健脾补肾活血泄浊法对慢性肾衰患者肠道微生态的影响

Effect of the Method of Jianpi Bushen Huoxue Xiezhuo Method on Intestinal micro-ecology in patients with Chronic Renal Failure

目的:观察肾康合剂联合中药灌肠液治疗,评价健脾补肾活血泄浊法对慢性肾衰患者肠道菌群微生态紊乱的纠正作用,并初步探讨其延缓慢性肾衰的机制。方法:选取60例中医辨证属于脾肾气虚,湿瘀内阻型的慢性肾衰患者分为治疗组30例、对照组30例。对照组采用基础治疗,治疗组在常规基础治疗的基础上加用肾康合剂口服及中药灌肠液灌肠,观察治疗组和对照组治疗前后主要症状积分、血肌酐、尿素氮、肠道菌落数量及种类、优势菌种类等指标的前后变化。结果:治疗组及对照组在临床症状改善,血肌酐及尿素氮值的下降方面均有作用,但治疗组改善作用更为明显。在肠道微生态改变方面,结果显示治疗组总需氧菌菌落数及大肠杆菌菌落数均明显下降,与治疗前比较有统计学差异(P<0.01),与对照组比较也有统计学差异(P<0.01)。而肠球菌菌落数无明显变化。治疗组总厌氧菌菌落数较治疗前及对照组均有上升,且有统计学差异(P<0.05),其中乳酸杆菌及双歧杆菌菌落数均较对照组及治疗前上升,且有统计学差异(P<0.01)。结论:肾康合剂联合中药灌肠治疗可以在一定程度上通过调节肠道微生态起到改善慢性肾功能衰竭患者的临床症状,保护肾脏功能的作用,结肠是中药复方防治慢性肾衰竭的有效靶点之一。

Objective： To observe the therapeutic effect of Shenkang mixture combined with traditional Chinese medicine enema liquid in the treatment of intestinal micro-ecological disorder in patients with chronic renal failure by invigorating spleen and invigorating kidney and activating blood circulation and releasing turbidity, and to explore the mechanism of delaying chronic renal failure. Methods： 60 patients with chronic renal failure were divided into treatment group（n=30） and control group（n=30）.The control group was treated with basic treatment, the treatment group was treated with Shenkang mixture orally and enema with traditional Chinese medicine enema on the basis of routine basic treatment. The main symptom scores, serum creatinine and urea nitrogen were observed before and after treatment in the treatment group and the control group.Number and species of intestinal colonies, dominant species, etc. Changes in indicators before and after.Results： both the treatment group and the control group had significant effects on the improvement of clinical symptoms, the decrease of serum creatinine and urea nitrogen, but the improvement was more obvious in the treatment group.The results showed that the total number of aerobic bacteria and the number of Escherichia coli colonies in the treatment group were significantly lower than those before treatment（P〈0.01） and compared with the control group（P〈0.01）. But the colony number of Enterococcus did not change obviously. The total number of anaerobes in the treatment group was higher than that before treatment and in the control group（P〈0.05）. Among them, Lactobacillus and Bifidobacterium were found in the treatment group. Conclusion： Shenkang mixture combined with traditional Chinese medicine enema can improve the clinical symptoms of patients with chronic renal failure by regulating intestinal micro-ecology, protect the function of the kidney, and the colon is one of the effective targets for the prevention and treatment of chronic renal failure.