结肠序贯透析加中药保留灌肠治疗中晚期慢性肾衰竭38例疗效分析  

Curative effect of sequential colon dialysis in combination with retention-enema of traditional Chinese medicine on 38 patients with medium and advanced stages of chronic renal failure

作　　者：朱辟疆[1] 赵华[1] 周逊[1] 朱春梅[1] 刘永平[1] 邱建军[1] 

机构地区：[1]镇江市中西医结合肾脏病研究所,江苏镇江212028

出　　处：《中国中西医结合急救杂志》2010年第5期278-281,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：江苏省镇江市科研项目（镇徒科技发[2007]32号）

摘　　要：目的 观察结肠序贯透析加中药保留灌肠对中晚期慢性肾衰竭（CRF）的疗效.方法 选择CRF3期患者76例,按随机原则分为两组,每组38例.两组基础治疗相同,对照组为低蛋白饮食＋α-酮酸联合香砂六君丸,治疗组在对照组治疗基础上加用结肠序贯透析＋中药大黄牡蛎灌肠方200 ml保留灌肠,疗程均30 d.观察两组治疗前后血肌酐（SCr）、尿素氮（BUN）、钙（Ca^2＋）、磷（P^3＋）、尿酸（UA）、超敏C-反应蛋白（hs-CRP）及中医证候积分的变化.结果 治疗组治疗后SCr、BUN、P^3＋、UA及hs-CRP均较治疗前显著降低,且SCr、P^3＋、UA、hs-CRP显著低于对照组（P〈0.05或P〈0.01）;对照组仅BUN降低显著（P〈0.05）.两组治疗后中医证候积分均比治疗前显著降低,以治疗组较为显著（P〈0.05或P〈0.01）.治疗组总有效率89.47%,显著高于对照组总有效率63.15%（P〈0.01）.结论 对中晚期CRF患者进行结肠序贯透析加中药保留灌肠,在改善肾功能和临床症状,降低血P3＋、UA方面均有较好的疗效,同时能降低hs-CRP,改善微炎症状态,从而延缓CRF进展,推迟进入终末期肾病的进程.Objective To investigate the therapeutic effect of sequential colon dialysis in combination with retention-enema of traditional Chinese medicine （TCM） on patients with medium and advanced stages of chronic renal failure （CRF）. Methods Seventy-six patients with advanced stages of CRF were randomly and equally divided into two groups： treatment group and control group （each, n=38）. All patients in the two groups underwent the same comprehensive management ： low protein diet, α-keto acid and Xiangsha Liujun pill （香砂六君丸）; sequential colon dialysis in combination with retention-enema of TCM [Dahuang Mull decoction （大黄牡蛎方）, 200 ml] was added to those in the treatment group, and the period of treatment was 30 days in both groups. The therapeutic efficacy and the serum creatinine （SCr）, blood urea nitrogen （BUN）, Ca^2＋, p^3＋, uric acid （UA）, high sensitivity C-reactive protein （hs-CRP） and TCM syndrome integral scores were compared between the two groups. Results After treatment, the SCr, BUN, p^3＋, UA and hs-CRP levels of treatment group were significantly decreased, and they were lower than those of control group （P〈 0.05 or P〈0.01）, but in the control group only BUN was obviously decreased （P〈0.05）. After treatment, the TCM syndrome integral scores of two groups were also markedly decreased, and in treatment group, they were obviously lower than those in control group （P〈0.05 or P〈0.01）. The total effective rate in treatment group was 89.47% much higher than that in control group, 63.15% （P〈0.01）. Conclusion Sequential colon dialysis in combination with retention-enema of TCM has beneficial effects on medium and advanced stages of CRF; it may improve the inflammatory status, renal functions and clinical symptoms, decrease the level of P^3＋, UA and hs-CRP, delay the progress of CRF and put off the access into the end stage of renal disease.

关 键 词：结肠序贯透析 肾衰竭 慢性 中药治疗 

分 类 号：R285.6[医药卫生—中药学] R256.5[医药卫生—中医学]