control group(P<0.05).The stone excretion time and hematuria duration in the observation group were shorter than those in the control group(P<0.05).After treatment,the scores of low back pain,frequent micturition,urgent urination,and hematuria in the two groups were lower than those before treatment(P<0.05),and the observation group was lower than the control group(P<0.05).Before treatment,no significant difference in the levels of Cys-C,NGAL,andβ_(2)-MG was observed in the two groups(P>0.05).The levels of Cys-C,NGAL,andβ_(2)-MG in the two groups after treatment were higher than those before treatment(P<0.05),and the above levels in the observation group after treatment were lower than those in the control group(P<0.05).The incidence of postoperative complications was 20.00%(9/45)in the observation group,lower than 24.44%(11/45)in the control group(P>0.05).Conclusion BazhengHuashiCapsulesare of clinical value in promoting the excretion of residual stones and improving the renal function in patients with ureteral calculi after MPCNL.