通腑泻浊法灌肠防治急性脑梗塞后甘露醇肾损害临床疗效研究  

Clinical Effect Study of Preventing Mannitol Kidney Damage after Acute Cerebral Infarction by the Decoction of Catharsis and Purging Turbidity

作　　者：潘东[1] 陈可为[1] 白慧梅[1] 

机构地区：[1]天津中医药大学第二附属医院脑病针灸部,天津300150

出　　处：《时珍国医国药》2012年第12期3072-3074,共3页Lishizhen Medicine and Materia Medica Research

基　　金：天津市中医药管理局中医;中西医结合科研课题(No.11061)

摘　　要：目的观察在不减低甘露醇剂量以保持疗效的前提下,中药直肠保留灌肠防治急性重症脑梗塞后静脉滴注甘露醇引起急性肾损害的临床疗效。方法实验一:将252例重症脑梗死患者,随机分为两组,应用甘露醇作为主要脱水剂,治疗组同时加以中药保留灌肠。在治疗前及第3、5、7、10天观察肾功能指标。并将治疗过程中出现肾损害的患者直接纳入实验二:其中实验一中治疗组出现肾损伤患者作为治疗一组(甘油果糖+灌肠),将实验一中对照组出现肾损伤患者随机分为治疗二组(甘露醇+灌肠)和对照组(甘油果糖+呋塞米),观察患者第10天肾功能指标及GCS评分。结果两组实验数据显示,治疗组较对照组具有明显差异,实验一中两组患者治疗过程中各项肾功能指标差异有统计学意义(P<0.01)。实验二中治疗组各项指标较入组时均有明显降低(P<0.01),治疗第10天,治疗一组肾功能各项指标较治疗二组与对照组亦有明显降低(P<0.01)。患者的意识水平GCS评分、NIHSS评分,治疗组均明显优于对照组。结论通腑泄浊法保留灌肠能预防甘露醇引起的急性肾损害;对已造成甘露醇肾损害患者具有治疗作用;同时能明显改善患者意识状况及神经功能。Objective To explore the clinical effect of using the Chinese medicine in the prevention and treatment of patients with mannitol kidney damage after severe cerebral infarction,in the premise that do not reduce the dose of mannitol in order to maintain the effect.Methods the first experiment：252 cases of severe cerebral infarction were randomly divided into two groups,conventionally use mannitol as the main dehydrating agent.Together with the mannitol use the Chinese medicine to enema for the treatment group.Observe the renal function indicators before treatment,3、5、7、10 days after treatment.During the course of treatment the patients with kidney damage were directly included in the second experiment.Take the patients with kidney injury in the first treatment group as the treatment group 1（Glycerol and fructose＋enema）,take the patients with kidney injury in the first control group as the treatment group 2（Mannitol＋enema）and control group（Glycerol and fructose＋Furosemide）.Observe the renal function indicators and GCS score of the patients on the 10th day of treatment.Results The two sets of experimental data showed that the treatment group had significant difference with the control group.In the first experiment,the renal function indicators of the two groups of patients have.significant difference during the treatment（P0.01）.In the second experiment,indicators were significantly lower（P0.01）.On the 10th day of treatment,the renal function indicators of the treatment group 1 were lower than those of the treatment group 2 and the control group.（P0.01）.As for the patient＇s level of consciousness GCS score,NIHSS score,the treatment group was significantly better than the control group.Conclusion The decoction of catharsis and purging turbidity is effective for the prevention and treatment of mannitol kidney damage in the treatment of the severe cerebral infarction patients with mannitol.At the same time it can significantly improve the state of consciousness and neurological fun

关 键 词：通腑泻浊法 中药灌肠 脑梗塞 甘露醇 急性肾损害 

分 类 号：R743.3[医药卫生—神经病学与精神病学]