通腑泻浊方灌肠预防甘露醇肾损害22例临床观察  

Prevention of mannitol renal damage by enema of Tongfu Xiezhou Fang in 22 cases

作　　者：陈可为[1] 白慧梅[1] 郭家奎[2] 张津玮[2] 

机构地区：[1]天津中医药大学天津300193 [2]天津中医药大学第二附属医院

出　　处：《北京中医药大学学报》2012年第12期855-857,861,共4页Journal of Beijing University of Traditional Chinese Medicine

基　　金：天津市卫生局中医、中西医结合科研课题(No.11061)

摘　　要：目的探讨治疗重症脑梗死患者在不减低甘露醇剂量以保持疗效的前提下,利用通腑泻浊方灌肠预防甘露醇肾损害的疗效。方法将48例重症脑梗死患者(格拉斯哥昏迷评分≤8分)随机分为治疗组22例和对照组26例,常规应用甘露醇作为主要脱水剂,治疗组在应用甘露醇的同时加以中药保留灌肠30 min,1日1次;对照组用甘露醇时不予以灌肠。监测2组患者治疗前、治疗第5天血清胱抑素C、血肌酐、尿素氮、24 h尿量等。结果治疗组发生甘露醇肾损害2例,发生率9.1%;对照组1例因脑水肿加重死亡,发生甘露醇肾损害10例,发生率38.5%,经统计学比较2组差异有统计学意义(P<0.05)。2组患者治疗过程中各项肾功能指标相比较,治疗组优于对照组,差异有统计学意义(P<0.05)。结论通腑泻浊方保留灌肠在预防重症脑梗死患者应用甘露醇导致肾损害方面确有疗效。Object To inwstigate the effect of enema of Tongfu Xiezhou Fang in prevention of mannitol renal damage during treatment in the patients with severe cerebral infarction without reducing the dose of mannital in order to keep the curative effect. Methods The patients （n = 48 ） with severe cerebral infarction （Glasgow Coma Score〈8） were randomly divided into treatment group （n = 22） and control group （n = 26）. Mannito] was used conventionally as main dehydrating agent, and treatment group was given retention enema of Tongfu Xiezhou Fang for 30 minutes （ once a day） at the same time of applying mannitol, and control group was not given enema. The levels of serum cystatin C and serum creatinine （SCr）, blood urea nitrogen （BUN） and 24-hour urine output were detected in two groups before treatment and on the 5th day of t~：eatment. Results There were 2 cases with mannitol renal damage in treatment group （9. ! % ）. There was one dead case due to cerebral edema and 10 cases with mannitol renal damage in control group （38.5%）. The difference between two groups had statistical significance after statistical comparison （ P 〈 0.05 ）. The comparison in indexes of kidney function showed that the results were better in treatraent group than those in control group （ P 〈 0. 05 ）. Conclusion The retention enema of Tongfu Xiezhou Fang has reliable curative effect of preventing mannitol renal in the patients with severe cerebral infarction. damage

关 键 词：通腑泻浊方 灌肠 预防 甘露醇肾损害 

分 类 号：R256.5[医药卫生—中医内科学]