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补肾消石中药对肾结石患者体外冲击波碎石所致肾损伤的保护作用

[The protective effect of Chinese herbs for supplementing shen to eliminate stone on renal injury induced by extracorporeal shockwave lithotripsy in patients with renal calculus].

作者信息

Sheng Bin-wu, Chen Xing-fa, He Da-lin

机构信息

The First Hospital Affiliated to Medical School of Xi'an Jiaotong University, Xi'an 710061.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2008 Aug;28(8):694-7.

Abstract

OBJECTIVE

To study the protective effect of Chinese herbs for supplementing Shen to eliminate stone on renal injury induced by extracorporeal shockwave lithotripsy (ESWL) in patients with renal calculus.

METHODS

Sixty patients with diagnosis of renal calculus confirmed by X-ray film or CT combined with abdominal B ultrasonography but showing no obvious symptoms, were randomized into the treated group and the control group. They all were scheduled to receive ESWL treatment. To the patients in the treated group, prescribed Chinese herbs was orally administered in the three days before and after ESWL, patients in the control group ate and drank as usual. Changes of blood levels of nitric oxide (NO), endothelin-1 (ET-1), superoxide dismutase (SOD), malondialdehyde (MDA), tumor necrosis factor alpha (TNF-alpha), urinary levels of N-acetyl-D-glucosaminidase (NAG), gamma-glutamyltransferase (gamma-GT) and beta 2-microglobulin (beta 2-MG) before and after ESWL were observed.

RESULTS

Blood levels of NO, ET-1, MDA and TNF-alpha significantly increased after ESWL in the control group, higher than the levels in the treated group (P < 0.05); and level of SOD decreased gradually in the control group reaching the valley 72 h after ESWL (P < 0.05), while in the treated group it was unchanged and remained at the level higher than that in the control group (P < 0.05). As for the urinary levels of NAG, gamma-GT and beta2-MG, after ESWL, they were all higher in the control group than those in the treated group, showing statistical significance (P <0. 05).

CONCLUSION

ESWL could induce renal damage in patients with renal calculus and the Chinese herbs for supplementing Shen to eliminate stone can reduce the renal tubular damage by way of anti-oxidation and regulating the renal hemorrheologic disorder and the release of inflammatory mediators.

摘要

目的

探讨补肾排石中药对肾结石患者体外冲击波碎石术(ESWL)所致肾损伤的保护作用。

方法

选取60例经X线片或CT联合腹部B超确诊为肾结石但无明显症状的患者,随机分为治疗组和对照组。两组均行ESWL治疗。治疗组患者在ESWL治疗前后3天口服中药,对照组患者饮食如常。观察ESWL治疗前后两组患者血中一氧化氮(NO)、内皮素-1(ET-1)、超氧化物歧化酶(SOD)、丙二醛(MDA)、肿瘤坏死因子α(TNF-α)水平,以及尿中N-乙酰-D-氨基葡萄糖苷酶(NAG)、γ-谷氨酰转移酶(γ-GT)和β2-微球蛋白(β2-MG)水平的变化。

结果

对照组ESWL治疗后血中NO、ET-1、MDA和TNF-α水平显著升高,高于治疗组(P<0.05);对照组SOD水平逐渐下降,ESWL治疗后72小时降至谷底(P<0.05),而治疗组SOD水平无变化,且高于对照组(P<0.05)。ESWL治疗后,对照组尿中NAG、γ-GT和β2-MG水平均高于治疗组,差异有统计学意义(P<0.05)。

结论

ESWL可导致肾结石患者肾损伤,补肾排石中药可通过抗氧化、调节肾血流紊乱及炎症介质释放减轻肾小管损伤。

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