丹参川芎嗪注射液联合中药灌肠对慢性肾脏病的疗效及作用机制研究

Effect of Salvia Miltiorrhiza and Ligustrazine Injection in Combination with Traditional Chinese Medicine Enema on Chronic Kidney Disease and its Mechanism

目的:观察丹参川芎嗪注射液联合中药灌肠对慢性肾脏病(CKD)的疗效及对内皮素(ET),6-酮前列腺素F1a(6-Keto-PGF1a)及血栓素B2(TXB2)的影响。方法:70例CKD 3期、4期患者随机分为观察组和对照组各35例。对照组给予常规西医对症处理及大黄液灌肠治疗,每次注入200 mL,保留灌肠1～2 h,以灌入距离肛门大约20 cm处为标准。1次/d。观察组加用丹参川芎嗪注射液15 mL,以生理盐水100 mL稀释,静脉滴注。连续10 d;休息2 d再行下1个疗程。共2个疗程。于治疗前后检测血肌酐(SCr)、尿素氮(BUN),ET,6-Keto-PGF1a及TXB2水平。结果:观察组总有效率71.43%,优于对照组的45.71%(P<0.05);治疗后观察组BUN和SCr水平均低于对照组(P<0.05,P<0.01);治疗后两组ET和TXB2水平下降,6-keto-PGF1a水平上升,观察组ET和TXB2均低于对照组,而6-keto-PGF1a水平高于对照组(P<0.05)。结论:丹参川芎嗪注射液能降低CKD 3期、4期患者血BUN和SCr水平,提高临床疗效,并能改善患者高凝状态,保护血管内皮功能。

Objective：To observe the effect of salvia miltiorrhiza and ligustrazine injection in combination with traditional Chinese medicine enema on chronic kidney disease（CKD）,endothelin（ET）,6-keto-prostaglandin F1α（6-keto-PGF1α） and thromboxane B2（TXB2）.Method：Seventy patients with stage 3-4 CKD were randomly divided into observation group and control group（n=35 each）.Control group was received western medicine therapy and rhubarb fluid enema.200 mL rhubarb fluid were given via retention enema for 1-2 h and inserted into the intestine 20cm daily.The patients in observation group,on the basis of control group,were received salvia miltiorrhiza and ligustrazine injection 15 mL,diluted with 100 mL saline,iv,for 10 days.After two days＇ rest,the patients were received another course.There were two courses.Serum creatine（SCr）,blood urea nitrogen（BUN）,ET,6-Keto-PGF1α and TXB2 were tested before and after treatment.Result：The total effective rate of observation group（71.43%） was higher than control group（45.71%） with a significant difference（P0.05）.BUN and SCr in observation group were lower than control group（P0.05,P0.01）;After treatment,ET and TXB2 were decreased,and 6-keto-PGF1α increased in two growps.ET and TXB2 in observation group were lower than those in control group,however,6-keto-PGF1α in observation group was higher than that in control group（P0.05）.Conclusion：Salvia miltiorrhiza and ligustrazine injection can decrease BUN and SCr in patients with stage 3-4 CKD,improve clinical efficacy,ameliorate hypercoagulative state and protect vascular endothelial function.