滋肾通淋排石汤辅助治疗在肾结石术后患者中的应用及机制

Application and Mechanism of Adjuvant Therapy of Zishen Tonglin Paishi Decoction(滋肾通淋排石汤) in Patients after Renal Calculi Surgery

目的探讨滋肾通淋排石汤辅助治疗在肾结石术后患者中的应用及机制。方法选取该院2021年2月—2022年2月收治的肾结石术后患者202例,按照随机数字表法分为对照组和观察组各101例。两组患者均给予常规的输尿管软镜碎石术进行治疗,术后给予对照组患者常规体位排石治疗,观察组患者在对照组基础上给予滋肾通淋排石汤联合进行治疗,两组均治疗2周。比较两组治疗后的临床疗效,治疗前后的中医证候积分、肾功能、炎性应激指标水平,不同时点的视觉模拟评分(visual analog scale,VAS)。结果治疗后观察组临床总有效率高于对照组;与治疗前比较,治疗后两组尿频、腰痛、少腹急满、血尿、淋漓不爽评分及血清β2微球蛋白(β2 microglobulin,β2-MG)、肌酐(serum creatinine,Scr)、中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase-associated lipocalin,NGAL)、尿素氮(blood urea nitrogen,BUN)、白细胞介素-10(interleukin-10,IL-10)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、高迁移率族蛋白-1(high mobility group box-1 protein,HMGB1)、单核细胞趋化蛋白-1(monocyte chemoattractant protein-1,MCP-1)水平均降低,观察组低于对照组;与治疗前比较,治疗3 d~2周后两组VAS评分呈逐渐降低趋势,观察组低于对照组,差异均有统计学意义(均P<0.05)。结论滋肾通淋排石汤应用于肾结石术后患者,可以减轻疼痛,改善肾功能,抑制炎症反应和应激反应,提升临床治疗效果。

Objective To explore the application and mechanism of Zishen Tonglin Paishi Decoction(滋肾通淋排石汤)adjuvant therapy in patients after renal calculi surgery.Methods A total of 202 patients with postoperative renal calculi treated in the hospital from February 2021 to February 2022 were selected and divided into the control group and the observation group according to the random number table method,with 101 cases in each.Both groups were given conventional flexible ureteroscopic lithotripsy for treatment.The control group was given conventional postural stone expulsion after operation and the observation group was given Zishen Tonglin Paishi Decoction on the basis of the control group.Both groups were treated for 2 weeks.The clinical efficacy after treatment,TCM syndrome scores,renal function,inflammatory stress index levels before and after treatment and visual analog scale(VAS)scores at different time points were compared between the two groups.Results After treatment,the total clinical effective rate of the observation group was higher than that of the control group.Compared with those before treatment,the scores of frequent urination,low back pain,low abdominal fullness,hematuria,dripping discomfort,serumβ2-microglobulin(β2-MG),the levels of serum creatinine(Scr),neutrophil gelatinase-associated lipocalin(NGAL),blood urea nitrogen(BUN),interleukin-10(IL-10),high-sensitivity C-reactive protein(hs-CRP),high mobility group box-1(HMGB1)and monocyte chemotactic protein-1(MCP-1)decreased,and those of the observation group were lower than those of the control group.Compared with those before treatment,the VAS scores of the two groups gradually decreased from 3 days to 2 weeks after treatment,and the score of the observation group was lower than that of the control group with statistical significance(all P<0.05).Conclusion Zishen Tonglin Paishi Decoction can relieve pain,improve renal function,inhibit inflammatory response and stress response and improve clinical treatment effect in patients after renal calculi surgery.