腹膜透析液联合尿毒清颗粒保留灌肠对CKD5期非透析患者肾功能及电解质的影响  

Influence of Peritoneal Dialysis Solution and Uremic Clearance Granules Retention Enema on Renal Function and Electrolyte in Non-dialysis Patients with 5 Stage CKD

作　　者：刘岸 艾超 唐婧 唐蕾[1,2] 毛乾泰 安扬 LIU An;AI Chao;TANG Jing;TANG Lei;MAO Qiantai;AN Yang(Beijing Tsinghua Changgung Hospital,Beijing 102218,China;School of Clinical Medicine,Tsinghua University)

机构地区：[1]清华大学附属北京清华长庚医院,北京102218 [2]清华大学临床医学院

出　　处：《西部中医药》2022年第9期95-98,共4页Western Journal of Traditional Chinese Medicine

基　　金：北京市自然科学基金(重点研究专题项目)(京020170103)。

摘　　要：目的:探讨腹膜透析液联合尿毒清颗粒保留灌肠对慢性肾脏病(chronic kidney disease,CKD)5期非透析患者肾功能及电解质的影响。方法:将肾小球滤过率(glomerular filtration rate,GFR)<15 mL/min的CKD 5期患者68例采用随机数字表法分为对照组及观察组各34例。两组均参照美国肾脏病基金会制定的肾脏病生存质量指导(kidney disease outcomes quality initiative,KDOQI)和改善全球肾脏病预后组织(kidney disease:improving global outcomes,KDIGO)指南给予西医基础治疗,对照组患者每天1.5%腹膜透析液1000 mL清洁灌肠,观察组先予1.5%腹膜透析液1000 mL清洁肠道,后用尿毒清颗粒2包加入生理盐水200 mL保留灌肠40 min。观察两组患者临床疗效、中医证候积分、肾功能及血清电解质[磷(P)、钾(K)]。结果:观察组总有效率为94.12%,高于对照组的76.47%(P<0.05)。治疗后两组患者5项中医证候积分均下降,观察组低于对照组(P<0.05)。治疗后两组患者肌酐(serum creatinine,SCr)、尿素氮(blood urea nitrogen,BUN)、尿酸(uric acid,UA)均下降(P<0.05),且观察组低于对照组(P<0.05);GFR均升高(P<0.05),观察组高于对照组(P<0.05)。治疗后观察组P、K水平低于对照组(P<0.05)。结论:腹膜透析液联合尿毒清颗粒保留灌肠对CKD 5期非透析患者病情控制具有积极作用,能改善电解质紊乱。Objective:To discuss the effects of peritoneal dialysis solution and uremic clearance granules retention enema on renal function and electrolyte in non-dialysis patients with stage 5 CKD.Methods:All 68patients with glomerular filtration rate(GFR)<15 mL/min were allocated to the control group and the observation group by using random number table method,with 34 cases in each group.Both groups accepted basic therapy of Western medicine by referring to KDOQI and KDIGO guideline,the control group accepted the cleansing enema of 1.5% peritoneal dialysis solution,1000mL each day,while the observation group received bowel cleaning with1000 mL of 1.5% peritoneal dialysis solution,and then retention enema for 40 minutes with 200 mL of normal saline and two packs of uremic clearance granules.To observe clinical effects,TCM syndrome scores,renal function and serum electrolytes [phosphorus(P) and potassium(K)] between both groups.Results:Total effective rate of the observation group was 94.12%,higher than 76.47% of the control group(P<0.05).After the treatment,five items of TCM syndrome scores reduced in both groups,the observation group was lower than the control group(P<0.05).After the treatment,SCr,BUN and UA in both groups decreased(P<0.05),the observation group was lower than the control group(P<0.05);GFR increased(P<0.05),the observation group was higher than the control group(P<0.05).After the treatment,the levels of P and K of the observation group were lower than these of the control group(P<0.05).Conclusion:Peritoneal dialysis solution and uremic clearance granules retention enema have positive effects on controlling the disease conditions in patients,which could correct electrolyte disturbance.

关 键 词：慢性肾脏病 5期非透析 电解质 肾功能 腹膜透析液 保留灌肠 尿毒清颗粒 

分 类 号：R256.51[医药卫生—中医内科学]