中药保留灌肠治疗维持性腹膜透析湿热证临床研究  

Clinical Research on the Treatment of Damp-Heat Syndrome in Maintenance Peritoneal Dialysis with Traditional Chinese Medicine Retention Enema

作　　者：郭思扦 李庆[1] 李泽森 何立乾 王旭栋 史健 GUO Siqian;LI Qing;LI Zesen;HE Liqian;WANG Xudong;SHI Jian(Shaanxi University of Chinese Medicine,Xianyang 712046,China;Shaanxi Provincial Hospital of Chinese Medicine,Xi'an 710003,China)

机构地区：[1]陕西中医药大学,陕西咸阳712046 [2]陕西省中医医院,陕西西安710003

出　　处：《现代中医药》2025年第2期88-93,共6页Modern Chinese Medicine

基　　金：陕西省中医药管理局科研课题(SZY-KJCYC-2020-YJ)。

摘　　要：目的观察中药保留灌肠对腹膜透析患者辨证属湿热证的临床疗效及安全性。方法回顾性分析纳入符合标准的70例终末期肾脏病患者,将其随机分为治疗组35例和对照组35例,对照组予以常规腹膜透析及西医基础治疗,治疗组在上述基础上加用中药保留灌肠治疗(隔日1次,共7次),治疗2 w后,对比两组治疗前后肾功能、电解质、超滤量、BNP、BCM、中医症状积分及临床疗效。结果治疗组患者总有效率91.42%,优于对照组总有效率71.42%(P<0.05);治疗组治疗后肾功能、电解质、炎症指标、BNP、BCM及腹痛不适、乏力、便秘、纳差、水肿等各项症状评分明显低于治疗前及对照组治疗后,且超滤量水平明显高于治疗前及对照组治疗后(P<0.05);治疗组治疗后血红蛋白指标高于对照组,但其差异无统计学意义(P<0.05)。结论中药保留灌肠能明显改善维持性腹膜透析患者的肾功能、容量负荷、促进电解质稳定、减轻微炎症状态、缓解临床症状,对血红蛋白水平无明显提高作用。Objective To observe the clinical efficacy and safety of traditional Chinese medicine retention enema in patients with peritoneal dialysis and diagnosed with damp-heat syndrome.Methods A retrospective analysis was conducted on 70 patients with end-stage renal disease who met the inclusion criteria.They were randomly divided into a treatment group of 35 cases and a control group of 35 cases.The control group received conventional peritoneal dialysis and basic Western medical treatment,while the treatment group was given traditional Chinese medicine retention enema in addition to the above treatment(once every other day for a total of 7 times).After 2 weeks of treatment,the renal function,electrolytes,ultrafiltration volume,BNP,BCM,TCM symptom scores and clinical efficacy were compared between the two groups before and after treatment.Results The total effective rate of the treatment group was 91.42%,which was significantly higher than that of the control group(71.42%,P<0.05).After treatment,the renal function,electrolytes,inflammatory markers,BNP,BCM and scores of abdominal pain,fatigue,constipation,anorexia and edema in the treatment group were significantly lower than those before treatment and those in the control group after treatment,and the ultrafiltration volume was significantly higher than that before treatment and that in the control group after treatment(P<0.05).The hemoglobin level in the treatment group after treatment was higher than that in the control group,but the difference was not statistically significant(P>0.05).Conclusion Traditional Chinese medicine retention enema can significantly improve the renal function,fluid load,promote electrolyte stability,reduce micro-inflammatory state and relieve clinical symptoms in patients with maintenance peritoneal dialysis,but has no significant effect on increasing hemoglobin levels.

关 键 词：脏邪腑出法 腹膜透析 中药灌肠 终末期肾脏病 容量负荷 

分 类 号：R256.5[医药卫生—中医内科学]