八正散加味结合甲磺酸左氧氟沙星对肾结石体外冲击波碎石术后肾组织损伤的影响  

Effect of Bazheng powder combined with levofloxacin on renal tissue injure of patients with renal extracorporeal shockwave lithotripsy

作　　者：相聪坤[1] 

机构地区：[1]河北省中医院药学部,石家庄050011

出　　处：《国际中医中药杂志》2016年第3期216-219,共4页International Journal of Traditional Chinese Medicine

基　　金：河北省科技计划项目（12277794）

摘　　要：目的探讨八正散加味结合甲磺酸左氧氟沙星对肾结石体外冲击波碎石（extracorporeal shockwvave lithotripsy,ESWL）术后肾组织损伤的影响。方法将符合入选标准的100例肾结石患者按随机数字表法分为2组各50例，均行ESWL术。对照组ESWL术后嘱患者多饮水，适当运动以促进排石，在此基础上连续服用3d甲磺酸左氧氟沙星控制感染，3d后不再服任何药物。八正散组在对照组基础上服用八正散加味。均治疗15d，比较2组患者血清胱抑素C（cystatin C，CysC）与尿中性粒细胞明胶酶相关脂质运载蛋白（neutrophil gelatinase-associated lipocalin，NGAL）术后不同时点的变化，判定。肾组织损伤情况，评价临床疗效。结果八正散组总有效率为96．0％（48／50），对照组为60．0％（30／50），2组比较差异有统计学意义舒=16．842，P〈0．01）。术后15d，八正散组血清CysC[（0．97±0．10）mg／L比（1．13±0．25）meCL，t=4．202]和尿NGAL[（4．04±1．32）μg／L比（6．91±2．96）μg／L，t=6．262]水平；对照组血清CysC[（0．95±0．12）mg／L比（1．09±0．20）mg／L，t=4．244]和尿NGAL[（4．66±1．57）ug／L比（7．19±1．81）μg/L，t=7．762]水平均明显低于同组术后24h（P〈0．01），且八正散组术后尿NGAL水平明显低于对照组（t=2．137，P=0．035）。结论八正散辅助ESWL可加速肾结石排出及ESWL术后肾损伤的修复，同时推测2次碎石术间最好间隔2周。Objective To evaluate the effect of Bazheng powder combined with levofloxacin on renal tissue injure of patients after renal extracorporeal shockwave lithotripsy. Methods A total of 100 patients with renal calculus were randomly divided into a Bazheng powder group （50 patients） and a control group （50 patients）. ESWL was used in the 2 groups. After ESWL operation, patients in the control group were administered with large amount of drinking water and appropriate exercises to promote stone removal. And on this basis, ethanesulfonic acid levofloxacin was administered for successive 3 days. The Bazheng powder group was additionally added Bazheng powder on the basis of the control group for 15 days. 15 days later, C Cys and NGAL and therapeutic effect in both groups were evaluated. Results The total effective rate of the Bazheng powder group was significantly better than the control group （96% vs. 60%, χ2=16.842, P〈0.01）. The serum Cys C （0.97 ±0.10 mg/L vs. 1.13 ± 0.25 mg/L, t=4.202） and NGAL（4.04 ±1.32 g/L vs. 6.91 ± 2.96 g/L, t=-6.262） in the Bazheng powder group decreased, the serum Cys C （0.95 ±0.12 mg/L vs. 1.09 ±0.20 mg/L, t=4.244） and NGAL（4.66 ±1.57 g/L vs. 7.19 ± 1.81 g/L, t=7.762） levels in the control group were also decreased after thetreatment （P〈0.01）, and Bazheng powde group of postoperative urinary NGAL level was significantly lower than the control group （t=2.137, P=0.035）. Conclusion Bazheng powder combined with ESWL can accelerate renal calculi removal and repair renal injury after ESWL operation. We also speculate that the best interval is 2 weeks for two lithoclasty operation.

关 键 词：肾结石 碎石术 冲击波 肾损伤 八正散 中西医结合疗法 

分 类 号：R699[医药卫生—泌尿科学]