中药灌肠联合熏蒸辅助治疗脾肾阳虚、浊毒血瘀型慢性肾脏病3~5期非透析患者60例随机对照试验  

Chinese Herbal Enema Combined with Fumigation as Adjunctive Therapy for 60 Cases of Non-dialysis Chronic Kidney Disease Patients of Stage 3-5 with Spleen-kidney Yang Deficiency and Turbid Toxin Blood Stasis Pattern:A Randomized Controlled Trial

作　　者：黄雪莹 张宁[1] 李翔宇 张倩 石凯峰[1] 闫璞 李同侠[1] HUANG Xueying;ZHANG Ning;LI Xiangyu;ZHANG Qian;SHI Kaifeng;YAN Pu;LI Tongxia(Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing,100102)

机构地区：[1]中国中医科学院望京医院,北京市100102

出　　处：《中医杂志》2024年第7期703-709,共7页Journal of Traditional Chinese Medicine

基　　金：北京市科技计划课题(Z171100001017110);北京市中医药科技发展资金项目(BJZYYB-2023-43)。

摘　　要：目的观察中药灌肠联合熏蒸辅助治疗脾肾阳虚、浊毒血瘀型CKD3~5期非透析患者的临床疗效及安全性。方法将120例脾肾阳虚、浊毒血瘀型CKD3~5期非透析治疗患者随机分为治疗组和对照组各60例。对照组给予西医基础治疗,治疗组在对照组基础上联合中药肾衰灌肠方滴注保留灌肠及肾衰熏蒸方进行熏蒸,中药熏蒸和中药灌肠交替进行,均两日1次,每周3次。两组疗程均为4周。比较两组患者治疗前后血肌酐(Scr)水平、估计肾小球滤过率(eGFR)及中医症状总积分,治疗后比较两组中医症状疗效和临床疗效。治疗期间观察两组患者不良反应。结果与本组治疗前比较,两组治疗后中医症状总积分明显降低(P<0.01)。与对照组治疗后比较,治疗组Scr、中医症状总积分明显下降,eGFR明显升高(P<0.05)。治疗组中医症状疗效总有效率(96.67%)高于对照组(46.67%,P<0.01),治疗组临床疗效总有效率(75.00%)高于对照组(28.33%,P<0.01)。治疗期间两组患者生命体征平稳,治疗后血常规、尿常规、便常规、肝功能指标及心电图较治疗前无明显异常改变。结论中药灌肠联合熏蒸辅助治疗脾肾阳虚、浊毒血瘀型CKD3~5期非透析治疗患者可以明显减轻临床症状,改善肾功能,且安全性较好。Objective To observe the clinical efficacy and safety of Chinese herbal enema combined with fumi⁃gation as adjunctive therapy for non-dialysis chronic kidney disease(CKD)patients of stage 3-5 with spleen-kidney yang deficiency and turbid toxin blood stasis pattern.Methods A total of 120 non-dialysis CKD,patients of stage 3-5 with spleen-kidney yang deficiency and turbid toxin blood stasis pattern were randomly divided into treatment group and control group,with 60 cases in each group.The control group received conventional western medical treat⁃ment,while the treatment group additionally received Chinese herbal enema combined with fumigation,with enema and fumigation performed alternately,once every other day,three times a week.The treatment course for both groups was 4 weeks.The levels of serum creatinine(Scr),estimated glomerular filtration rate(eGFR),and the total score of traditional Chinese medicine symptoms were compared before and after treatment in both groups.The efficacy of tradi⁃tional Chinese medicine symptoms and clinical efficacy were compared between the two groups after treatment.Adverse reactions in both groups were observed during the treatment period.Results The total score of traditional Chinese medicine symptoms was significantly reduced after treatment in both groups(P<0.01).Compared to the control group after treatment,the treatment group showed significant decreases in Scr and the total score of traditional Chinese medicine symptoms,and a significant increase in eGFR(P<0.05).The total effective rate of traditional Chinese medicine symptoms in the treatment group(96.67%)was higher than that in the control group(46.67%,P<0.01),as well as the total effective rate of clinical efficacy in the treatment group(75.00%)versus that in the control group(28.33%,P<0.01).During the treatment period,the vital signs of patients in both groups remained stable,and there were no significant abnormalities in blood routine,urine routine,stool routine,liver function indica⁃tors,and electrocardiogram aft

关 键 词：慢性肾脏病 脾肾阳虚 浊毒血瘀 非透析治疗 中药灌肠 中药熏蒸 随机对照试验 

分 类 号：R277.5[医药卫生—中医学]