高位结肠透析治疗维持性腹膜透析患者的临床疗效观察

Clinical Observation of High Colonic Dialysis in Patients of Maintenance Peritoneal Dialysis

目的观察高位结肠透析治疗维持性腹膜透析患者的临床疗效。方法 80例维持性腹膜透析患者随机分为对照组和治疗组,对照组给予基础治疗,治疗组在对照组基础上加用高位结肠透析,每周2次,12周后观察相关生化指标变化。并根据《中药新药临床研究指导原则》慢性肾衰竭症状分级量化表,胃肠道症状分级量表(GSRS)和主观综合营养评估表(SGA)对患者中医证候、胃肠道症状及营养状况等进行综合评估。结果 (1)治疗12周后治疗组SCr、BUN、UA较治疗前显著下降(P<0.05),且治疗组低于对照组(P<0.05);(2)治疗12周后治疗组CRP降低,Hb、ALB较治疗前升高(P<0.05);且治疗组Hb、ALB高于对照组,CRP低于对照组(P<0.05);(3)治疗12周后治疗组倦怠乏力、腰膝酸软、食少纳呆、恶心呕吐、大便干结、浮肿中医征候积分低于治疗前(P<0.05),治疗组中医证候积分明显低于对照组(P<0.05);(4)治疗后治疗组GSRS积分、SGA积分较治疗前显著降低(P<0.05),治疗组明显低于对照组(P<0.05)。结论高位结肠透析能在一定程度上有效改善维持性腹膜透析患者肾功能,微炎症状态、营养状况及胃肠道症状,并能改善倦怠乏力、腰膝酸软、食少纳呆、恶心呕吐、大便干结、浮肿等中医证候症状。

Objective To explore the clinical efficacy of high colonic dialysis in maintenance of peritoneal dialysis patients.Methods 80 patients with maintenance peritoneal dialysis were ran- domly divided into control group （basic treatment） and treatment group （basic treatment＋high colonic dialysis） ,with 2 times a week.After 12 weeks,the changes of related biochemical inde- xes were observed.And according to chronic renal failure symptoms grading quantification table in the Chinese Medicine New Drug Clinical Research Guidelines ,Gastrointestinal Symptom Rat- ing Scale （GSRS） and Subjective Global Assessment （SGA） were used to evaluate the TCM syndromes,gastrointestinal symptoms and nutritional status of patients.Reselts After treatment for 12 weeks,the SCr, BUN and UA in the treatment group significantly decreased compared with those before treatment （P〈O.05）, and were better than those in the control group.The CRP in the treatment group decreased,and the Hb and ALB increased compared with those be-fore treatment （P〈O.05）.The Hb,ALB and CRP in the treatment group were better than those in the control group （P〈O. 05）.The weakness, weak waist and knees, less appetite,nausea, vomiting, stool dryness and edema in the treatment group were better than those before treat- ment and in the control group （P〈O. 05）.The GSRS and SGA scores in the treatment group was significantly lower than those before treatment and better than those in the control group （P〈 O. 05）.Conclusion High colonic dialysis can improve the maintenance peritoneal dialysis patients with renal function, microinflammatory state,nutritional status and gastrointestinal symptoms, and can decrease weakness, weak waist and knees, less appetite, nausea, vomiting, stool dry- ness and edema.