肾衰灌肠液辅助治疗慢性肾脏病3~4期的临床疗效及对血清IS、PCS、TMAO的影响  

Clinical Efficacy of Renal Failure Enema as an Adjuvant Therapy for Chronic Kidney Disease Stages 3-4 and Its Effect on Blood IS,PCS,and TMAO

作　　者：王婧[1] 张勉之 WANG Jing;ZHANG Mianzhi(Tianjin University of Traditional Chinese Medicine(TCM),Tianjin 300193,China;Affiliated Hospital of Tianjin Institute of TCM,Tianjin 300120,China)

机构地区：[1]天津中医药大学,天津300193 [2]天津市中医药研究院附属医院,天津300120

出　　处：《中国实验方剂学杂志》2025年第6期164-170,共7页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：中国中医科学院科技创新工程项目(CI2022E024XB);张勉之天津市名中医传承工作室项目。

摘　　要：目的:观察肾衰灌肠液保留灌肠辅助治疗慢性肾脏病3~4期患者的临床疗效和对血清尿毒症毒素的影响。方法:将2023年6月—2023年11月天津市中医药研究院附属医院肾病科住院部60例慢性肾脏病3~4期患者采用随机数表法分为对照组和观察组各30例。两组均行科内常规中西医对症治疗;观察组在对照组基础上加用院内制剂肾衰灌肠液100~200 mL,隔日1次。总疗程4周。比较两组治疗前后血肌酐(SCr)、尿素氮(BUN)、尿酸(UA)、24 h尿蛋白定量、血清尿毒症毒素硫酸吲哚酚(IS)、硫酸对甲酚(PCS)、氧化三甲胺(TMAO)的变化。计算中西医临床总有效率并记录不良反应情况。结果:治疗前,两组患者基线水平具有可比性。治疗后观察组总有效率(80.0%,24/30)优于对照组(53.3%,16/30),差异具有统计学意义(Z=2.267,P=0.023)。与本组治疗前比较,两组治疗后中医证候积分均较前降低,其中观察组差异具有统计学意义(P<0.01)。与对照组治疗后比较,观察组患者中医证候积分明显降低且治疗前后差值更大(P<0.05)。与本组治疗前比较,两组患者治疗后SCr均较治疗前下降(P<0.05),观察组患者BUN水平明显降低(P<0.05),观察组患者IS、PCS水平明显降低(P<0.05,P<0.01),与对照组治疗后比较,观察组患者IS水平明显降低(P<0.05)。试验期间,两组患者均无不良反应发生。结论:肾衰灌肠液能够辅助治疗慢性肾脏病CKD 3~4期患者,既能减缓肾功能进展,又能较好地下调尿毒症毒素含量,且对肾脏病患者中医证候有显著改善,值得临床应用推广。Objective:To observe the clinical efficacy of renal failure enema for retention enema as an adjuvant therapy in patients with chronic kidney disease stages 3-4 and its effect on serum uremic toxins including indoxyl sulfate(IS),p-cresol sulfate(PCS),and trimethylamine oxide(TMAO).Methods:A total of 60 patients with stage 3-4 chronic kidney disease in the Department of Nephrology,Affiliated Hospital of Tianjin Institute of Traditional Chinese Medicine from June 2023 to November 2023,were divided into a control group and an observation group.Each group consisted of 30 patients,and the random number table method was used for the division.Both groups received routine symptomatic treatment of traditional Chinese medicine(TCM)and Western medicine in the department.The observation group,based on the treatment of the control group,was additionally given 100-200 mL of the hospital-made renal failure enema capsules once every other day.The total treatment course was 4 weeks.The changes in serum creatinine(SCr),blood urea nitrogen(BUN),uric acid(UA),24-hour urine total protein quantification(24 h UTP),and serum uremic toxins such as IS,PCS,and TMAO were compared between the two groups before and after treatment.The total clinical effective rate of TCM and Western medicine was calculated and the adverse reactions were recorded.Results:Before treatment,the baseline levels of the two groups were comparable.After treatment,the total effective rate of the observation group(80.0%,24/30)was superior to that of the control group(53.3%,16/30),and the difference was statistically significant(Z=2.267,P=0.023).After treatment,the TCM pattern scores of the two groups were lower than before,and the constipation symptoms in the observation group were improved(P<0.01).Compared with the control group after treatment,the observation group showed decreased TCM syndrome scores,and the difference before and after treatment was larger(P<0.05).Compared with before treatment,the SCr in both groups decreased after treatment(P<0.05).BUN levels decre

关 键 词：肾衰灌肠液 慢性肾脏病 疗效观察 尿毒症毒素 

分 类 号：R259[医药卫生—中西医结合] R969.4[医药卫生—中医内科学] R692[医药卫生—中医学]