基于肠肾轴理论探讨耳穴压豆对尿毒症透析患者肠源性尿毒素的影响及相关机制探讨  

Based on the Theory of Gut-kidney Axis to Explore the Effect of Auricular Acupoint Pressing Beans on Intestinal-derived Uremic Toxins in Uremic Dialysis Patients and the Related Mechanism

作　　者：雷天香[1] 林少勤 付菊荣[1] 李玉玲[1] 罗坤明 陈河梅 LEI Tianxiang;LIN Shaoqin;FU Jurong(Department of Nephrology,The Second Hospital of Middle School of Guangdong Province,Guangzhou,510095)

机构地区：[1]广东省第二中医院肾病科,广州510095

出　　处：《中国中西医结合肾病杂志》2024年第4期323-326,I0004,共5页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：广东省中医药局科研项目(No.20201030)。

摘　　要：目的:探讨基于肠肾轴理论耳穴压豆对尿毒症透析患者肠源性尿毒素的影响。方法:通过便利抽样法选取广东省第二中医院2021年01月—2022年01月住院的52例尿毒症透析患者,均给予基于肠肾轴理论耳穴压豆法治疗,比较治疗前后肾功能指标、血清肠源性尿毒症毒素硫酸对甲酚(PCS)、硫酸吲哚酚(IS)、便秘症状积分,使用16S rDNA测序分析观察微生态指标肠道菌群变化。结果:治疗后、随访4周血清肌酐(Scr)、尿素氮(BUN)、血清肠源性尿毒症毒素PCS、IS、便秘症状积分均低于治疗前,差异有统计学意义(P<0.05)。尿毒症透析患者治疗后肠道菌群多样性明显增加,尿毒症透析患者治疗后肠道菌群仍旧以变形杆菌、厚壁菌门为主,其中拟杆菌门相对比治疗前丰度增下降,差异有统计学意义(P<0.05)。结论:基于肠肾轴理论耳穴压豆可有效减轻尿毒症血液透析患者肾功能受损程度,降低PCS、IS水平,调节大便性状,改变肠道菌群结构。Objective:To investigate the effect of ear-point compression of bean on enteric-borne urotoxin in dialysis patients with uremia based on entero-renal axis theory.Methods:52 uremic dialysis patients admitted to the Second Middle School Hospital of Guangdong Province from January 2021 to January 2022 were selected by convenience sampling method.All of them were treated with auricular acupoint pressure bean method based on entero-renal axis theory.Renal function indexes,serum enteric-borne uremic toxin para-sol sulfate(PCS),indoxyl sulfate(IS)and constipation symptom scores before and after treatment were compared.16S rDNA sequencing was used to observe the changes of intestinal microflora.Results:After treatment and at 4 weeks of follow-up,serum creatinine(Scr),urea nitrogen(BUN),serum enteric-borne uremic toxin PCS,IS and constipation symptom scores were lower than before treatment,and the differences were statistically significant(P<0.05).The intestinal flora diversity of uremia dialysis patients increased significantly after treatment,and Proteus and Firmicutes still dominated the intestinal flora of uremia dialysis patients after treatment,and the abundance of Bacteroides decreased compared with that before treatment,with statistical significance(P<0.05).Conclusion:Based on the theory of entero-renal axis,ear point compression of beans can effectively reduce the degree of renal damage,reduce the level of PCS and IS,adjust stool characteristics,and change the structure of intestinal flora in uremic hemodialysis patients.

关 键 词：肠肾轴理论 耳穴压豆 尿毒症 血液透析 肠源性尿毒素 

分 类 号：R692.5[医药卫生—泌尿科学]