中药干预腹膜透析肠功能障碍的疗效观察

Curative effect observation of TCM intervention of intestinal barrier dysfunction in CAPD

[目的]评价中医药干预腹膜透析相关肠道功能障碍的疗效。[方法]回顾性分析304例规律腹透并存在肠功能障碍患者资料,按有无中药干预治疗分为治疗组(口服中药≥6个月或行结肠透析≥3个月)和对照组。观察中医证候积分、肠功能评分、实验室检查、腹膜透析相关指标,评价中医疗效。[结果]治疗组总有效率显著优于对照组(P<0.01)。治疗组治疗后中医证候积分和肠功能评分较对照组显著减低。治疗后血浆白蛋白治疗组显著高于对照组,而两组治疗前后血红蛋白、D/PC、24 h尿量方面、血肌酐(SCr)、尿素氮(BUN)、及血清钾(K+)情况均未发现差异有统计学意义。对照组治疗后的24h超滤量、残余肾功能(RRF)显著降低,较治疗组差异有统计学意义(P<0.05)。[结论]中药干预可改善腹膜透析肠功能障碍患者中医证候,纠正肠道功能障碍,维持营养状态,有效维持腹透患者的超滤水平,保护残余肾功能,疗效确切。

[Objective] To estimate the curative effect of TCM on intervention of intestinal barrier dysfunction in CAPD. [Methods] Total304 CAPD patients with intestinal dysfunction in our center of peritoneal dialysis were divided into treatment group(oral medicine≥ 6 months or colon dialysis ≥ 3 months) and control group according to with or without the intervention of TCM therapy. Observe the relevant indexes of TCM syndromes in patients with peritoneal dialysis integral, bowel function score, laboratory examination, peritoneal dialysis. Evaluate TCM intervention effect on complications of peritoneal dialysis intestinal function disorder. [Results] The total effective rate of the treatment group was significantly better than the control group(P<0.01). Between two groups after treatment, TCM syndrome integral and bowel function score were significantly lower than the control group. Plasma albumin in the treatment group was significantly higher than that in control group. However, D/PC, 24 h urine, SCr, BUN and K+were had no significant changes between two groups after treatment. The 24 h ultrafiltration volume and RRF in control group were more significantly decreased than that in treatment group(P<0.05). [Conclusion] Traditional Chinese medicine intervention can improve TCM syndrome in patients with bowel dysfunction of peritoneal dialysis, correct functional bowel disorders, nutritional status of maintenance, to improve the quality of life of patients, with significant advantages. At the same time, the intervention of traditional Chinese medicine treatment can maintain the level of effective ultrafiltration in peritoneal dialysis patients, protecting residual renal function.