中药结肠透析治疗慢性肾脏病Ⅲ～Ⅴ期疗效的相关性分析

Correlation Analyses of Curative effects by Using Chinese Medicine Colon Dialysis in Patients with Chronic Kidney Disease Ⅲ–Ⅴ Stages

目的：分析中药结肠透析对慢性肾脏病（CKD）Ⅲ-Ⅴ期患者的治疗效果,探讨其疗效与透析频率及患者年龄、性别、CKD分期、贫血程度、营养状况的相关性。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组患者在基础治疗的前提下,均予中药结肠透析治疗4周,观察实验室指标变化,比较不同治疗频率、年龄、性别、CKD分期、贫血程度及营养状态对中药结肠透析疗效的影响。结果：3组患者治疗前后血肌酐、血尿酸、内生肌酐清除率差值比较,差异统计学意义（P〈0.05）,A、B组中药结肠透析优于C组;60岁以下患者行中药结肠透析的疗效优于老年患者,并且年龄与其血肌酐下降比例（R1）及内生肌酐清除率升高比例（R2）呈负相关（R12=0.23,R22=0.227）;而性别、CKD分期、贫血及营养状态对中药结肠透析的疗效无明显相关性（P〉0.05）。结论：每日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。60岁以下患者行中药结肠透析能获得更好的疗效。

Objective： To analyze the curative effect by using Chinese medicine colon dialysis to treat patients with chronic kidney disease（ CKD） at stage 3 to 5 and assess the correlation between the curative effect and Chinese Medicine colon dialysis frequencies,the age of patients,the gender of patients,the stage of CKD,the degree of anemia and the nutritional status. Methods： 69 patients of CKD Ⅲ - Ⅴwere divided into three groups： A（ once per day）,B（ once every other day） and C（ twice per week）. 63 patients were enrolled finally. The study was lasted for four weeks and laboratory index were extracted,and then we compared the curative effect between the different ages,genders,the stages of CKD,the degree of anemia and the nutritional status. Results： Significant difference was found in serum creatinine（ Scr）,blood uric acid,endogenous creatinine clearance rate（ Ccr） in the range before and after treatment respectively（ P〈 0. 05） and the effect of once per day treatment and once every other day treatment was better than that of twice per week treatment. The curative effect of the patients under 60 with Chinese medicine colon dialysis was better than that of elderly patients and there was a negative correlation between the age and the proportion of Ccr decreased（ R12= 0. 23） and Scr improved（ R22=0. 227）. But no relation was found between the genders,the stages of CKD,the degrees of anemia,nutritional status and the curative effect of Chinese medicines colon dialysis（ P〈 0. 05）. Conclusion： The effect of once per day treatment and once every other day treatment was better than that of twice per week treatment. The patients under 60 had a better effect by using Chinese medicines colon dialysis.