大黄牡蛎灌肠方联合序贯式结肠透析治疗慢性肾脏病2~4期临床研究  

Dahuang Muli Enema Prescription Combined with Sequential Colon Dialysis in the Treatment of Chronic Kidney Disease in 2-4 Stage

作　　者：周冬林 陈宇 胡春安 姚洁 阳贵林 ZHOU Donglin;CHEN Yu;HU Chun’an;YAO Jie;YANG Guilin(Department of Nephrology and Rheumatology of Traditional Chinese Medicine,General Hospital of Pingxiang Mining Group Co.,Jiangxi Province,Pingxiang 337000,China)

机构地区：[1]萍乡矿业集团有限责任公司总医院中医肾病风湿科,江西萍乡337000

出　　处：《中国中医药现代远程教育》2024年第14期118-121,共4页Chinese Medicine Modern Distance Education of China

基　　金：江西省中医药管理局科技计划项目【No.SZYYB20216884】。

摘　　要：目的观察大黄牡蛎灌肠方联合序贯式结肠透析治疗慢性肾脏病(CKD)2~4期的临床效果。方法将60例CKD2~4期患者按照随机、平行对照原则分成两组,对照组给予大黄牡蛎灌肠方中药保留灌肠配合CKD基础治疗,治疗组给予大黄牡蛎灌肠方联合序贯式结肠透析配合CKD基础治疗。观察两组疗效性指标、安全性指标及不良反应情况。结果治疗后,治疗组中医证候积分较治疗前降低,尿素氮(BUN)、血肌酐(Scr)、内生肌酐清除率(Ccr)、同型半胱氨酸(Hcy)均较治疗前改善,差异均有统计学意义(P<0.05);甲状旁腺激素(PTH)、β_(2)微球蛋白(β_(2)-MG)水平较治疗前下降,但差异均无统计学意义(P>0.05)。治疗后,两组丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)水平比较,差异无统计学意义(P>0.05)。结论大黄牡蛎灌肠方联合序贯式结肠透析不仅可以明显改善CKD2~4期患者的临床证候,而且可以明显改善其肾功能,对Hcy等蛋白结合型毒素清除效果显著,对PTH、β_(2)-MG等中分子毒素也有一定清除效果,是卓有成效的治疗方法。Objective To observe the clinical efficacy of Dahaung Muli enema prescription combined with sequential colon dialysis in the treatment of chronic kidney disease(CKD)in 2-4 stage.Methods Sixty patients with stage CKD in 2-4 stage were divided into two groups according to the principle of random and parallel control.The control group was given Dahaung Muli enema prescription and Chinese medicine retention enema combined with basic CKD treatment,and the treatment group was given Dahaung Muli enema prescription combined with sequential colon dialysis combined with basic CKD treatment.The efficacy indexes,safety indexes and ad-verse reactions of the two groups were observed.Results After treatment,the TCM syndrome score in the treatment group was lower than before treatment,and urea nitrogen(BUN),blood creatinine(Scr),endogenous creatinine clearance(Ccr)and homocysteine(Hcy)were improved compared with before treatment,and the difference was statistical significance(P<0.05).The levels of parathyroid hor-mone(PTH)andβ_(2)-microglobulin(β_(2)-MG)were decreased compared with those before treatment,but the differences were not statisti-cally significant(P>0.05).After treatment,there was no significant difference in the levels of alanine aminotransferase(ALT)and as-partate aminotransferase(AST)between two groups(P>0.05).Conclusion Dahaung Muli enema prescription combined with sequential colon dialysis can not only significantly improve the clinical syndromes of CKD2-4 patients,but also significantly improve their renal function.It has a remarkable effect on the clearance of protein-binding toxins such as Hcy,and a certain effect on the clearance of PTH,β_(2)-MG and other medium molecular toxins,which is an effective treatment method.

关 键 词：水肿 慢性肾脏病 大黄牡蛎灌肠方 序贯式结肠透析 中西医结合疗法 

分 类 号：R69[医药卫生—泌尿科学]