扶正化浊活血汤对慢性肾衰竭血透患者肠道微生态的影响  

Effects of Fuzheng Huazhuo Huoxue Decoction(扶正化浊活血汤)on Intestinal Microecology in Patients with Chronic Renal Failure Undergoing Hemodialysis

作　　者：张小燕[1] 卢浩 刘小菊 ZHANG Xiaoyan;LU Hao;LIU Xiaoju(Lishui TCM Hospital Affiliated to Zhejiang Chinese Medical University,Lishui 323000,Zhejiang,China)

机构地区：[1]浙江中医药大学附属丽水中医院,浙江丽水323000

出　　处：《辽宁中医杂志》2023年第5期152-155,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：丽水市科技计划项目(2021SJZC040)。

摘　　要：目的研究扶正化浊活血汤对慢性肾衰竭(chronic renal failure,CRF)血液透析患者肠道微生态的影响。方法以2020年1月-2022年6月该院104例CRF血液透析患者为样本,采用随机数字表均分为观察组和对照组各52例,两组均常规采用碳酸氢盐透析治疗,同时积极治疗贫血、高血压病或糖尿病等基础疾病,观察组在此基础上采用扶正化浊活血汤治疗,两组疗程均为8周,比较两组疗效、中医证候积分、肾功能指标、肠道菌群以及肠道屏障功能。结果观察组和对照组有效率分别为90.38%(47/52)和75.00%(39/52)(P<0.05);两组中医证候积分、血肌酐(serum creatinine,Scr)和尿素氮(blood urea nitrogen,BUN)和浆胱抑素C(cystatin C,CysC)明显降低(P<0.05),且观察组各指标低于对照组,差异有统计学意义(P<0.05);观察组肠道双歧杆菌、乳酸杆菌和拟杆菌属含量明显增加(P<0.05),大肠杆菌和肠球菌含量明显降低(P<0.05),对照组组各菌群含量无明显变化(P>0.05);观察组血清D-乳酸、降钙素原(procalcitonin,PCT)和二胺氧化酶(diamine oxidase,DAO)水平明显降低(P<0.05),对照组各指标无明显变化(P>0.05)。结论扶正化浊活血汤治疗CRF具有良好效果,可改善肠道菌群分布并减轻肠黏膜屏障损伤,对缓解患者症状和改善肾功能具有积极作用。Objective To study the effects of Fuzheng Huazhuo Huoxue Decoction(扶正化浊活血汤)on intestinal microecology in patients with chronic renal failure(CRF)undergoing hemodialysis.Methods A total of 104 patients with CRF undergoing hemodialysis in the hospital from January 2020 to June 2022 were selected as the samples,and they were divided into observation group(52 cases)and control group(52 cases)by using the random number table method.Both groups were routinely treated with bicarbonate dialysis and actively treated basic diseases such as anemia,hypertension or diabetes,and on this basis,the observation group added Fuzheng Huazhuo Huoxue Decoction.The course of treatment in both groups was 8 weeks.The efficacy,scores of TCM syndromes,renal function indicators,intestinal flora and intestinal barrier function were compared between the two groups.Results The effective rates of observation group and control group were 90.38%(47/52)and 75.00%(39/52),respectively(P<0.05).The scores of TCM syndromes and levels of serum creatinine(Scr),blood urea nitrogen(BUN)and plasma cystatin C(CysC)were significantly decreased in both groups(P<0.05),and the scores and levels in the observation group were lower than those in the control group(P<0.05).The contents of intestinal bifidobacteria,lactobacilli and bacteroides in the observation group were significantly enhanced(P<0.05)while the contents of Escherichia coli and Enterococcus were significantly reduced(P<0.05),but there were no significant changes in the contents of floras in the control group(P>0.05).The levels of serum D-lactic acid,procalcitonin(PCT)and diamine oxidase(DAO)were declined significantly(P<0.05),and there were no obvious changes in the indicators in control group(P>0.05).Conclusion Fuzheng Huazhuo Huoxue Decoction has a good effect in the treatment of CRF,and it can improve the distribution of intestinal flora and reduce the damage of intestinal mucosal barrier,and has a positive effect on relieving symptoms and improving renal function.

关 键 词：慢性肾功能衰竭 血液透析 扶正化浊活血汤 肠道菌群 肠黏膜屏障 

分 类 号：R692.5[医药卫生—泌尿科学]