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自拟中药组方化石汤预防上尿路结石术后复发的研究
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Abstract:
目的：探究中药组方化石汤对上尿路结石术后复发的预防作用。方法：随访潍坊市人民医院60例经治疗后结石全部排出的临床痊愈的上尿路结石患者，采用随机单盲对照的方法，验证自拟中药组方化石汤对上尿路结石患者预防的疗效；并应用大鼠草酸钙结石模型加以验证，探究其可能的作用机制。结果：临床研究中两组患者的基本情况的比较：年龄(44.23 ± 2.37岁vs 45.47 ± 2.94岁)、性别(70%:30% vs 63.3%:36.7%)的差异无统计学意义(P > 0.05)。结石复发率(3.3% vs 16.7%)的差异无统计学意义(P > 0.05)，尿液生化检测方面，尿PH值(6.4 ± 0.55 vs 5.9 ± 1.14)、尿UA (2.85 ± 0.76 mmol/L vs 3.31 ± 0.95 mmol/L)、尿Ox (0.43 ± 0.32 mmol/L vs 0.61 ± 0.38 mmol/L)的差异存在统计学意义(P < 0.05)。尿Ca (4.53 ± 1.06 mmol/L vs 5.24 ± 0.95 mmol/L)的差异则具有显著统计学意义(P < 0.01)。动物研究方面：大鼠尿液检测指标中，尿Ca：空白组与结石组(0.29 ± 0.06 mmol/L vs 0.39 ± 0.06 mmol/L)相比，差异存在显著统计学意义(P < 0.01)，化石汤组与结石组(0.33 ± 0.08 mmol/L vs 0.39 ± 0.06 mmol/L)相比，差异有统计学意义(P < 0.05)，但空白组与化石汤组(0.29 ± 0.06 mmol/L vs 0.33 ± 0.08 mmol/L)相比较，差异无统计学意义(P > 0.05)。尿Mg：空白组与结石组(0.86 ± 0.07 mmol/L vs 0.63 ± 0.06 mmol/L)比较，差异存在显著统计学意义(P < 0.01)，化石汤组与结石组(0.75 ± 0.12 mmol/L vs 0.63 ± 0.06 mmol/L)相比，差异有统计学意义(P < 0.05)，化石汤组与空白组(0.75 ± 0.12 mmol/L vs 0.86 ± 0.07 mmol/L)相比较，差异具有统计学意义(P < 0.05)。尿Ox：空白组与结石组(0.24 ± 0.03 mmol/24 h vs 0.39 ± 0.03 mmol/24 h)的差异存在显著统计学意义(P < 0.01)，化石汤组与结石组(0.31 ± 0.08 mmol/24 h vs 0.39 ± 0.03 mmol/24 h)相比较，差异具有显著统计学意义(P < 0.01)，空白组与化石汤组(0.24 ± 0.03 mmol/24 h vs 0.31 ± 0.08 mmol/24 h)相比差异有统计学意义(P < 0.05)。大鼠血液指标中，BUN：空白组、化石汤组与结石组 (9.03 ± 0.75 mmol/L、10.12 ± 1.17 mmol/L vs 13.25 ± 0.89 mmol/L)相比，差异存在显著统计学意义(P < 0.01)，空白组与化石汤组相比(9.03 ± 0.75 mmol/L vs 10.12 ± 1.17 mmol/L)差异具有统计学意义(P < 0.05)。血清Cr：空白组与化石汤组和结石组(26.13 ± 1.86 μmol/L、29.84 ± 2.43 μmol/L vs 34.46 ± 5.23 μmol/L)相比，差异存在显著统计学意义(P < 0.01)，空白组与化石汤组(26.13 ± 1.86 μmol/L vs 29.84 ± 2.43 μmol/L)相比较，差异具有统计学意义(P < 0.05)。空白组、结石组以及化石汤组的血清Ca (2.13 ± 0.27 mmol/L vs 2.21 ± 0.45 mmol/L vs 2.14 ± 0.38 mmol/L)、血清P (2.78 ± 0.41 mmol/L vs 2.96 ± 0.32 mmol/L vs 2.83 ± 0.14 mmol/L)浓度结果差异均无统计学意义(P > 0.05)。大鼠肾指数：结石组较空白组、化石汤组肾脏明显增大(1.04% ± 0.22% vs 0.93% ± 0.12%、0.97% ± 0.21%)，但差异均无统计学意义(P > 0.05)。大鼠肾组织Elisa检测指标结果：超氧化物歧化酶(SOD)活力结果：空白组、化石汤组与结石组(128.43 ± 23.76 U/mgprot、98.63 ± 19.36 U/mgprot vs 56.13 ± 12.14 U/mgprot)相比，差异具有显著统计学意义(P <
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