中药保留灌肠治疗慢性肾功能衰竭临床研究

Clinical Effect of Traditional Chinese Medicine Retention Enema in Treatment of Chronic Renal Failure

目的观察大黄龙骨牡蛎汤保留灌肠治疗慢性肾衰竭(chronic renal failure,CRF)脾肾气虚证的临床疗效。方法将41例非透析CRF患者随机分为治疗组和对照组,对照组21例给予一般治疗,治疗组20例在对照组治疗的基础上加大黄龙骨牡蛎汤灌肠治疗,2周为1个疗程,共治疗2个疗程。观察比较两组患者临床疗效、中医症状评分以及血尿素氮(blood urea nitrogen,BUN)、血清肌酐(serum creatinine,SCr)、肾小球滤过率(glomerular filtration rate,GFR)、24小时尿蛋白定量(24-hour urinary protein quantity,24hPr)、白蛋白(albumin,ALB)、血清总蛋白(serum total protein,TP)、血红蛋白(hemoglobin,Hb)水平。结果两组患者临床疗效分布比较,差异有统计学意义(P<0.05)。与治疗前比较,对照组治疗效果不明显(P>0.05),治疗组水肿、倦怠乏力、腰膝酸软、气短懒言、脘腹胀满、口淡不渴评分均有明显降低(P<0.05)。治疗后治疗组食少纳呆、倦怠乏力、腰膝酸软、气短懒言、脘腹胀满、口淡不渴评分下降幅度均显著大于对照组(P<0.05)。与治疗前比较,对照组各指标水平均无明显改变(P>0.05);治疗组BUN、SCr水平均明显下降(P<0.05),GFR、Hb水平均明显升高(P<0.05)。治疗组BUN、SCr降低值,GFR升高值均显著大于对照组(P<0.05)。结论在西医治疗基础上合用大黄龙骨牡蛎汤灌肠,能够改善患者肾功能,提高CRF的临床疗效。

Objective To investigate the clinical effect of retention enema with Dahuang Longgu Muli Decoction in the treatment of chronic renal failure(CRF).Methods A total of 41 CRF patients who did not undergo dialysis were randomly divided to treatment group with 20 patients and control group with 21 patients.The patients in the control group were given general treatment,and those in the treatment group were given retention enema with Dahuang Longgu Muli Decoction in addition to the treatment in the control group.Each course of treatment was 2 weeks,and both groups were treated for 2 courses.The two groups were observed and compared in terms of clinical outcome,traditional Chinese medicine symptom score,blood urea nitrogen(BUN),serum creatinine(SCr),glomerular filtration rate(GFR),24-hour urine protein quantitation,albumin,serum total protein,and hemoglobin(Hb).Results There was a significant difference in the distribution of clinical outcomes between the two groups(P<0.05).The control group had no marked improvement after treatment(P>0.05),while the treatment group had significant reductions in the scores of edema,fatigue/weakness,soreness and weakness of the waist and knees,short breath and laziness to speak,abdominal fullness and distention,and tastelessness in the mouth and not thirsty(P<0.05).Compared with the control group,the treatment group had significantly greater reductions in the scores of poor appetite,fatigue/weakness,soreness and weakness of the waist and knees,short breath and laziness to speak,abdominal fullness and distention,and tastelessness in the mouth and not thirsty(P<0.05).After treatment,the control group had no significant changes in related indices(P>0.05),while the treatment group had significant reductions in BUN and SCr(P<0.05)and significant increases in GFR and Hb(P<0.05).Compared with the control group,the treatment group had significantly greater reductions in BUN and SCr and a significantly greater increase in GFR(P<0.05).Conclusion Retention enema with Dahuang Longgu Muli Decoction combined with Western medicine treatment can improve the renal function and clinical outcome of CRF patients.