中药保留灌肠联合血液透析治疗终末期糖尿病肾病临床研究  

Clinical Study on Retention Enema with Chinese Medicine Combined with Hemodialysis for End-Stage Diabetic Nephropathy

作　　者：秦雪娟 卢昭 李红帅 QIN Xuejuan;LU Zhao;LI Hongshuai

机构地区：[1]开封市中医院,河南开封475001

出　　处：《新中医》2021年第17期97-101,共5页New Chinese Medicine

摘　　要：目的:观察中药保留灌肠联合血液透析治疗终末期糖尿病肾病的临床疗效。方法:将58例终末期糖尿病肾病规律血液透析患者随机分为对照组及观察组各29例。对照组给予每周3次血液透析治疗,观察组给予每周2次血液透析联合中药保留灌肠治疗。2组均治疗并观察2个月。比较2组治疗前后中医证候评分、血检查指标[血红蛋白、尿素氮、血肌酐、血钾、血磷、β2微球蛋白、甲状旁腺激素(PTH)]的变化,观察2组治疗过程中并发症发生率。结果:治疗后,2组倦怠乏力、食少纳呆、腰膝酸软、皮肤瘙痒评分均较治疗前下降(P<0.05),观察组食少纳呆、腰膝酸软、皮肤瘙痒评分均低于对照组(P>0.05),倦怠乏力评分高于对照组(P>0.05)。治疗后,2组血红蛋白水平均较治疗前上升,观察组高于对照组,差异均无统计学意义(P>0.05);治疗后,2组尿素氮、血肌酐水平均较治疗前下降,观察组高于对照组,差异均无统计学意义(P>0.05)。治疗后,2组血钾、β2微球蛋白水平均较治疗前下降,观察组高于对照组,差异均无统计学意义(P>0.05);治疗后,2组血磷、PTH水平均较治疗前下降,观察组低于对照组,差异均无统计学意义(P>0.05)。治疗过程中,观察组低血压、低血糖、心律失常、便秘发生率均低于对照组,其中低血压、便秘差异有统计学意义(P<0.05)。结论:中药保留灌肠联合血液透析治疗终末期糖尿病肾病可缓解临床症状,血液透析次数从每周3次更为每周2次,减少透析过程中并发症的发生,改善预后。Objective: To observe the clinical effect of retention enema with Chinese medicine combined with hemodialysis for end-stage diabetic nephropathy. Methods: A total of 58 cases of patients with end-stage diabetic nephropathy who underwent hemodialysis were randomly divided into the control group and the observation group,29 cases in each group. The control group was given hemodialysis,three times a week. The observation group was given retention enema with Chinese medicine combined with hemodialysis,twice a week. Both groups were treated and observed for two months. Before and after treatment, the changes in Chinese medicine syndrome score and blood examination indexes[hemoglobin,urea nitrogen,serum creatinine,serum potassium,serum phosphorus,β2 microglobulin,and parathormone(PTH)] were compared between the two groups. The incidence of complications was observed in the two groups during treatment. Results:After treatment,scores of fatigue and lack of strength,torpid intake,soreness and weakness of the waist and knees,and skin pruritus in the two groups were decreased when compared with those before treatment(P<0.05);scores of torpid intake,soreness and weakness of the waist and knees,and skin pruritus in the observation group were lower than those in the control group(P<0.05), and the score of fatigue and lack of strength was higher(P<0.05). After treatment,levels of hemoglobin in the two groups were increased when compared with those before treatment,and the level in the observation group was higher than that in the control group,there being no significance in differences(P>0.05).After treatment,levels of urea nitrogen and serum creatinine in the two groups were decreased when compared with those before treatment,and the two levels in the observation group were higher than those in the control group,there being no significance in differences(P>0.05). After treatment,levels of serum potassium and β2 microglobulin in the two groups were decreased when compared with those before treatment,and the levels in the obse

关 键 词：终末期糖尿病肾病 血液透析 中药保留灌肠 补肾通腑泻浊方 

分 类 号：R587.2[医药卫生—内分泌]