Sheng B et al, 2010: The protective effects of the traditional Chinese herbs against renal damage induced by extracorporeal shock wave lithotripsy: a clinical study
Sheng B, He D, Zhao J, Chen X, Nan X
Department of Geriatric Surgery, The Afflicted First Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, 710061, Shaanxi, China
Extracorporeal shock wave lithotripsy (ESWL)-induced renal damage can occur as a result of multiple mechanisms. We have reported previously that Astragalus membranaceus, Salvia miltiorrhiza, a decoction of six drugs containing rhizoma Rehmanniae preparata and supplements of a few traditional Chinese medicinal herbs for invigorating the kidney and excreting calculus, have a protective effect on renal injury induced by high-energy shock waves (HESW) in rabbits. In this clinical study we further investigate the protective effects of these traditional Chinese herbs against renal damage induced by ESWL. Sixty consenting patients with renal calculus who underwent ESWL treatment were included and randomly assigned to the medication group or control group. Post-ESWL plasma nitric oxide (NO), endothelin-1 (ET-1), malondialdehyde (MDA), and serum tumor necrosis factor α (TNF-α) increased significantly in the controls (P < 0.05), while in the medication group, slightly but not significantly elevated levels of plasma ET-1, NO, and serum TNF-α were found. The difference between the groups was statistically significant (P < 0.05). The levels of superoxide dismutase (SOD) decreased gradually in the controls, reaching a trough 72 h after ESWL (P < 0.05), while in the treated group it was unchanged, and remained at a level higher versus the controls (P < 0.05). Plasma NO peaked twice by 72 h and at 1 week in the controls (P < 0.05). Urinary enzymes and β(2)-microglobulin increased significantly and peaked by 24 h and immediately after ESWL (P < 0.05). These values were greater in the controls, and the difference was statistically significant (P < 0.05). This study demonstrates that the preparations of traditional Chinese medicines for invigorating the kidney and excreting calculus can reduce renal tubular damage induced by ESWL, and can shorten the recovery time of renal tubules in human subjects.
Urol Res. 2011 Apr;39(2):89-97. doi: 10.1007/s00240-010-0286-1. Epub 2010 Jul 6
PMID: 20607528 [PubMed - in process]
In view of the potential risk of tissue injury that might occur when shock waves hit the kidney, it is desirable to have access to tools that might counteract such effects. This seems to be particularly important for patients who need repeated treatment sessions.
This article is an interesting report on the positive effects of traditional Chinese herbs. The authors have measured a number of blood and urine variables that reflect tissue injury, with particular focus on the effects of free oxygen radicals. Significant effects were recorded and the results are indeed notable. Although Chinese herb preparations are not easily available world-wide a further exploration of this field seems highly important in order to develop efficient tissue protective agents.
The results also suggest an improved fragment clearance after ESWL in patients treated with herb preparations.