脐疗治疗脾肾亏虚夹瘀浊型慢性肾脏病患者胃肠功能紊乱的临床观察

Clinical Observation of Umbilical Therapy in Treating Gastrointestinal Dysfunction in Patients with Chronic Kidney Disease Differentiated as Spleen-kidney Deficiency with Stagnation and Turbidity

目的观察脐疗治疗脾肾亏虚夹瘀浊型慢性肾脏病患者胃肠功能紊乱的临床疗效。方法纳入64例脾肾亏虚夹瘀浊型慢性肾脏病(3~5期)合并有胃肠功能紊乱的患者,采用随机数字表法分为观察组和对照组,每组32例。对照组予西医基础治疗,观察组在对照组治疗基础上联合脐疗。观察两组患者治疗前后中医证候评分和肾功能指标(血肌酐和尿素氮)的变化,并比较两组临床疗效。结果治疗后,观察组中医证候评分优于对照组,差异具有统计学意义(P<0.05);两组血肌酐和尿素氮水平均低于治疗前(P<0.05),且观察组治疗后低于对照组(P<0.05)。治疗后,观察组中医证候各单项的疗效均优于对照组,其中观察组恶心呕吐、肢体困重、脘腹胀满、大便干结或溏泄、脉沉细涩的总有效率优于对照组,差异有显著统计学意义(P<0.01);而食少纳呆、夜尿频数、面浮肢肿、口中黏腻、舌苔有瘀点瘀斑的总有效率优于对照组,差异有统计学意义(P<0.05)。结论脐疗联合西医治疗可提高脾肾亏虚夹瘀浊型慢性肾脏病患者胃肠功能紊乱的临床疗效,能有效改善临床症状,减缓肾功能的损伤。

Objective To observe the clinical efficacy of umbilical therapy in treating gastrointestinal dysfunction in patients with chronic kidney disease(CKD)differentiated as spleen-kidney deficiency with stagnation and turbidity.Method Sixty-four CKD patients(in stages 3-5)differentiated as spleen-kidney deficiency with stagnation and turbidity coupled with gastrointestinal dysfunction were recruited and divided into an observation group and a con-trol group using random number table method,with 32 cases in each group.The control group was intervened by basic Western medicine treatment,while the observation group was given additional umbilical therapy.The traditional Chinese medicine(TCM)symptoms score and kidney function parameters[serum creatinine(Scr)and blood urea nitrogen(BUN)]were observed before and after treatment in the two groups,and clinical efficacy was compared.Result After treatment,the observation group was superior to the control group comparing the TCM symptoms score,and the difference was statistically significant(P<0.05);the levels of Scr and BUN decreased after treatment in both groups(P<0.05)and were lower in the observation group than in the control group(P<0.05).After treatment,the observation group showed more notable efficacy compared with the control group in improving TCM symptom component scores,of which,the total effective rates for nausea and vomiting,body heaviness,abdominal bloating,dry or loose stool and sunken thin unsmooth pulse were higher in the observation group than in the control group,with statistically significant differences(P<0.01);the total effective rates for poor appetite and decrease in food intake,frequent urination at night,puffy face and swelling limbs,slimy feeling in the mouth and spotted tongue coating were also obviously higher in the observation group than in the control group,with statistically significant differences(P<0.05).Conclusion Umbilical therapy plus Western medicine treatment can enhance the clinical efficacy for gastrointestinal dysfunction in patients with CKD differentiated as spleen-kidney deficiency with stagnation and turbidity;it can effectively improve the clinical symptoms and slow down the damage to kidney function.