补肾导浊汤对输尿管镜钬激光碎石术后留置内支架管的影响及Cys C、β2-MG、NAG变化的研究  

Effect of Bushen Daozhuo Decoction on Patients with Indwelling Stent After Ureteroscopic Holmium Laser Lithotripsy and Changes of Cys C,β-MG,NAG

作　　者：胡青林[1] 马文军[1] 刁磊[1] 采有金 王选峰 孙大林[2] 金保方[2] HU Qinglin;MA Wenjun;DIAOLei;CAI Youjin;WANG Xuanfeng;SUN Dalin;JIN Baofang(Department of Urology,Chuzhou Hospital of Integrated Traditional Chinese and Western Medicine,Anhui University of Traditional Chinese Medicine,Chuzhou 239000,Anhui,China;Andrology Department of Integrative Medicine,Zhongda Hospital,School of Medicine,Southeast University,Nanjing 210009,Jiangsu,China)

机构地区：[1]安徽中医药大学附属滁州中西医结合医院泌尿外科,安徽滁州239000 [2]东南大学附属中大医院中西医结合男科,江苏南京210009

出　　处：《中华中医药学刊》2020年第9期21-24,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(81774315)。

摘　　要：目的观察和研究补肾导浊汤对输尿管镜钬激光碎石术后留置内支架管患者的影响及胱抑素C(Cys C),β2-微球蛋白(β2-MG),尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)水平变化。方法选取2018年1月—2018年12月医院输尿管镜钬激光碎石术后留置内支架管患者130例,采用单双号法将其分为观察组和对照组,每组65例。对照组加用热淋清颗粒、观察组加用补肾导浊汤,观察和比较两组患者用药前后肾功能[尿素氮(BUN)、血肌酐(Scr)]、Cys C、β2-MG、NAG水平及术后排石率、留置内支架管不适感及相关并发症等。结果观察组住院时间(3.10±0.57)d,对照组(5.44±1.02)d,二者比较差异有统计学意义(t=4.204,P=0.045<0.05);观察组结石完全排出率60.00%(39/65)、排出有效率92.31%(60/65)均高于对照组(P<0.05)。观察组术后并发症12例(18.46%)低于对照组(P<0.05)。用药后,两组患者BUN、Scr水平均较本组用药前下降,但仅有观察组差异有统计学意义(P<0.05);且用药后,观察组BUN、Scr水平低于对照组(P<0.05)。用药后,两组患者血清Cys C、β2-MG和尿NAG水平均较本组用药前下降(P<0.05);且用药后,观察组血清Cys C、β2-MG和尿NAG水平均低于对照组(P<0.05)。结论补肾导浊汤能促进输尿管镜钬激光碎石术留置内支架管患者结石排出、保护肾功能,对降低碎石与内支架管留置风险意义巨大;值得进一步增加样本数量、纳入更多指标加以观察和比较,为补肾导浊汤在输尿管镜钬激光碎石术后留置内支架管中的使用价值提供更加完善的理论依据。Objective To observe and study the effect of Bushen Daozhuo Decoction on patients with indwelling stent after ureteroscopic holmium laser lithotripsy and changes of cystatin C(CysC),β2-microglobulin(β2-MG)and urine N-acetyl-β-D-glucosaminidase(NAG).Methods A total of 130 patients with indwelling stents after ureteroscopic holmium laser lithotripsy from January 2018 to December 2018 were enrolled.The patients were divided into observation group and control group(65 cases in each)by single and double numbers.The control group was treated with Relinqing Granules,and the observation group was given Self-made Bushen Daozhuo Decoction.The renal function[urea nitrogen(BUN),serum creatinine(Scr)]of the two groups before and after treatment was observed and compared.The levels of Cys C,β2-MG and NAG,postoperative stone removal rate,indwelling internal stent tube discomfort and related complications were observed and compared.Results The hospitalization time[(3.10±0.57)d]in the observation group was statistically significant compared with that of the control group[(5.44±1.02)d](t=4.204,P=0.045<0.05).The complete discharge rate of stones in the observation group was 60.00%(39/65).The discharge efficiency was 92.31%(60/65),higher than that of the control group(P<0.05).Postoperative complications in the observation group[12 cases(18.46%)]were lower than those in the control group(P<0.05).After medication,the levels of BUN and Scr of the two groups were lower than those before treatment,but there was only significant difference in the observation group before and after treatment(P<0.05).And after medication,the levels of BUN and Scr of the observation group were lower than those of the control group(P<0.05).After treatment,the levels of serum Cys C,β2-MG and urinary NAG in the two groups were lower than those before treatment(P<0.05),and those in the observation group were lower than those in the control group(P<0.05).Conclusion Bushen Daozhuo Decoction can promote stone excretion and protect renal function in patients

关 键 词：补肾导浊汤 输尿管镜钬激光碎石术 留置内支架管 效果 胱抑素 β2-微球蛋白 尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG) 

分 类 号：R269.934[医药卫生—中西医结合]