葛根素治疗草酸钙结石80例临床观察
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摘要
目的研究葛根素治疗草酸钙结石的临床疗效及其作用机制。方法选取收治的160例草酸钙结石患者,随机分为观察组(葛根素+枸橼酸氢钾钠组)和对照组(枸橼酸氢钾钠组),各80例,治疗4周,随访3个月。评估患者治疗前和治疗4周后结石排净率、尿草酸含量、尿钙含量、尿骨桥蛋白表达及复发情况。结果治疗4周后,观察组结石排净率明显高于对照组(P<0.05);治疗4周后,观察组尿草酸含量、尿钙含量显著低于对照组,尿骨桥蛋白的表达明显高于对照组(P<0.05);观察组3个月内复发率明显低于对照组(P<0.05)。结论葛根素具有清除草酸钙结石,降低草酸钙结石复发率的功效,其作用机制可能与降低尿草酸、尿钙的含量及提高尿骨桥蛋白的表达有关。
Objective To study the clinical effect of puerarin in treating calcium oxalate stone and its mechanism of action.Methods160 cases with calcium oxalate stone who received by the hospital were randomly divided into 2 groups:observation group(puerarin+potassium sodium hydrogen citrate)and control group(potassium sodium hydrogen citrate),80 cases for each group.Both groups were treated for 4 weeks and followed up for 3 months.These patients were assessed in terms of stone clearance rate,oxalic acid level in urine,calcium level in urine,ostoepontin expression in urine and reoccurrence before and after 4 weeks of treatment.Results 4 weeks after treatment,the stone clearance rate of the observation group was much higher than that of the control group(P<0.05);4 weeks after treatment,the levels of oxalic acid and calcium in urine were much lower than those of the control group,while the ostoepontin expression of the observation group was significantly higher than that of the control group(P<0.05);Within 3 months,the reoccurrence rate of the observation group was much lower than that of the control group(P<0.05).Conclusion Puerarin has the functions of clearing calcium oxalate stone and reducing its reoccurrence.Its mechanism of action might be associated with the decrease of oxalic acid and calcium levels in urine and the increase of ostoepontin expression.
Objective To study the clinical effect of puerarin in treating calcium oxalate stone and its mechanism of action.Methods160 cases with calcium oxalate stone who received by the hospital were randomly divided into 2 groups:observation group(puerarin+potassium sodium hydrogen citrate)and control group(potassium sodium hydrogen citrate),80 cases for each group.Both groups were treated for 4 weeks and followed up for 3 months.These patients were assessed in terms of stone clearance rate,oxalic acid level in urine,calcium level in urine,ostoepontin expression in urine and reoccurrence before and after 4 weeks of treatment.Results 4 weeks after treatment,the stone clearance rate of the observation group was much higher than that of the control group(P<0.05);4 weeks after treatment,the levels of oxalic acid and calcium in urine were much lower than those of the control group,while the ostoepontin expression of the observation group was significantly higher than that of the control group(P<0.05);Within 3 months,the reoccurrence rate of the observation group was much lower than that of the control group(P<0.05).Conclusion Puerarin has the functions of clearing calcium oxalate stone and reducing its reoccurrence.Its mechanism of action might be associated with the decrease of oxalic acid and calcium levels in urine and the increase of ostoepontin expression.
引文
[1]谢伟基,林智郡,张夏兰,等.汕头地区在职人员肾结石发病率调查和病因分析[J].中国中西医结合肾病杂志,2014,15(11):965-967.
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[7]李延军,仝华,阳东荣,等.泌尿系结石2379例成分成因分析及代谢评估[J].实用医技杂志,2016,23(6):599-601.
[8]贺俊斌,林日辉,龙寒,等.草酸降解酶预防治疗草酸钙结石症的研究进展[J].广东医学,2015,36(7):1132-1136.
[9]陈雪花,吕建林,徐彦,等.高尿酸尿性含钙肾结石的代谢特征[J].江苏医药,2014,40(17):2031-2033.
[10]彭文标,张波,蔡海权,等.中山地区泌尿系结石患者235例结石成分及代谢分析[J].中国社区医师:医学专业,2012,14(5):130-131.
[11]张彬.尿路净合剂对特发性草酸钙结石患者尿液成石因素的影响[D].杭州:浙江中医药大学,2016.
[12]Walker V,Cook P,Griffin D G.Characterisation of risk factors for stones in hyperuricosuric men attending a stone clinic[J].Urolithiasis,2014,42(4):291-300.
[13]Kirejczyk J K,Porowski T,Filonowic R,et al.An association between kidney stone composition and urinary metabolic disturbances in children[J].J Pediatr Urol,2014,10(1):130-135.
[14]Hirose M,Tozawa K,Okada A,et al.Role of osteopontin in early phase of renal crystal formation:immunohistochemical and microstructural comparisons with osteopontin knock-out mice[J].Urol Res,2012,40(2):121-129.
[15]Tugcu V,Simsek A,Tarhan T,et al.OPN gene polymorphism(Ala250)and lower serum OPN levels are associated with urolithiasis[J].Ren Fail,2013,35(6):825-829.
[16]夏维.骨桥蛋白与特发性草酸钙结石的相关性研究[D].南昌:南昌大学,2014.
[17]段美婷,王婧,余婧,等.葛根素与阿片类药物联合应用对神经病理性痛的镇痛作用[J].西北药学杂志,2015,30(2):162-164.
[18]Chen F,Liu S,Wu J.Puerarin-induced immune hemolytic anemia[J].Int J Hematol,2013;98(1):112-113.
[19]罗敬华,曾晓艳,范桂香,等.葛根素对神经病理性痛模型小鼠的镇痛作用[J].西北药学杂志,2013,28(1):48-50.
[20]黄帧桧,柏松,陈莉,等.葛根素联用非洛地平对肾性高血压大鼠肾脏Apelin和APJ mRNA及蛋白表达的影响[J].中国中药杂志,2013,38(3):381-385.
[2]卢艳华.尿石症流行病学及体外冲击波碎石术的影响因素研究[D].武汉:华中科技大学,2011.
[3]Luo C F,Hou N,Tian J,et al.Metabolic profile of puerarin in rats after intragastric administration of puerarin solid lipid nanoparticles[J].Int J Nanomedicine,2013,8:933-940.
[4]那彦群,叶章群,孙颖浩,等.中国泌尿外科疾病诊断治疗指南手册[M].北京:人民卫生出版社,2014:267.
[5]陈璐,杨为民,涂忠,等.武汉市居民泌尿系结石成分分析——一项多中心研究[J].临床外科杂志,2017,25(9):712-714.
[6]晁亮,王军起,孙家庆,等.淮海地区338例患者肾结石成分分析[J].当代医学,2014,20(2):24-25.
[7]李延军,仝华,阳东荣,等.泌尿系结石2379例成分成因分析及代谢评估[J].实用医技杂志,2016,23(6):599-601.
[8]贺俊斌,林日辉,龙寒,等.草酸降解酶预防治疗草酸钙结石症的研究进展[J].广东医学,2015,36(7):1132-1136.
[9]陈雪花,吕建林,徐彦,等.高尿酸尿性含钙肾结石的代谢特征[J].江苏医药,2014,40(17):2031-2033.
[10]彭文标,张波,蔡海权,等.中山地区泌尿系结石患者235例结石成分及代谢分析[J].中国社区医师:医学专业,2012,14(5):130-131.
[11]张彬.尿路净合剂对特发性草酸钙结石患者尿液成石因素的影响[D].杭州:浙江中医药大学,2016.
[12]Walker V,Cook P,Griffin D G.Characterisation of risk factors for stones in hyperuricosuric men attending a stone clinic[J].Urolithiasis,2014,42(4):291-300.
[13]Kirejczyk J K,Porowski T,Filonowic R,et al.An association between kidney stone composition and urinary metabolic disturbances in children[J].J Pediatr Urol,2014,10(1):130-135.
[14]Hirose M,Tozawa K,Okada A,et al.Role of osteopontin in early phase of renal crystal formation:immunohistochemical and microstructural comparisons with osteopontin knock-out mice[J].Urol Res,2012,40(2):121-129.
[15]Tugcu V,Simsek A,Tarhan T,et al.OPN gene polymorphism(Ala250)and lower serum OPN levels are associated with urolithiasis[J].Ren Fail,2013,35(6):825-829.
[16]夏维.骨桥蛋白与特发性草酸钙结石的相关性研究[D].南昌:南昌大学,2014.
[17]段美婷,王婧,余婧,等.葛根素与阿片类药物联合应用对神经病理性痛的镇痛作用[J].西北药学杂志,2015,30(2):162-164.
[18]Chen F,Liu S,Wu J.Puerarin-induced immune hemolytic anemia[J].Int J Hematol,2013;98(1):112-113.
[19]罗敬华,曾晓艳,范桂香,等.葛根素对神经病理性痛模型小鼠的镇痛作用[J].西北药学杂志,2013,28(1):48-50.
[20]黄帧桧,柏松,陈莉,等.葛根素联用非洛地平对肾性高血压大鼠肾脏Apelin和APJ mRNA及蛋白表达的影响[J].中国中药杂志,2013,38(3):381-385.