结肠透析、尿毒清颗粒保留灌肠联合常规治疗对慢性肾脏病骨矿物质代谢紊乱患者的临床疗效  

Clinical effects of colon dialysis and retention enema of Niaoduqing Granules combined with conventional treatment on patients with mineral and bone disorder in chronic kidney disease

作　　者：张静[1] 王辞晓[2] 邓剑波[1] 童心[1] 沈莉[1] 龚财判 周小园 冉茂霞 何镇佐 周翔 ZHANG Jing;WANG Ci-xiao;DENG Jian-bo;TONG Xin;SHEN Li;GONG Cai-pan;ZHOU Xiao-yuan;RAN Mao-xia;HE Zhen-zuo;ZHOU Xiang(Department of Nephrology,Dazhou Municipal Central Hospital,Dazhou 635000,China;The Second Department of Nephrology,The Hospital Affiliated to Chengdu University of Traditional Chinese Medicine,Chengdu 610072,China;Department of Nephrology,Tongchuan District People’s Hospital of Dazhou City,Dazhou 635000,China;Department of Nephrology,The Third People’s Hospital of Dazhou City,Dazhou 635000,China)

机构地区：[1]达州市中心医院肾病内科,四川达州635000 [2]成都中医药大学附属医院肾病二科,四川成都610072 [3]达州市通川区人民医院肾病内科,四川达州635000 [4]达州市第三人民医院肾病内科,四川达州635000

出　　处：《中成药》2022年第10期3174-3179,共6页Chinese Traditional Patent Medicine

基　　金：四川省中医药管理局科研课题(2020LC0109)。

摘　　要：目的 考察结肠透析、尿毒清颗粒保留灌肠联合常规治疗对慢性肾脏病骨矿物质代谢紊乱患者的临床疗效。方法 120例患者随机分为对照组和观察组,每组60例,对照组给予常规治疗(血压控制、纠正贫血、纠正水电解质紊乱等),观察组在对照组基础上加用结肠透析、尿毒清颗粒保留灌肠,疗程16周。检测临床疗效、中医证候评分、显效和有效患者临床特征、钙磷代谢指标(血钙、血磷、PTH)、肾功能指标(Scr、BUN、eGFR)、血清相关蛋白(GF-23、Klotho)变化。结果 观察组总有效率、脾虚血瘀证治疗有效率高于对照组(P<0.05)。治疗后,2组中医证候评分、血磷、PTH、BUN、血清相关蛋白降低(P<0.05),血钙升高(P<0.05),以观察组更明显(P<0.05);观察组有效患者Scr水平低于对照组(P<0.05),内生肌酐清除率更高(P<0.05);观察组Scr降低(P<0.05),eGFR升高(P<0.05),并比对照组更明显(P<0.05)。结论 结肠透析、尿毒清颗粒保留灌肠联合常规治疗可纠正慢性肾脏病骨矿物质代谢紊乱患者钙磷代谢紊乱,改善肾功能。AIM To investigate the clinical effects of colon dialysis and retention enema of Niaoduqing Granules combined with conventional treatment on patients with mineral and bone disorder in chronic kidney disease.METHODS One hundred and twenty patients were randomly assigned into control group(60 cases) for 16-week intervention of conventional treatment(controlling blood pressure, correcting anemia, correcting water and electrolyte disorders, etc.), and observation group(60 cases) for 16-week intervention of colon dialysis, retention enema of Niaoduqing Granules and conventional treatment. The changes in clinical efficacy, TCM syndrome scores, clinical features of patients with marked effectiveness and effectiveness, calcium-phosphorus metabolism indices(blood calcium, blood phosphorus, PTH), kidney function indices(Scr, BUN, eGFR) and serum-related proteins(GF-23, Klotho) were detected.RESULTS The observation group demonstrated higher total effective rate and therapeutical effective rate of Spleen Deficiency and Blood Stasis Syndrome than the control group(P<0.05). After the treatment, the two groups displayed decreased TCM syndrome scores, blood phosphorus, PTH, BUN and serum-related proteins(P<0.05), and increased blood calcium(P<0.05), especially for the observation group(P<0.05);patients with effectiveness in the observation group exhibited lower Scr(P<0.05) and higher endogenous creatinine clearance rate(P<0.05) than those in the control group;decreased Scr(P<0.05) and increased eGFR(P<0.05) were observable in the observation group, which were more obvious than those in the control group(P<0.05).CONCLUSION For the patients with mineral and bone disorder in chronic kidney disease, colon dialysis and retention enema of Niaoduqing Granules combined with conventional treatment can correct calcium-phosphorus metabolism disorder and improve renal functions.

关 键 词：结肠透析 尿毒清颗粒 保留灌肠 常规治疗 慢性肾脏病 骨矿物质代谢紊乱 

分 类 号：R287[医药卫生—中药学]