摘要
【目的】探讨尿石清合剂对湿热型草酸钙肾结石患者肾盂压力、尿液及炎症指标的影响。【方法】将60例湿热型草酸钙肾结石患者随机分为观察组和对照组,每组各30例。所有患者均给予微通道经皮肾镜取石术(m-PCNL)治疗,观察组术后给予抗感染和口服尿石清合剂治疗,对照组给予术后抗感染和等量的安慰剂(饮用水)治疗,疗程为4周(包括住院1周及出院后继续服用3周)。观察2组患者术前术后肾盂压力、尿液[尿量、尿骨桥蛋白(OPN)、尿钙(Ca2+)、尿草酸]及炎症指标[白细胞(WBC)、降钙素原(PCT)、C反应蛋白(CRP)]的变化情况。【结果】(1)观察组术后第1~5天各观察时点的肾盂压力均明显高于对照组(P<0.05)。(2)术后第1天,2组患者PCT、WBC、CRP水平均较术前明显升高(P<0.05),但观察组的水平均低于对照组(P<0.05);术后第3~7天,2组患者PCT、WBC、CRP水平均较术后第1天明显下降(P<0.05),且观察组的下降作用均明显优于对照组(P<0.05)。(3)术后第1~5天各观察时点,观察组的总尿量均明显高于术前(P<0.05),而对照组均略低于术前,但差异均无统计学意义(P>0.05);术后组间比较,观察组的总尿量均明显高于与对照组(P<0.05)。(4)术后第1~4周,2组患者尿OPN水平均明显高于术前,尿Ca2+、尿草酸水平均明显低于术前(P<0.05);组间比较,观察组术后第1~4周的尿OPN水平均明显高于对照组,尿Ca2+、尿草酸水平均明显低于对照组(P<0.05)。【结论】湿热型草酸钙肾结石患者术后服用尿石清合剂,可有效提高肾盂压力,增加尿量,促进结石排出,降低术后炎症指标;还可增加尿OPN含量,降低尿钙、尿草酸含量,从而起到有效预防结石复发的作用。
Objective To investigate the effect of Niaoshiqing Mixture on pyelic pressure,urine and inflammatory indicators in patients with damp-heat type of calcium oxalate renal caculi.Methods Sixty cases of damp-heat type of calcium oxalate renal caculi were randomized into observation group and control group,30 cases in each group.All of the patients were treated with micro-channel percutaneous nephrolithotripsy(m-PCNL).After the operation,the patients in the observation group were given anti-inflammation treatment and oral use of Niaoshiqing Mixture,and the patients in the control group were given anti-inflammation treatment and oral use of the same volume of placebo liquid(drinking water).The medication lasted a total of 4 weeks(consisting of one week of hospitalization and 3 weeks after discharging from the hospital).Before and after operation,pyelic pressure,urine parameters of urine volume,urinary osteopontin(OPN),urinary calcium(Ca2+)and urinary oxalic acid,and inflammatory indicators of white blood cell(WBC),procalcitonin(PCT)and C-reactive protein(CRP)in the two groups were measured.Results(1)The pyelic pressure in the observation group at various time points on postoperative day 1-5 was obviously higher than that in the control group(P<0.05).(2)On the first postoperative day,the levels of PCT,WBC and CRP in the two groups were higher than the preoperative levels(P<0.05),but the levels in the observation group were lower than those in the control group(P<0.05).On postoperative day 3-7,the levels of PCT,WBC and CRP in the two groups were decreased in comparison with those on the first postoperative day(P<0.05),and the decrease in the observation group was superior to that in the control group(P<0.05).(3)On postoperative day 1-5,the total urine volume of the observation group was larger than that before operation(P<0.05),while the urine volume of the control group was mildly decreased in comparison with that before operation,the difference being insignificant(P>0.05).The inter-group comparison showed that the tota
作者
黎志辉
黄新凯
钟喨
赖海标
曾建峰
LI Zhi-Hui;HUANG Xin-Kai;ZHONG Liang;LAI Hai-Biao;ZENG Jian-Feng(Dept.of Urology,Zhongshan Hospital Affiliated to Guangzhou University of Chinese Medicine,Zhongshan 528400 Guangdong,China;West Pearl River Bank Branch Center of General Base for Prevention and Treatment of Li thiasis with Integrated Chinese and Western Medicine,Zhongshan 528400 Guangdong,China;West Pearl River Bank Branch Center of South China Training Center for Raykeen Laser Precise Treatment,Zhongshan 528400 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2020年第1期35-40,共6页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
广东省中山市科技局科研项目（编号：2017B1045）
关键词
尿石清合剂
肾结石
肾盂压力
炎症指标
尿液
Niaoshiqing Mixture
renal caculi
pyelic pressure
inflammatory indicators
urine
