结肠透析联合中药灌肠对慢性肾脏病3—4期湿浊血瘀证患者的影响

Effect of Colon Dialysis Combined with Traditional Chinese Medicine Enema on Patients with Stage 3-4 Chronic Kidney Disease with Damp Turbidity and Blood Stasis Syndrome

目的:观察结肠透析联合中药灌肠对慢性肾脏病(chronic kidney disease,CKD)3—4期湿浊血瘀证患者的影响。方法:108例CKD 3—4期湿浊血瘀证患者随机平均分为治疗组和对照组。两组均给予西医基础治疗,治疗组给予常规结肠透析联合中药灌肠,对照组给予常规结肠透析。两组均隔日1次,每周3次,连续治疗4周。比较两组患者综合疗效、证候评分疗效及肾功能[血肌酐、肾小球滤过率(estimated glomerular filtration rate,eGFR)]。结果:治疗4周后,两组共脱落12例,剩余96例,治疗组49例,对照组47例。(1)综合疗效:治疗组有效率为83.7%(41/49),对照组有效率为6.4%(3/47),两组有效率比较,差异有统计学意义(P<0.001)。(2)证候评分疗效:治疗组有效率75.5%(37/49),对照组有效率2.1%(1/47),两组有效率比较,差异有统计学意义(P<0.001)。(3)eGFR疗效:治疗组有效率为51.0%(25/49),对照组有效率为4.2%(2/47),两组有效率比较,差异有统计学意义(P<0.001)。(4)证候评分:治疗后,两组患者证候评分均显著降低,治疗组证候评分为33(31.00,34.00)分,低于同期对照组(P<0.05)。(5)肾功能:治疗后,两组患者血肌酐水平显著降低,治疗组血肌酐为(290.36±105.33)μmol·L^(-1),低于同期对照组,差异有统计学意义(P<0.001);两组患者eGFR显著升高,治疗组eGFR为(25.05±3.62) mL·min^(-1)·1.73 m^(-2),高于同期对照组,差异有统计学意义(P<0.001)。结论:结肠透析联合中药灌肠能够显著改善CKD3—4期湿浊血瘀证患者临床症状,提高患者肾功能。

Objective:To observe the effect of colon dialysis combined with traditional Chinese medicine enema on patients with stage 3-4 chronic kidney disease(CKD)with damp turbidity and Blood stasis syndrome.Methods:108 stage 3-4 CKD patients with damp turbidity and Blood stasis syndrome were randomly and equally divided into treatment group and control group.Both groups were given the basic treatment of Western medicine,the treatment group was given conventional colon dialysis combined with TCM enema,and the control group was given conventional colon dialysis.The two groups received treatment once every other day,3 times a week,for 4 consecutive weeks.The comprehensive curative effect,syndrome score curative effect,and renal function[serum creatinine,estimated glomerular filtration rate(eGFR)]were compared between the two groups.Results:After 4 weeks of treatment,a total of 12 cases dropped out in both groups,96 cases remained,49 cases in the treatment group,and 47 cases in the control group.(1)Comprehensive curative effect:The effective rate of the treatment group was 83.7%(41/49),and that of the control group was 6.4%(3/47).The difference was statistically significant(P<0.001).(2)Syndrome score curative effect:The effective rate of the treatment group was 75.5%(37/49),and that of the control group was 2.1%(1/47),and the difference was statistically significant(P<0.001).(3)Efficacy of eGFR:The effective rate of the treatment group was 51.0%(25/49),and that of the control group was 4.2%(2/47),and the difference was statistically significant(P<0.001).(4)Syndrome score:After treatment,the syndrome scores of the two groups were significantly reduced,and the syndrome score of the treatment group was 33(31.00,34.00),which was lower than that of the control group(P<0.05).(5)Renal function:After treatment,the serum creatinine levels of the two groups decreased significantly,and the serum creatinine in the treatment group was(290.36±105.33)μmol·L^(-1),which was lower than that of the control group at the same period,and the difference was statistically significant(P<0.001).The eGFR of the two groups was significantly increased,and the eGFR of the treatment group was(25.05±3.62)mL·min^(-1)·1.73 m^(-2),which was higher than that of the control group during the same period,and the difference was statistically significant(P<0.001).Conclusion:Colon dialysis combined with TCM enema can significantly improve the clinical symptoms of stage 3-4 CKD patients with damp turbidity and Blood stasis syndrome,and improve the renal function of patients.