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叶下珠对肾结石患者代谢参数的影响:疾病预防的新视角。

Effect of phyllanthus niruri on metabolic parameters of patients with kidney stone: a perspective for disease prevention.

机构信息

Divisão de Nutrição e Dietética, Instituto Central, Hospital das Clínicas, Universidade de São Paulo, Faculdade de Medicina. São Paulo, Brasil.

Divisão de Urologia, Hospital das Clínicas, Universidade de São Paulo, Faculdade de Medicina, São Paulo, Brasil.

出版信息

Int Braz J Urol. 2018 Jul-Aug;44(4):758-764. doi: 10.1590/S1677-5538.IBJU.2017.0521.

Abstract

UNLABELLED

Phyllanthus niruri (P.niruri) or stone breaker is a plant commonly used to reduce stone risk, however, clinical studies on this issue are lacking.

OBJECTIVE

To prospectively evaluate the effect of P. niruri on the urinary metabolic parameters of patients with urinary lithiasis.

MATERIALS AND METHODS

We studied 56 patients with kidney stones <10mm. Clinical, metabolic, and ultrasonography assessment was conducted before (baseline) the use of P. niruri infusion for 12-weeks (P. niruri) and after a 12-week (wash out) Statistical analysis included ANOVA for repeated measures and Tukey's/McNemar´s test for categorical variables. Significance was set at 5%.

RESULTS

Mean age was 44±9.2 and BMI was 27.2±4.4kg/m2. Thirty-six patients (64%) were women. There were no significant changes in all periods for anthropometric and several serum measurements, including total blood count, creatinine, uric acid, sodium, potassium, calcium, urine volume and pH; a significant increase in urinary potassium from 50.5±20.4 to 56.2±21.8 mg/24-hour (p=0.017); magnesium/creatinine ratio 58±22.5 to 69.1±28.6mg/ gCr24-hour (p=0.013) and potassium/creatinine ratio 39.3±15.1 to 51.3±34.7mg/gCr24- hour (p=0.008) from baseline to wash out. The kidney stones decreased from 3.2±2 to 2.0±2per patient (p<0.001). In hyperoxaluria patients, urinary oxalate reduced from 59.0±11.7 to 28.8±16.0mg/24-hour (p=0.0002), and in hyperuricosuria there was a decrease in urinary uric acid from 0.77±0.22 to 0.54±0.07mg/24-hour (p=0.0057).

CONCLUSIONS

P.niruri intake is safe and does not cause significant adverse effects on serum metabolic parameters. It increases urinary excretion of magnesium and potassium caused a significant decrease in urinary oxalate and uric acid in patients with hyperoxaluria and hyperuricosuria. The consumption of P.niruri contributed to the elimination of urinary calculi.

摘要

目的

前瞻性评估叶下珠(Phyllanthus niruri)对尿路结石患者尿代谢参数的影响。

材料与方法

我们研究了 56 例肾结石<10mm 的患者。在使用叶下珠输液 12 周(叶下珠)前后进行临床、代谢和超声评估,并进行了 12 周的洗脱期。统计分析包括重复测量方差分析和分类变量的 Tukey/McNemar 检验。显著性水平设为 5%。

结果

平均年龄为 44±9.2 岁,BMI 为 27.2±4.4kg/m2。36 例(64%)为女性。所有时期的人体测量和多项血清测量均无显著变化,包括全血细胞计数、肌酐、尿酸、钠、钾、钙、尿量和 pH 值;尿钾从 50.5±20.4 增加至 56.2±21.8mg/24 小时(p=0.017);镁/肌酐比值从 58±22.5 增加至 69.1±28.6mg/gCr24 小时(p=0.013)和钾/肌酐比值从 39.3±15.1 增加至 51.3±34.7mg/gCr24 小时(p=0.008),从基线到洗脱期。肾结石从每位患者 3.2±2 减少至 2.0±2(p<0.001)。在高草酸尿症患者中,尿草酸从 59.0±11.7 减少至 28.8±16.0mg/24 小时(p=0.0002),而在高尿酸尿症患者中,尿尿酸从 0.77±0.22 减少至 0.54±0.07mg/24 小时(p=0.0057)。

结论

叶下珠的摄入是安全的,不会对血清代谢参数产生显著的不良影响。它增加了镁和钾的尿排泄,导致高草酸尿症和高尿酸尿症患者的尿草酸和尿酸显著减少。叶下珠的摄入有助于消除尿路结石。

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