大黄牡公汤联合结肠透析治疗慢性肾功能衰竭的临床研究  

Clinical study of Dahuang Mugong decoction(大黄牡公汤) combined with sequential colon dialysis in treatment of chronic renal failure

作　　者：王海涛[1] 黄远航[1] 陈椰[1] 黄俊[1] 王寅[1] 张虹[1] 童俊容[1] 朱起之[1] 

机构地区：[1]广州军区广州总医院肾内科,广东广州510010

出　　处：《中国中西医结合急救杂志》2006年第1期13-15,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：广东省中医药局科研基金资助项目(1040138)

摘　　要：目的:观察大黄牡公汤联合结肠透析治疗慢性肾功能衰竭(CRF)的临床疗效并探讨其作用机制。方法:对98例CRF患者进行结肠透析及大黄牡公汤水煎剂保留灌肠,观察患者治疗前后症状、体征改善情况;检测治疗前后血尿素氮(BUN)、血肌酐(SC r)、血尿酸(UA)、白蛋白(A lb)、电解质水平及体重的变化;应用比浊法检测中分子物质(MM)的吸光度。结果:患者治疗前后中医症状积分、C a2+、血磷(SP)及A lb比较差异均有显著性(P<0.05或P<0.01);BUN、SC r、UA、内生肌酐清除率(CC r)及MM吸光度治疗前后比较差异也有显著性(P<0.05或P<0.01);透析过程中及透析后K+、N a+、C l-水平及体重等均无明显变化,无明显不良反应发生。显效36例,有效47例,无效15例,总有效率为84.69%。结论:大黄牡公汤联合结肠透析对CRF有明显的疗效,作用机制为肠道透析作用及大黄制剂对肾功能的延缓及保护作用。Objective.. To observe the clinical efficacy of combination of Dahuang Mugong decoction （DMD,大黄牡公汤） and sequential colon dialysis in treatment of chronic renal failure （CRF） and explore its potential mechanism. Methods： Ninty -eight patients with CRF were treated with sequential colon dialysis and DMD. Besides the observation on the clinical symptoms and signs, the serum levels of blood urea nitrogen （BUN）,serum creatinine （SCr）, uric acid （UA）,serum phosphorus C（SP）, inorganic], Ca^2＋ and albumin （Alb） were measured with auto -analysis machine and the optical density （A4~0 value） of medium molecule substance （MM） with nephelometer between pre- treatment and post-treatment. Results： The accumulated score of the clinical symptoms and signs were decreased with the combination of DMD and sequential colon dialysis （P〈0. 05 or P〈0.01）. The serum levels of BUN, SCr, UA, SP and the A450 value of MM were decreased successfully （P〈0. 01 or P〈0. 051. The serum level of Ca^2＋, Alb and clearance of creatinine （CCr） were improved （P〈0.05 or P〈0. 01）. The serum levels of K＋ , Na＋ , Cl^- and body weight did not change significantly and there were no severe side - effects in the course of treatment. In the therapy 36 cases were remarkably improved, 47 effective and 15 ineffective. The total effective rate was 84.69 %. Conclusion： DMD combined with sequential colon dialysis is an effective therapy for patients with CRF and the potential mechanism may be the action of colon dialysis and renal protection of rhubarb.

关 键 词：大黄牡公汤 结肠透析 肾功能衰竭 慢性 

分 类 号：R692.5[医药卫生—泌尿科学]