以泄浊汤剂保留灌肠治疗湿浊阻滞型慢性肾衰竭患者研究为基础的辨证施治  

Treating the dampness and turbidity retardation type renal failure by Xiezhuo decoction retention enema based on syndrome differentiation

作　　者：王倩倩[1] 杨晓峰[1] 周长学[1] 高文 丁蕾[1] WANG Qianqian;YANG Xiaofeng;ZHOU Changxue;GAO Wen;DING Lei

机构地区：[1]枣庄市立医院,山东枣庄277100

出　　处：《中医临床研究》2022年第18期45-47,共3页Clinical Journal Of Chinese Medicine

基　　金：山东省中医药科技项目(2020M125)。

摘　　要：目的:根据慢性肾衰竭分期辨证,选择湿浊阻滞型患者,取经典组方泄浊汤灌肠,研究腹膜透析配合中药汤保留灌肠治疗,分析慢性肾衰竭患者治疗前后湿浊阻滞型积分改变趋势,探索用中医药延缓慢性肾衰竭病程进展。方法:纳入研究共70例患者,按就诊顺序随机划分到干预组和基础组,每组35例,所有患者均采用腹膜透析为基础治疗,干预组增加中药汤保留灌肠治疗。治疗周期取16周。记录检测西医肾功能指标内生肌酐清除率(Creatinine Clearance,Ccr)、血肌酐(Serum Creatinine,Scr)、尿素氮(Blood Ure Nitrogen,BUN)等变化,分析研判中医证候积分的变化,运用36项简明健康状况调查量表(The Mos 36-item Short From Health Survey,SF-36)评估慢性肾衰竭健康状况质量。结果:干预组和基础组湿浊阻滞型证候积分差异明显;将组内与治疗前比较,两组组间比较,发现干预组西医肾功能指标CCr、Scr、BUN优于基础组,差异具有统计学意义(P<0.05),干预组患者SF-36健康量表评分更高(P<0.05)。结论:对于腹膜透析的尿毒症患者,采取经典组方泄浊汤灌肠辅助治疗有利于西医肾功能指标改善,不会导致离子紊乱,可减少并发症,提高健康指标,对终末期肾病进展具有延缓作用,应该将中医药应用到尿毒症的“末病治疗”。Objective:To study the effect of peritoneal dialysis plus retention enema with TCM medicine Xiezhuo decoction(泄浊汤)on chronic renal failure.To analyze the change trend of TCM syndrome score of CRF patients,and to detect endogenous creatinine clearance rate,serum creatinine and urea nitrogen in order to explore the use of TCM to delay the progress of renal failure.Methods:70 patients were randomly divided into the intervention group(35 cases)and the control group(35 cases).All patients were treated by peritoneal dialysis.The intervention group was treated by peritoneal dialysis plus TCM medicine retention enema.The treatment cycle was 16 weeks.The changes of endogenous CCR,SCR and BUN were recorded,and the changes of TCM syndrome score were analyzed.SF-36 health scale was used to evaluate the health-related quality of life of chronic renal failure.Results:The difference between the intervention group and the control group in TCM syndrome score was statistically significant(P<0.05).The endogenous CCR,SCR,BUN and other indicators in the intervention group were better than the control group,and the difference was statistically significant(P<0.05).The SF-36 health scale score in the intervention group was higher(P<0.05).Conclusions:For uremia patients,retention enema with TCM medicine Xiezhuo decoction plus peritoneal dialysis is beneficial to the improvement of renal function,and will not affect the electrolyte balance,can reduce complications,improve the quality of life,delay the risk of entering the end-stage kidney.Therefore,TCM medicine should be applied to the"end disease treatment"of uremia.

关 键 词：慢性肾衰竭 中药灌肠 湿浊阻滞型 中医证候积分 SF-36健康量表 

分 类 号：R692.5[医药卫生—泌尿科学]