CAJ | 학술논문

目的：观察加味健脾益肾方对草酸钙肾结石患者经皮肾镜碎石取石或输尿管镜碎石取石术后尿骨桥蛋白(OPN)的影响，探讨加味健脾益肾方预防草酸钙肾结石的作用机制。方法将116例草酸钙肾结石术后患者随机分为试验组62例和对照组54例。试验组服用加味健脾益肾方，隔日1次；对照组口服枸橼酸氢钾钠颗粒，每日3次。观察2组患者服药前及服药2、4周时尿OPN、尿钙、尿草酸含量。结果治疗组治疗2、4周时患者尿OPN含量与治疗前比较显著上升(P＜0.05)，且与对照组比较差异有统计学意义(P＜0.05)，对照组治疗前后OPN含量比较差异无统计学意义(P＞0.05)。2组治疗后尿草酸、尿钙含量与治疗前比较，差异均无统计学意义(P＞0.05)。结论加味健脾益肾方可以升高尿中OPN水平，抑制草酸钙结石形成，从而预防草酸钙肾结石经皮肾镜碎石取石或输尿管镜碎石取石术后患者结石复发。
목적：관찰가미건비익신방대초산개신결석환자경피신경쇄석취석혹수뇨관경쇄석취석술후뇨골교단백(OPN)적영향，탐토가미건비익신방예방초산개신결석적작용궤제。방법장116례초산개신결석술후환자수궤분위시험조62례화대조조54례。시험조복용가미건비익신방，격일1차；대조조구복구연산경갑납과립，매일3차。관찰2조환자복약전급복약2、4주시뇨OPN、뇨개、뇨초산함량。결과치료조치료2、4주시환자뇨OPN함량여치료전비교현저상승(P＜0.05)，차여대조조비교차이유통계학의의(P＜0.05)，대조조치료전후OPN함량비교차이무통계학의의(P＞0.05)。2조치료후뇨초산、뇨개함량여치료전비교，차이균무통계학의의(P＞0.05)。결론가미건비익신방가이승고뇨중OPN수평，억제초산개결석형성，종이예방초산개신결석경피신경쇄석취석혹수뇨관경쇄석취석술후환자결석복발。
Objective To observe the effects of modified Jianpi Yishen Decoction on urinary osteopontin (OPN) in calcium oxalate nephrolithiasis patients after percutaneous nephrolithotomy (PCNL) or ureteroscope lithotomy (URL);To clarify the mechanism of modified Jianpi Yishen Decoction on the prevention of calcium oxalate kidney stones. Methods Totally 116 calcium oxalate nephrolithiasis patients were randomly divided into trial group (62 cases) and control group (54 cases). The trial group took modified Jianpi Yishen Decoction every other day, while the control group took potassium sodium hydrogen citrate granules three times a day. The concentrations of OPN, urinary calcium and urinary oxalic acid of the patients in the two groups were observed before treatment and 2 weeks and 4 weeks of treatment. Results The concentration of urinary OPN of 2 weeks and 4 weeks of the treatment in the trial group was significantly increased compared with before treatment (P<0.05), and the difference was statistically significant compared with the control group (P<0.05). The concentration of urinary OPN in the control group had no significant change after treatment (P>0.05). The differences in the concentrations of urinary calcium and urinary oxalic acid of the two groups between before and after treatment were not significant (P>0.05). Conclusion Modified Jianpi Yishen Decoction can effectively restrain the formation of the calcium oxalate stones by increasing the level of urinary OPN, which demonstrates effective prevention in the calcium oxalate nephrolithiasis patients after PCNL or URL.