The Study On Treating Upper Urinary Tract Stones With XZHS Decoction In Clinical Efficacy And Mechanism

Objective: Through clinical observation and animal experiments,the effect of XZHS Decoction on the dissolution and removal of stones in upper urinary tract stones is analyzed to clarify the clinical efficacy and lay a foundation for further clinical application and in-depth study.Method: 1.Clinical rearch: This research used randomized parallel control method to randomly divide 91 patients,with upper urinary calculi,kidney deficiency or dampness and dampness syndrome,into 45 cases of XZHS Decoction group(treatment group)and 46 cases of the Paishi Granule group(control group).The treatment group was treated with XZHS Decoction,and the control group was treated with Paishi Granules.Take 8 weeks as a course of treatment.The two groups were observed before and after treatment,curative effect index change including clinical symptoms,size of cross-sectional area and location of the stone,etc,and safety indicator change such as liver function,renal function,urine routine,and electrocardiogram.2.Experimental rearch:(1)Forty SD rats were randomly divided into four groups: blank group,model group,Paishi Granule drug group and XZHS Decoction drug group,with 10 rats in each group.Use 0.75% ethylene glycol with 1% ammonium chloride to replicate the model of upper urinary calcium oxalate stone of rats.The experimental period was 4 weeks.The body weight of the animals was weighed weekly,and the general condition of the rats was observed.At the end of the experiment,the urine p H,urinary acid,urinary calcium,urinary NAG,RBP and blood BUN and Cr were measured at 24h;the pathological changes of rat kidney tissue sections were observed.(2)Fifteen SD rats were randomly divided into three groups: blank group,Paishi Granule group and XZHS Decoction group,with 5 rats in each group.After the rats were anesthetized,the ureter was connected to the physiological recorder with an insulated electrode,the blank group was pouring belly with 3 ml of normal saline,the group of Paishi Granule was pouring belly with 3 ml of Paishi Granule,and the XZHS Decoction group was pouring belly with 3 ml of XZHS Decoction.The frequency of rat ureteral peristalsis was recorded by physiological recorder.After 1 hour of observation,the changes of ureteral peristaltic waves were recorded every 10 minutes after medication or feeding water of each group of animals.Result: 1.Clinical part:(1)The average cross-sectional area of the stones in the treatment group was reduced by(0.13�0.36)cm2,which was statistically significant,P <0.05,compared with the control group(0.09�0.36)cm2,indicating that the treatment group had better effect on reducing the cross-sectional area of stones than the control group.(2)The total effective rate was 75.6% in the treatment group and 69.6% in the control group.There was a statistically significant difference between the two groups(P <0.05),indicating that the therapeutic effect of the treatment group was better than that of the control group.(3)The total effective rate(85.7%)of upper urinary calculi in the treatment group was statistically significant,P<0.05,compared with the total effective rate(68.8%)of the control group.Comparison of the efficacy of each syndrome in the treatment group,the total effective rate(85.7%)of upper urinary tract stones of dampness-heat pouring downward was higher than that of kidney failing to receive qi(76.9%)and syndrome of intermingled deficiency and excess(50.0%).P <0.05 was statistically significant.The treatment group has a good therapeutic effect on the upper urinary calculi of lower coke heat type and is superior to the control group.(4)In the improvement of "waist and abdominal cramps,lumbar abdominal pain,urinary pain",the treatment group was better than the control group(P <0.05).2.Experimental part:(1)The diuresis,excretion of oxalic acid,and the ability to inhibit the formation of calcium oxalate crystals in the urine were better in the treatment group than in the control group.(2)Compared with the control group,the ureteral peristalsis frequency of the treatment group of rats was more obviousConclusion: 1.XZHS Decoction has a significant effect on reducing the cross-sectional area of stones;the comprehensive curative effect of patients after treatment is better than that of Paishi Granule group;XZHS Decoction has better curative effect on upper urinary calculi of dampness-heat pouring downward;XZHS Decoction can improve the clinical symptoms of "waist and abdominal cramps,lumbar abdominal pain,urinary pain".It is very worthy of further promotion and application in clinical treatment of urinary calculi.2.Through the influence of urine metabolism,XZHS Decoction can increase the urine output,reduce the risk factors of stone formation,reduce the concentration of oxalic acid in urine,which reduce the abnormal rate of urine metabolism of stone disease.XZHS Decoction is ability to reduce the formation of calcium oxalate crystals and reduce kidney damage.