中药结肠透析治疗慢性肾脏病(CKD)Ⅲ-Ⅴ期的最佳治疗频率探讨

Discussion on Best Treatment Frequency by Using Chinese Medicine Colon Dialysis in Patients with Chronic Kidney Disease Ⅲ–Ⅴ Periods

目的:通过不同频率中药结肠透析治疗慢性肾脏病(CKD)Ⅲ-Ⅴ期患者,探讨较佳的中药结肠透析治疗模式。方法:将69例CKDⅢ-Ⅴ期患者按就诊顺序分为A组(每日1次),B组(隔日1次)与C组(每周2次),最终符合病例63例,3组患者均予中药结肠透析,治疗4周,观察实验室指标变化。结果:3组患者治疗后Scr、UA、Ccr较同组治疗前均有不同程度的下降(P<0.05),治疗后3组组间比较,差异有统计学意义(P<0.05),A、B组结肠透析优于C组;3组患者治疗后BUN、SCys C,较同组治疗前均有不同程度的下降(P<0.05),治疗后3组组间比较差异无统计学意义(P>0.05);3组患者治疗后HB较同组治疗前有所升高(P<0.05),治疗后3组组间比较差异无统计学意义(P>0.05);3组患者治疗后K+、Na+、Cl-差异无统计学意义(P>0.05)。结论:中药结肠透析可不同程度的延缓慢性脏病Ⅲ-Ⅴ期的进程,每天1次与隔日1次的治疗频率效果优于每周2次的治疗频率。结合患者依从性及经济可行性,隔日1次中药结肠透析是一种较为理想的治疗频率。

Objective： To assess the best effective frequency of colon dialysis by using traditional Chinese medicine treatment of patients with chronic kidney disease（ CKD） at stage Ⅲ- Ⅴ. Methods： 60 cases of CKD Ⅲ- Ⅴwere divided into the treatment group A（ once per day）,group B（ once every other day） and group C（ twice per week）. The colon dialysis therapy of traditional Chinese medicine was used for four weeks and laboratory indexes were observed. Results：Compared with the same group before treatment,serum creatinine（ Scr）,blood uric acid（ UA） and endogenous creatinine clearance rate（ Ccr） were reduced significantly（ P〈0. 05）. The comparison between the three groups after treatment had statistically significant difference（ P 0.〈05）. A and B groups were better than group C. The decreasing of urea nitrogen（ BUN） and serum cystatin C were decreased after treatment（ P〉 0. 05） and there was no statistically significant difference after treatment among the three groups（ P〈 0. 05）. Compared with the same group before the treatment,hemoglobin（ HB） was increased（ P〈 0. 05） and there was no significant difference after treatment among the three groups（ P 〉0. 05）. After the treatment,there was no statistically significant difference in K^＋,Na^＋ and Cl^- in three groups（ P 〉0. 05）. Conclusion： The colon dialysis of TCM once per day is？ satisfactory and patients＇ tolerance is good as well. It is a reliable treatment frequency.