Prospective study of Wu-Ling-San Formula prophylaxis against recurrent calcium oxalate nephrolithiasis

• Main Authors: EUGENE LIN, 林育慶
• Other Authors: 陳汶吉
• Format: Others
• Language: en_US
• Published: 2008
• Online Access: http://ndltd.ncl.edu.tw/handle/46048553429474159184

碩士 === 中國醫藥大學 === 中西醫結合研究所 === 96 === Objectives: Wu-Ling-San formula has been proved to have a preventive effect on the treatment of calcium oxalate nephrolithiasis both in vitro and in vivo. In this study, we examined the efficacy of Wu-Ling-San formula prophylaxis for preventing recurrent calcium oxalate nephrolithiasis. Methods: This was a prospective clinical study that evaluated the 24-hour urine parameters of 10 patients with kidney stones. All patients with a history of recurrent calcium oxalate nephrolithiasis who were aged 40 to 59 years old. The patients were asked to drink enough fluid to urinate at least 2 L daily during the study period. A 24-hour urine collection was performed to establish the baseline levels of multiple urinary parameters before taking the medicine. The patients were randomized divided into two groups. The medication group took 2 gm Wu-Ling-San formula three times daily for 1 month. The control group took 2 gm placebo formula three times daily for 1 month. All the patients received 24-hour urine collection was performed of multiple urinary parameters after complete the study. The serum liver, renal function and electrolyte was also collected. Results: A total of 10 patients were enrolled, of whom 7 (70%) were men and 3 (30%) were women. All the patients completed of the study. The mean age was 50.7 years old (range 40 to 59). The patients reported a lifetime total of 3 to 6 (average 4.2) stone episodes. The patients had undergone 2 to 3 (average 2.5) stone procedures. The baseline urine output level was 2260±434 ml/day in Wu-Ling-San formula (WLS)group and 2660±844 ml/day in placebo group. After treatment with Wu-Ling-San formula group, the mean urine output level increased to 2580?b526ml/day (percentage of change, 14.1%). With placebo therapy, the mean decreased slightly to 2660.0?b850ml/day (percentage of change, -0.1%). Compare with both group, WLS group significantly increased the urine output. (student t-test, p<0.05). No patient complain of side effects, including fatigue, dizziness, impotence, musculoskeletal symptoms, or gastrointestinal disturbance. The serum liver function, renal function, electrolyte and urinary parameters were no significant change in both groups. Conclusions: Wu-Ling-San formula is a promising adjunct to surgical and medical management of kidney stones. Compare with potassium citrate, they might be better accepted by patients than medications taken three times daily because of the lower gastrointestinal disturbance. Active therapy with Wu-Ling-San Formula did have a positive effect on the urine volume without electrolyte imbalance. Patients need ongoing education and encouragement to meet the goals of urinary output, and treatment with Wu-Ling-San Formula might help patients reach these goals. Keywords: Calcium oxalate; Urinary Stone; Traditional Chinese medicine; Wu-Ling-San Formula; Nephrolithiasis