大黄与药用炭保留灌肠治疗慢性肾衰竭的临床疗效

Effects of Rhubarb and Medicinal Charcoal Coloclysis on Patients with Chronic Renal Failure

目的观察大黄与药用炭保留灌肠治疗慢性肾衰竭(CRF)患者的临床疗效。方法CRF患者40例,分为治疗组和对照组各20例。治疗组用药用炭粉剂15 g及大黄碳酸氢钠片15片加入0.9%氯化钠溶液400 mL中高位灌肠,qd;对照组用含大黄的中药保留灌肠,qd,疗程均为30 d。治疗前后测定血红蛋白(Hb)、血清总蛋白(Tp)、血清清蛋白(Alb)、血清尿素氮(BUN)、血清肌酐(Scr)和血尿酸(UA)等指标,并计算eGFR。结果治疗组患者BUN、Scr和UA较治疗前水平均明显下降(P<0.01),Hb,TP,Alb较治疗前水平升高(P>0.05)。二氧化碳结合力较治疗前上升(P<0.01)。对照组治疗后BUN、Scr、UA较治疗前水平均明显下降(均P<0.01),Hb,Tp和Alb较治疗前下降(P>0.05)。治疗组治疗后Scr及UA较对照组治疗后降低更明显(P<0.01),估计肾小球滤过率(eGFR)较对照组治疗后升高更明显(P<0.05)。结论用大黄与药用炭粉灌肠治疗CRF患者有明显效果,是CRF非透析治疗的有效方法之一。

Objective To investigate the effect of rhubarb and medicinal charcoal powder coloclysis on patients with chronic renal failure （CRF）. Methods Forty patients with CRF were divided into two groups： group A as a control was treated with rhubarb and orther traditional medicine coloclysis, group B was treated with both rhubarb and medicinal charcoal powder coloclysis. The levels of hemoglobin （Hb）, serum total protein （TP）, albumin （ALB）, blood urea nitrogen （BUN）, serum creatintine（Scr） , serum uric acid （UA） , CO2 CP and Na ＋ were measured before and after treatment. Results The levels of BUN, Scr and UA were decreased after treatment in group A and B （P 〈 0.01 ）. The levels of Hb, TP and ALB were increased after treatment （ P 〈 0.0l ） in two groups. A significant CO., CP improvement, rather than Na ^＋ , was observed after treatment in group B （ P 〈 0.01 ）. The degree of Scr and UA improvement after treatment in group B was more remarkable, compared with group A（ P 〈 0.05 ）. eGFR in group B was higher compared to that in group A after treatment （P 〈 0.05 ） . Conclusion Combination of rhubarb and medicinal charcoal powder coloclysis is an effective method for CRF patients.