中药灌肠配合连续性肾脏替代疗法治疗重症急性肾损伤临床研究  

Clinical study on TCM enema combined with continuous renal replacement therapy on the treatment of severe acute renal injury

作　　者：李尚 智霞[4] 李聪 樊晓意 Li Shang;Zhi Xia;Li Cong;Fan Xiaoyi(Department of Neurosurgery, People＇s Hospital of Hengshui City, Hengshui 053000, China Corresponding author： Zhi Xia, Department of Blood Purification Section, Handan Central Hospital of Hebei, Handan 056001, China;Email： 31013205 [e-mail])

机构地区：[1]河北省衡水市人民医院神经外科,053000 [2]河北省衡水市人民医院高压氧科,053000 [3]河北省衡水市人民医院肝胆外科,053000 [4]河北省邯郸市中心医院血液净化科,056001

出　　处：《国际中医中药杂志》2018年第5期414-417,共4页International Journal of Traditional Chinese Medicine

摘　　要：目的评价中药灌肠配合连续性肾脏替代疗法（continuous renal replacement therapy,CRRT）治疗重症急性肾损伤（acutekidneyinjury，AKI）患者的疗效。方法将100例重症AKI患者采用随机数字表法分为2组，每组50例。对照组采用CRRT治疗，观察组在对照组基础上配合中药灌肠。2组均连续治疗14d。观察患者肾功能及尿量的恢复时间；采用全自动生化分析仪测定24h尿蛋白定量，计算24h尿白蛋白排泄率；以全自动生化分析仪检测血清BUN、SCr、胱抑素C（CysC）水平，评价临床疗效。结果观察组总有效率为70．O％（35／50）、对照组为50．O％（25／50），2组比较差异有统计学意义（X^2=4．167，p=0．041）。治疗后，观察组血清BUN[（6．51±1．07）mol／L比（8．22±2131）mol／L，t=4．750]、SCr[（91．29±21．05）μmol／L比（108．67±19．34）pmol／L，t=4．299]、CysC[（0．85±0．33）mg／L比（1．03±0．45）mg／L，t=2．2812水平低于对照组（P〈0．叭或P〈0．05）；24h尿蛋白定量[（115．37±26．15）mg／24h比（167．55±38．66）mg／24h，t=7．905]、24h尿白蛋白排泄率[（198．41±33．24）μg／min比（226．19±38．35）μg／min，t=3．871]低于对照组（P〈0．01）。结论中药灌肠配合CRRT可促进重症AKI患者肾功能的恢复，有效延缓肾损伤的进展。Objective To evaluate the clinical efficacy of TCM enema combined with continuous renal replacement therapy on the treatment of severe acute renal injury. Methods A total of 100 patients of severe AKI patients were divided into 2 groups by random digital table, each of which was 50 cases. The control group was treated with CRRT, and the observation group cooperated with the traditional Chinese medicine enema on the basis of the control group. The 2 groups were treated continuously for 14 d. The renal function and urine volume recovery time were observed; 24 h urinary protein and 24 h urinary albumin excretion rate were determined by automatic biochemical analyzer.The blood urea nitrogen （BUN）, serum creatinine （SCr）, serum cystatin C （Cys C） were detected. And theclinical efficacy was compared between the two groups. Results The total effective rate of the observation group was 70.0% （35/50） and the control group was 50.0% （25/50）. The difference between the 2 groups was statistically significant. After treatment, the levels of serum BUN （6.51 ± 1.07 mol/L vs. 8.22±2.31 mol/L, 1=4.750）, SCr （91.29 ± 21.05 pmol/L vs. 108.67 ± 19.34 p.mol/L, t=4.299） and Cys C （0.85± 0.33 mg/L vs. 1.03± 0.45 mg/L, t=2.281） in the observation group were significantly lower than those of the control group （P〈0.01 or P〈0.05）. The urinary albumin excretion rate of 24 h urine protein （115.37 ± 26.15 mg/24 h vs. 167.55± 38.66 mg/24 h, t=7.905） and 24 h urine （198.41 ± 33.24 μg/min vs. 226.19 ± 38.35 μg/min, t=3.871） was significantly lower than that of the control group （P〈0.01）. Conclusions TCM enema combined with CRRT can promote the recovery of renal function in patients with severe AKI, can effectively delay the progression of renal injury.

关 键 词：急性肾损伤 灌肠 复方(中药) 血液透析滤过 血尿素氮 血肌酐 血清胱抑素C 

分 类 号：R692.5[医药卫生—泌尿科学]