通淋固本方联合气压弹道碎石术治疗对输尿管结石患者肾功能及外周血NGAL、氧化应激指标的影响

Effect of Treating Ureteral Calculi with Tonglin Guben Formula(通淋固本方)Combined with Pneumatic Lithotripsy on Renal Function,NGAL and Oxidative Stress Indexes in Peripheral Blood of Patients with Ureteral Calculi

目的探究通淋固本方与气压弹道碎石术联合治疗对输尿管结石患者肾功能及外周血中性粒细胞相关载脂蛋白(NGAL)、氧化应激指标的影响。方法选取2019年1月—2021年1月于德州市人民医院接受治疗的输尿管结石患者为研究对象,随机数表法分为对照组和观察组各57例,对照组给予气压弹道碎石治疗,观察组在对照组的基础上给予通淋固本方治疗。观察两组治疗后的临床疗效以及并发症的发生情况;分别测量两组患者术前和术后的的血清过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)、活性氧(ROS)等氧化应激水平和尿素氮(BUN)、血肌酐(SCr)水平;测定术后24 h、48 h及72 h的外周血NGAL含量。结果观察组患者结石清除率高于对照组,住院时间及血尿时间均短于对照组(P<0.05),两组患者并发症发生率比较差异无统计学意义(P>0.05),两组患者治疗后血清CAT与GSH-Px均有不同程度的降低,而血清MDA、ROS水平有显著的提高,但与治疗前比较差异无统计学意义(P>0.05),观察组患者BUN、SCr、胱抑素C(Cys-C)水平均低于治疗前及对照组(P<0.05),对照组治疗后BUN、SCr、Cys-C水平高于治疗前(P<0.05)。观察组24 h、48 h及72 h的血清NGAL水平均显著低于对照组(P<0.05)。结论对于输尿管结石患者在气压弹道碎石术的基础上给予通淋固本方治疗有利于改变患者的肾功能、加快排石速度,减少住院时间及血尿时间,且安全有效。

Objective To explore the effects of Tonglin Guben Formula(通淋固本方)combined with pneumatic lithotripsy on renal function,neutrophil gelatinase-associated lipocalin(NGAL)and oxidative stress indexes in patients with ureteral calculi.Methods Patients with ureteral calculi who received treatment in the hospital from January 2019 to January 2021 were selected as the research objects,and were divided into the control group and the observation group by random number table method,57 cases in each group.The control group was given pneumatic ballistic lithotripsy treatment,and the observation group was given Tonglin Guben Formula on the basis of the control group.The clinical efficacy and complications of the two groups were observed after treatment.Serum levels of CAT(catalase),GSH-Px(glutathione peroxidase),MDA(malonaldehyde),ROS(reactive oxygen species)and the levels of urea nitrogen(BUN)and serum creatinine(SCr)were measured before and after surgery in two groups.The NGAL levels in peripheral blood were measured at 24 h,48 h and 72 h after operation.Results The stone clearance rate in the observation group was higher than that in the control group,and the length of hospital stay and hemuria time were shorter than that in the control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).After treatment,the serum levels of CAT and GSH-Px in the two groups were decreased to varying degrees,while the serum levels of MDA and ROS were significantly increased.However,there was no statistical significance compared with those before treatment(P>0.05),and the levels of BUN,SCr and Cystatin C(CYS-C)in the observation group were lower than those before treatment and those of the control group(P<0.05),while the levels of BUN,SCr and CYS-C in the control group were higher than those before treatment(P<0.05).The serum NGAL level in the observation group was significantly lower than that in the control group at 24 h,48 h and 72 h after operation(P<0.05).Conclusion For ureteral calculi patients,on the basis of pneumatic ballistic lithotripsy,Tonglin Guben Formula is safe and effective,which is beneficial to change the renal function of patients,accelerate the stone removal rate and reduce the length of hospital stay and hematuria time.