通腑泄浊法中药灌肠联合血液透析治疗慢性肾功能衰竭的临床观察
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摘要
目的:探讨通腑泄浊法中药灌肠联合血液透析治疗慢性肾功能衰竭的临床疗效。方法:选择2016年3月—2017年6月医院收治的90例慢性肾功能衰竭患者为对象,按照随机数字表法分为对照组(45例)和观察组(45例),对照组给予透析治疗,观察组给予通腑泄浊法中药灌肠联合血液透析治疗,共治疗4周。观察两组患者的临床疗效、中医证候积分、生化指标和炎症因子水平。结果:治疗4周后,观察组93.33%显著高于对照组75.56%(χ~2=5.414,P=0.020)。观察组的腰膝酸软、气短懒言、倦怠乏力、食少纳呆等积分显著低于对照组(P<0.05)。观察组SCr和BUN显著低于对照组,CCr和Hb显著高于对照组(P<0.05)。观察组TNF-α、IL-6和CRP水平显著低于对照组(P<0.05)。结论:通腑泄浊法中药灌肠联合血液透析治疗慢性肾功能衰竭临床疗效确切,可改善中医症状,提高肾功能,降低炎症反应。
Objective: To study the clinical observation of Tongfu Jiangzuo enema combined with hemodialysis for the treatment of patients with chronic renal failure. Methods: Ninety patients with chronic renal failure in March 2016 to June 2017 in our hospital were selected as control, and they were randomly divided into control group(45 cases) and observation group(45 cases). The control group was given hemodialysis treatment and the observation group was given Tongfu Jiangzuo enema combined with hemodialysis treatment, lasting for 4 weeks treatment. The clinical efficacy, TCM syndrome integral, biochemical indicators and inflammatory factor levels were observed. Results: After 4 weeks treatment, the total effective rate 93.33% in observation group was significantly higher than the control group's 75.56%(χ~2=5.414,P=0.020). The sore of lumbar debility, shortness of breath, languid lazy words, eat less and stay in observation group were significantly lower than those of the control group(P<0.05). The levels of SCr and BUN in observation group were significantly lower than those of the control group, while CCr and Hb were significantly higher than those of the control group(P<0.05). The levels of inflammatory factors TNF-α, IL-6 and CRP in observation group were significantly lower than those of the control group(P<0.05). Conclusion: Tongfu Jiangzuo enema combined with hemodialysis for the treatment of patients with chronic renal failure has clinical curative effect, and can improve TCM symptoms, renal function and reduce inflammation.
Objective: To study the clinical observation of Tongfu Jiangzuo enema combined with hemodialysis for the treatment of patients with chronic renal failure. Methods: Ninety patients with chronic renal failure in March 2016 to June 2017 in our hospital were selected as control, and they were randomly divided into control group(45 cases) and observation group(45 cases). The control group was given hemodialysis treatment and the observation group was given Tongfu Jiangzuo enema combined with hemodialysis treatment, lasting for 4 weeks treatment. The clinical efficacy, TCM syndrome integral, biochemical indicators and inflammatory factor levels were observed. Results: After 4 weeks treatment, the total effective rate 93.33% in observation group was significantly higher than the control group's 75.56%(χ~2=5.414,P=0.020). The sore of lumbar debility, shortness of breath, languid lazy words, eat less and stay in observation group were significantly lower than those of the control group(P<0.05). The levels of SCr and BUN in observation group were significantly lower than those of the control group, while CCr and Hb were significantly higher than those of the control group(P<0.05). The levels of inflammatory factors TNF-α, IL-6 and CRP in observation group were significantly lower than those of the control group(P<0.05). Conclusion: Tongfu Jiangzuo enema combined with hemodialysis for the treatment of patients with chronic renal failure has clinical curative effect, and can improve TCM symptoms, renal function and reduce inflammation.
引文
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[2] 常冰,胡振杰,魏义胜,等.静脉血液透析滤过治疗慢性心力衰竭并肾功能衰竭疗效[J].中国实用医药,2016,11(10):115-116.
[3] 张谭,车树强.补肾活血、祛湿泄浊法治疗慢性肾功能衰竭验案[J].内蒙古中医药,2017,36(13):43.
[4] 王永吉,董成,叶楠,等.肾康注射液治疗慢性肾功能衰竭上市后监测的倾向指数研究[J].中国卫生统计,2015,32(4):589-590.
[5] 强胜,杜珍芳,黄敏,等.固本泄浊饮延缓5/6肾切除大鼠慢性肾功能衰竭的机制研究[J].解放军医药杂志,2017,29(1):35-39.
[6] 王海燕.肾脏病学[M].3版.北京:人民卫生出版社,2008:1816.
[7] 郑筱黄.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:163-167.
[8] 董美平,许国斌,朱金强,等.不同国际标准化比率对伴有慢性肾功能衰竭的心房颤动患者缺血性脑卒中及出血风险的影响[J].临床药物治疗杂志,2015,13(4):25-27.
[9] 刘晓华,孙赞.慢性肾功能衰竭患者血清Hcy、SF和PTH联合检测的临床价值[J].陕西医学杂志,2017,46(9):1310-1312.
[10] 杨银忠,赵鹃,罗俊,等.PTH、IL-6和Cys-C联合检测对急、慢性肾功能衰竭鉴别诊断的评价[J].基础医学与临床,2016,36(10):1354-1358.
[11] 胡明亮,王丽,钟馨,等.慢性肾功能衰竭患者脑钠肽及超敏 C 反应蛋白水平与心力衰竭的相关性[J].医学临床研究,2016,33(6):1048-1050.
[12] 陈孜炜,张薇.川芎嗪治疗慢性肾功能衰竭患者的临床分析[J].中国生化药物杂志,2017,37(10):223-224.
[13] 王荣,许光达.于俊生运用温肾泄浊方治疗慢性肾衰竭经验[J].湖南中医杂志,2016,32(6):33-34.
[14] 李超群.肾康注射液联合血液透析对慢性肾功能衰竭透析次数、营养状况的临床观察[J].吉林医学,2014,35(6):1211-1212.
[15] 范彩文,乔黎焱,王维英,等.姚树锦补脏通腑法治疗慢性肾功能衰竭的经验[J].陕西中医,2015,36(4):476-478.
[16] 陈辉珍,蔡玲.补肾化瘀泄浊汤治疗糖尿病伴肾功能不全患者的疗效观察[J].中国中医药科技,2014,21(3):326-327.
[17] 廖成荣,李伟,马居里,等.马居里教授运用扶正泄浊保肾汤加减治疗慢性肾功能衰竭经验探析[J].光明中医,2014,29(2):234-235.
[18] 杨瑞霞.扶正泄浊保肾汤治疗慢性肾功能衰竭患者的临床疗效[J].光明中医,2016,31(24):3547-3549.
[19] 闫渊,马晓燕.健脾补肾泄浊法治疗慢性肾功能衰竭的Meta分析[J].医药前沿,2016,6(21):330-331.
[20] 赵莉,苏衍进,马居里,等.自拟扶正泄浊保肾汤配合西医常规治疗CRF(2-4期)30例疗效观察[J].云南中医中药杂志,2015,36(4):55-56.