加味黄连解毒汤灌肠用于慢性肾衰竭氮质血症期患者的疗效观察

Modified Coptidis Decoction for Detoxification Used as Enema for Patients with Chronic Renal Failure in the Phase of Azotemia

目的探讨加味黄连解毒汤灌肠治疗慢性肾衰竭氮质血症期的疗效。方法将120例慢性肾衰竭氮质血症期患者随机分为治疗组及对照组各60例。对照组给予西医常规治疗(包括去除各种诱发和加重肾衰竭的因素,如感染、高血压等;给予优质低蛋白、低盐、低磷饮食,纠正水、电解质及酸碱平衡紊乱;高血压者给予降压治疗;纠正贫血);治疗组在对照组治疗基础上,采用加味黄连解毒汤200ml灌肠,保留l^2 h。两组治疗时间均为4周。观察临床表现,检测治疗前后血肌酐(SCr)、血尿素氮(BUN)及血尿酸(UA)的水平。结果对照组、治疗组治疗后BUN和SCr含量均显著降低,差异有统计学意义(P<0.01或P<0.05);治疗组较对照组更明显,差异有统计学意义(均P<0.05)。治疗组总有效率95.00%,对照组总有效率65.00%,两组相比有显著性差异(P<0.01)。结论加味黄连解毒汤灌肠治疗慢性肾衰竭氮质血症期效果肯定,对慢性肾功能衰竭患者功能恶化速度有明显抑制,早期使用能有效干预肾功能衰竭的发展,逆缓步入透析的时间,同时降低了医疗费用。

Objective To investigate the effect of Modified Coptidis Decoction for Detoxification used as enema patients with chronic renal failure in the phase of azotemia. Methods 120 patients with chronic renal failure in the phase of azotemia were randomly divided into treatment group and control group,60 cases for each. Routine western medicine was performed in the control group,including the removal of a variety of factors that induce and aggravate the renal failure, such as infection and high blood pressure, giving high-quality, low-protein, low-salt, low- phosphorus diet, correcting the imbalance of water, electrolyte and acid-base,antihypertensive treatment were given for high blood pressure,and so on. In the treatment group,modified Coptidis Decoction for Detoxification was used based on the therapy in the control group, keeping 1-2 h. Observation period is 4 weeks. Clinical manifestation was observed and serum creatinine （SCr）, blood urea nitrogen（BUN）and uric acid（UA）were tested before and after treatment. Results After 4 weeks of treatment and care,there were significant improvement in biochemical mark- ers in both the treatment group and the control group,including SCr and BUN. And the improvement is more obvious in the treatment group. Total effective rate is 95.00% in the treatment group and 65.00% in the control group. Conclusion Modified Coptidis Decoction for Detoxification can significantly inhibit the speed of deterioration of patients with chronic renal failure, early use of this effective intervention can delay the development of renal failure and reduce medical costs.