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中华腔镜泌尿外科杂志(电子版) ›› 2021, Vol. 15 ›› Issue (05) : 415 -418. doi: 10.3877/cma.j.issn.1674-3253.2021.05.012

临床研究

中药田七治疗体外冲击波碎石术后早期肾损伤的前瞻性随机对照研究
廖国龙1, 刘颖2, 唐嘉妮1, 熊海云1, 庞俊1, 江东根1,†()   
  1. 1. 518107　深圳，中山大学附属第七医院泌尿外科
    2. 518107　深圳，中山大学附属第七医院手术麻醉中心
  • 收稿日期:2020-04-20 出版日期:2021-10-01
  • 通信作者: 江东根
  • 基金资助:
    深圳市光明区卫健局中医药科研项目(GM2019020021)

A prospective randomized controlled study of panax notoginseng in the treatment of early renal injury after ESWL

Guolong Liao1, ying Liu2, Jiani Tang1, Haiyun Xiong1, Jun Pang1, Donggen Jiang1,†()   

  1. 1. Department of Urology, the Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen 518107, China
    2. Department of Surgery Anesthesia Center, the Seventh Affiliated Hospital of Sun Yat-Sen University, Shenzhen 518107, China
  • Received:2020-04-20 Published:2021-10-01
  • Corresponding author: Donggen Jiang
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廖国龙, 刘颖, 唐嘉妮, 熊海云, 庞俊, 江东根. 中药田七治疗体外冲击波碎石术后早期肾损伤的前瞻性随机对照研究[J]. 中华腔镜泌尿外科杂志(电子版), 2021, 15(05): 415-418.

Guolong Liao, ying Liu, Jiani Tang, Haiyun Xiong, Jun Pang, Donggen Jiang. A prospective randomized controlled study of panax notoginseng in the treatment of early renal injury after ESWL[J]. Chinese Journal of Endourology(Electronic Edition), 2021, 15(05): 415-418.

目的

评价中药田七对体外冲击波碎石术（ESWL）术后早期肾损伤的治疗作用。

方法

选取2018年10月至2019年10月我科收治的行ESWL肾结石患者为研究对象，随机数字表法分为田七组和对照组。对照组术后常规处理，田七组除常规处理外碎石后1 d开始服用田七粉（2 g bid×7 d）。通过检测尿液肾损伤分子（KIM-1）、中性粒细胞明胶酶相关载脂蛋白（NAGL）、半胱氨酸蛋白酶抑制剂C（Cys-C）和血清氧化物歧化酶（SOD）、丙二醛（MDA）含量评估两组肾损伤情况。

结果

共140例患者符合入组标准，两组各70例，术前基线资料一致。两组ESWL术后尿液KIM-1、NAGL及Cys-C含量均显著高于术前，且田七组ESWL术后尿液KIM-1、NAGL及Cys-C含量均显著低于对照组。ESWL术后两组血清SOD含量均显著降低，MDA均显著升高。组间比较，术后田七组SOD含量显著高于对照组，MDA含量显著低于对照组。

结论

中药田七可改善ESWL术所致早期肾损伤，值得在临床推广使用。

关键词: 田七, 中药, 体外冲击波, 肾损伤
Objective

To evaluate the effect of panax notoginseng in the treatment of early renal injury after ESWL.

Methods

From October 2018 to October 2019, all the patients receiving ESWL in our department were included and randomly divided into two groups, the panax notoginseng group and the control group. The paxnax notoginseng group were assigned panax notoginseng powder (2 g bid×7 d) 1 day after ESWL. The renal injury was evaluated by detecting the levels of urine kidney injury molecule-1 (KIM-1), Neutrophil gelatinase associated lipocalin (NAGL), Cystatinc (Cys-C) and serum superoxide dismutase (SOD), malondialdehyde (MDA).

Results

A total of 140 patients complied with the criteria were finally included, 70 cases in each group. The baseline characteristics of the two groups were the same. The levels of Urinary KIM-1, NAGL and Cys-C after ESWL in both groups were significantly higher than that preoperative, respectively. Meanwhile, the levels of those markers in panax notoginseng group were significantly lower than that in control group after ESWL. The serum levels of SOD decreased while the MDA levels increased in both groups significantly after ESWL. Besides, The SOD level after ESWL in panax notoginseng group was significantly higher than that in the control group, while the MDA level was significantly lower.

Conclusion

Panax notoginseng may treat early kidney injury caused by ESWL, which is worthy of clinical application.

Key words: Panax notoginseng, Traditional Chinese medicine, ESWL, Kidney injury
表1 ESWL后服用田七（田七组）和未服用（对照组）两组患者基线资料比较
组别 例数 年龄[岁，(±s)] BMI[kg/m2，(±s)] 结石大小[cm，(±s)] 病程[d，(±s)] 性别(例) 位置(例)
男 女 左 右
田七组 70 35.8±9.4 20.5±1.6 1.7±0.2 9.4±5.3 26 28 22 25
对照组 70 34.8±7.9 20.2±1.4 1.6±0.2 9.6±5.4 24 22 28 25
统计值   t=0.691 t=0.973 t=1.647 t=-0.331 χ2 =0.161 χ2 =0.361
P值   0.491 0.332 0.102 0.741 0.688 0.548
表2 ESWL前后患者尿液KIM-1、NAGL及Cys-C含量情况[ng/ml，(±s)]
组别 例数 KIM-1 NGAL Cys-C
ESWL前1 d ESWL后3 d ESWL后7 d ESWL前1 d ESWL后3 d ESWL后7 d ESWL前1 d ESWL后3 d ESWL后7 d
田七组 70 92.8±7.0 115.4±9.0 97.3±11.5 4.0±0.9 8.6±1.1 6.9±1.0 25.4±2.6 34.1±3.5 29.1±1.0
对照组 70 92.4±7.2 121.2±8.2 103.8±8.1 3.9±0.8 9.4±1.3 7.6±0.9 25.0±2.5 37.0±3.6 29.7±1.6
t值   0.290 -3.995 -3.830 0.359 -3.972 -4.236 0.819 -4.886 -2.803
P值   0.772 <0.001 <0.001 0.720 <0.001 <0.001 0.414 <0.001 00.006
表3 ESWL前后患者血清SOD及MDA含量情况（±s）
组别 例数 SOD（μmol/ml） MDA（μmol/L）
ESWL前1 d ESWL后3 d ESWL后7 d ESWL前1 d ESWL后3 d ESWL后7 d
田七组 70 108.6±3.9 93.3±2.7 101.9±2.2 5.3±0.6 6.7±0.7 8.0±0.5
对照组 70 110.0±4.8 91.8±3.2 099.6±3.0 5.2±0.5 6.9±0.7 8.3±0.5
t值   -1.761 3.001 5.025 1.186 -2.604 -3.686
P值   00.080 0.003 <0.0010 0.238 00.010 <0.001
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