自拟健脾益肾方治疗慢性肾功能衰竭的效果及对肠道菌群和消化系统微炎症状况的影响

Effect of self-designed Jianpi Yishen Formula in the treatment of chronic renal failure and its impact on gut microbiota and microinflammatory status of digestive system

目的探讨自拟健脾益肾方治疗慢性肾功能衰竭(CRF)的效果及对肠道菌群和消化系统微炎症状况的影响。方法选择2019年7月至2022年6月郑州颐和医院收治的100例CRF患者作为研究对象,采用随机数表法分观察组和对照组各50例。两组患者均采用常规治疗,对照组患者在常规治疗基础上给予肾衰宁胶囊治疗,观察组患者在对照组治疗基础上联合自拟健脾益肾方治疗。6周为一个疗程,治疗两个疗程,比较两组患者的治疗效果和治疗前后的肠道菌群(乳酸杆菌、双歧杆菌、压氧菌菌落数)、炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平。结果观察组患者的治疗总有效率为96.00%,明显高于对照组的80.00%,差异有统计学意义(P<0.05);治疗后,两组患者的乳酸杆菌、双歧杆菌、压氧菌菌落数均升高,且观察组患者的乳酸杆菌、双歧杆菌、厌氧菌菌落数分别为(9.85±1.09)Log10CFU/g、(9.92±1.04)Log10CFU/g、(13.75±2.14)Log10CFU/g,明显高于对照组的(8.01±1.24)Log10CFU/g、(8.27±1.08)Log10CFU/g、(11.28±2.09)Log10CFU/g,差异均有统计学意义(P<0.05);治疗后,两组患者的CRP、IL-6、TNF-α均降低,且观察组患者的CRP、IL-6、TNF-α分别为(4.18±0.91)mg/L、(23.18±3.09)ng/L、(102.73±8.25)ng/L,明显低于对照组的(5.98±1.02)mg/L、(30.84±3.16)ng/L、(112.46±9.37)ng/L,差异均有统计学意义(P<0.05)。结论自拟健脾益肾方治疗CRF可有效改善患者的临床症状,调节肠道菌群,抑制微炎症状况,临床应用效果显著。

Objective To explore the effect and mechanism of self-designed Jianpi Yishen Formula in the treatment of chronic renal failure(CRF),and its impact on gut microbiota and microinflammatory status of digestive system status.Methods A total of 100 CRF patients admitted to Zhengzhou Yihe Hospital from July 2019 to June 2022 were selected as the study subjects.They were randomly divided into an observation group and a control group,with 50 patients in each group using a random number table method.Both groups of patients received routine treatment.The patients in the control group received Shenshuaining Capsule on the basis of routine treatment,while the patients in the observation group received a self-designed Jianpi Yishen Formula on the basis of the control group,with six weeks as one course of treatment,for two courses.The treatment efficacy,and levels of intestinal microbiota(Lactobacillus,Bifidobacterium,and aerobic bacteria),inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α)]before and after treatment were compared between the two groups.Results The total effective rate of treatment in the observation group was 96.00%,which was significantly higher than 80.00%in the control group(P<0.05).After treatment,the number of Lactobacilli,Bifidobacteria,and aerobic bacteria colonies in both groups increased,and the number of colonies in the observation group were(9.85±1.09)Log10CFU/g,(9.92±1.04)Log10CFU/g,(13.75±2.14)Log10CFU/g,which were significantly higher than(8.01±1.24)Log10CFU/g,(8.27±1.08)Log10CFU/g,and(11.28±2.09)Log10CFU/g in the control group,respectively(P<0.05).After treatment,the CRP,IL-6,and TNF-αlevels were decreased in both groups,and the levels in the observation group were(4.18±0.91)mg/L,(23.18±3.09)ng/L,and(102.73±8.25)ng/L,which were significantly lower than(5.98±1.02)mg/L,(30.84±3.16)ng/L,and(112.46±9.37)ng/L in the control group(P<0.05).Conclusion Self-designed Jianpi Yishen Formula can effectively improve the clinical symptoms of patients with CRF,regulate intestinal flora,and inhibit microinflammation,with significant effect,which can be popularized and applied in clinical practice.