益肾泄浊汤保留灌肠辅助治疗慢性肾衰竭行维持性血液透析伴高磷血症临床研究  

Clinical Study on Retention Enema with Yishen Xiezhuo Decoction as an Adjuvant Treatment for Chronic Renal Failure Undergoing Maintenance Hemodialysis Complicated with Hyperphosphatemia

作　　者：李开斌 杨毅 LI Kaibin;YANG Yi(Jinzhou Medical Uviversity Postgraduate Education Base(Chongqing University Three Gorges Hospital),Chongqing 404000,China;Urology and Kidney Disease Center,The Thirteenth People's Hospital of Chongqing,Chongqing 400053,China;Department of Hematology,Chongqing University Three Gorges Hospital,Chongqing 404000,China)

机构地区：[1]锦州医科大学研究生培养基地(重庆大学附属三峡医院),重庆404000 [2]重庆市第十三人民医院泌尿肾病中心,重庆400053 [3]重庆大学附属三峡医院血液科,重庆404000

出　　处：《新中医》2024年第20期70-74,共5页New Chinese Medicine

摘　　要：目的:观察益肾泄浊汤保留灌肠辅助治疗慢性肾衰竭(CRF)行维持性血液透析(MHD)伴高磷血症的临床疗效。方法:采用随机数字表法将88例CRF行MHD伴高磷血症患者分为观察组与对照组各44例。对照组予以碳酸钙D3片联合饮食色卡治疗,观察组在对照组基础上辅助益肾泄浊汤保留灌肠治疗。比较2组治疗前后中医证候积分、肾脏疾病生存质量专用量表(KDQOL-SFTM1.3)评分及血磷(P)、钙磷(Ca-P)乘积、甲状旁腺激素(iPTH)、肾功能指标[肌酐(SCr)、尿素氮(BUN)]水平,评估2组临床疗效、不良反应发生及疾病复发情况。结果:治疗后,观察组总有效率93.18%,高于对照组75.00%(P<0.05)。治疗后,2组中医证候积分、血P、Ca-P乘积、iPTH及血清SCr、BUN水平均较治疗前降低(P>0.05),KDQOL-SFTM1.3评分升高(P<0.05),且观察组中医证候积分、血P、Ca-P乘积、iPTH及血清SCr、BUN水平低于对照组(P<0.05),KDQOL-SFTM1.3评分高于对照组(P<0.05)。2组均未见严重不良反应。随访3个月,2组疾病复发率比较,差异无统计学意义(P>0.05)。结论:益肾泄浊汤保留灌肠辅助治疗CRF行MHD伴高磷血症疗效确切,能够有效促进患者血P代谢,改善肾功能,提高生活质量。Objective:To observe the clinical effect of retention enema with Yishen Xiezhuo Decoction as an adjuvant treatment for chronic renal failure(CRF)undergoing maintenance hemodialysis(MHD)complicated with hyperphosphatemia.Methods:A total of 88 cases of patients with CRF undergoing MHD complicated with hyperphosphatemia were divided into the observation group and the control group by random number table method,with 44 cases in each group.The control group was treated with Calcium Carbonate and Vitamin D3 Tablets combined with a diet color chart,and the observation group was additionally treated with retention enema with Yishen Xiezhuo Decoction on the basis of the control group.Traditional Chinese medicine(TCM)syndrome scores,Kidney Disease Quality of Life Short Form(KDQOL-SFTM1.3)scores,as well as levels of blood phosphorus(P),calcium phosphorus(Ca-P)product,parathyroid hormone(iPTH),and renal function indicators[creatinine(SCr)and urea nitrogen(BUN)]were compared before and after treatment between two groups.Clinical effects,incidence of adverse reactions and incidence of disease recurrence were evaluated in both groups.Results:After treatment,the total effective rate was 93.18%in the observation group,higher than that of 75.00%in the control group(P<0.05).After treatment,TCM syndrome scores,blood P,Ca-P product,iPTH,and the levels of serum SCr and BUN in the two groups were decreased when compared with those before treatment(P<0.05);KDQOL-SFTM1.3 scores were increased,and TCM syndrome scores,blood P,Ca-P product,iPTH,and the levels of serum SCr and BUN in the observation group were lower than those in the control group,with KDQOL-SFTM1.3 score in the observation group was higher than that in the control group(P<0.05).No serious adverse reations were observed in the two groups.After three months of follow-up,there was no significant difference being found in the recurrence rates between the two groups(P>0.05).Conclusion:Retention enema with Yishen Xiezhuo Decoction as an adjuvant treatment for CRF undergoing MHD c

关 键 词：慢性肾衰竭 血液透析 高磷血症 益肾泄浊汤 甲状旁腺激素 保留灌肠 

分 类 号：R692.5[医药卫生—泌尿科学]