通淋排石汤联合输尿管软镜碎石术治疗下焦湿热证肾结石效果及对机体氧化应激、尿液炎症上皮细胞因子的影响  

Effect of Tonglin Paishi Decoction combined withretrograde intrarenal stone surgery in the treatment of kidney stones with damp-heat in lower-Jiao and its effect on oxidative stress and urinary inflammatory epithelial cell factors

作　　者：张涵 谈晓华 鲍加玉 陈宇峰 李伟 ZHANG Han;TAN Xiaohua;BAO Jiayu(Yixing Traditional Chinese Medicine Hospital,Yixing Jiangsu 214200,China)

机构地区：[1]宜兴市中医医院,江苏宜兴214200

出　　处：《四川中医》2024年第2期164-167,共4页Journal of Sichuan of Traditional Chinese Medicine

摘　　要：目的:探讨通淋排石汤联合输尿管软镜碎石术(RIRS)治疗下焦湿热证肾结石效果及对机体氧化应激、尿液炎症上皮细胞因子的影响。方法:选取2017年2月~2022年6月医院收治的下焦湿热证肾结石患者103例进行回顾性研究,依据治疗方案不同划分为联合组(n=52)、对照组(n=51)。两组RIRS术后均给予常规处理,对照组再予以坦索罗辛口服,联合组在对照组基础上联合通淋排石汤治疗,两组均治疗2周。比较两组疗效、结石排净率与治疗前后中医证候积分、尿液炎症上皮细胞因子、血清氧化应激指标、肾功能指标水平;统计治疗期间不良反应情况。结果:治疗2周后联合组疗效、结石排净率分别为96.15%、71.15%,均高于对照组82.35%、50.98%(P<0.05);治疗2周后联合组中医证候积分、尿液单核细胞趋化蛋白~1(MCP-1)、高迁移率族蛋白1(HMGB1)水平均低于对照组,尿液三叶因子1(TFF1)水平高于对照组(P<0.05);治疗2周后联合组血清丙二醛(MDA)水平低于对照组,超氧化物歧化酶(SOD)水平高于对照组(P<0.05);治疗2周后联合组血清血肌酐(SCr)、尿素氮(BUN)、胱抑素C(Cys-C)水平均较对照组低(P<0.05);联合组不良反应与对照组差异无统计学意义(P>0.05)。结论:应用通淋排石汤联合RIRS治疗下焦湿热证肾结石可抑制氧化应激反应与尿液炎症上皮细胞因子水平,减轻肾功能损伤,显著提升疗效,且用药安全。Objective:To investigate the effect of Tonglin Paishi Decoction combined withretrograde intrarenal stone surgery(RIRS)in the treatment of kidney stones with damp-heat in lower-Jiao and its effect on oxidative stress and urinary inflammatory epithelial cell factors.Methods:A retrospective study was conducted on 103patients with kidney stones of damp-heat in lower-Jiao admitted to the hospital from February 2017to June 2022.They were divided into combined group(n=52)and control group(n=51)according to different treatment schemes.Both groups were given routine treatment after RIRS.The control group was given tamsulosin orally,and the combined group was treated with Tonglin Paishi Decoction on the basis of the control group.Both groups were treated for 2weeks.The efficacy,stone clearance rate,TCM syndrome score,urine inflammatory epithelial cell factor,serum oxidative stress index and renal function index before and after treatment were compared between the two groups.Adverse reactions during treatment were counted.Results:After 2weeks of treatment,the efficacy and stone clearance rate of the combined group were 96.15%and 71.15%,respectively,which were higher than those of the control group(82.35%,50.98%)(P<0.05).After 2weeks of treatment,the scores of TCM syndromes,the levels of urine monocyte chemoattractant protein-1(MCP-1)and high mobility group protein 1(HMGB1)in the combined group were lower than those in the control group,and the level of urine trefoil factor 1(TFF1)was higher than that in the control group(P<0.05).After 2weeks of treatment,the level of serum malondialdehyde(MDA)in the combined group was lower than that in the control group,and the level of superoxide dismutase(SOD)was higher than that in the control group(P<0.05).After 2weeks of treatment,the levels of serum creatinine(SCr),urea nitrogen(BUN)and cystatin C(Cys-C)in the combined group were lower than those in the control group(P<0.05).There was no significant difference in adverse reactions between the combined group and the control group(P>0.

关 键 词：通淋排石汤 输尿管软镜碎石术 下焦湿热证 肾结石 氧化应激 炎症上皮细胞因子 

分 类 号：R692.4[医药卫生—泌尿科学]