摘要
目的探讨中药结肠透析法对慢性肾脏病3~4期湿浊血瘀证患者肠道“微生态”的影响。方法选取2018年4月至2020年8月中国中医科学院望京医院肾病内分泌科门诊及住院患者108例,根据区组随机分为对照组和试验组,各54例。两组均给予基础治疗,对照组给予常规结肠透析法,试验组给予中药结肠透析法,隔日1次,疗程4周。比较两组治疗前后硫酸吲哚酚、血肌酐、尿素氮、估算的肾小球滤过率(eGFR)、血清内毒素、D-乳酸、大肠埃希菌、双歧杆菌。结果对照组脱落7例,试验组脱落5例。治疗前两组硫酸吲哚酚、血肌酐、尿素氮、eGFR比较,差异无统计学意义(P>0.05);治疗后两组硫酸吲哚酚、血肌酐、尿素氮均较治疗前降低,eGFR较治疗前升高,且试验组硫酸吲哚酚、血肌酐、尿素氮均低于对照组,eGFR高于对照组,差异有统计学意义(P<0.05)。治疗前两组血清内毒素、D-乳酸、大肠埃希菌比较,差异无统计学意义(P>0.05);治疗后两组血清内毒素、D-乳酸均较治疗前降低,且试验组低于对照组,差异有统计学意义(P<0.05);治疗后试验组大肠埃希菌少于治疗前及对照组,差异有统计学意义(P<0.05)。治疗前后,两组双歧杆菌组间和组内比较,差异无统计学意义(P>0.05)。结论中药结肠透析法能有效降低尿毒症毒素,改善慢性肾脏病患者肠道“微生态”,进而延缓肾功能进展。
Objective To investigate the influence of Chinese herbal colon dialysis on intestinal“microecology”in patients of dampness-turbidity blood stasis syndrome with stage three to four chronic kidney disease.Methods One hundred and eight outpatients and inpatients from the Department of Nephroendocrinology,Wangjing Hospital of China Academy of Chinese Medical Sciences from April 2018 to August 2020 were selected and divided into control group and test group according to the district group,with 54 patients in each group.Both groups were given basic treatment,control group was given routine colon dialysis,and test group was given Chinese herbal colon dialysis,once every other day,for four weeks.Indoxyl sulfate,blood creatinine,urea nitrogen,estimated glomerular filtration rate(eGFR),serum endotoxin,D-lactic acid,Escherichia coli,Bifidobacterium of two groups were compared before and after treatment.Results Control group lost seven cases and test group lost five cases.Before treatment,there were no significant differences between the two groups in indoxyl sulfate,blood creatinine,urea nitrogen,and eGFR(P>0.05).After treatment,the levels of indoxyl sulfate,blood creatinine,and urea nitrogen in the two groups were lower than those before treatment,and the eGFR in the two groups was higher than that before treatment,and the levels of indoxyl sulfate,blood creatinine,and urea nitrogen in test group were lower than those in control group,and the eGFR in test group was higher than that in control group,with statistically significant differences(P<0.05).Before treatment,there were no significant differences between the two groups in serum endotoxin,D-lactic acid,and Escherichia coli(P>0.05).After treatment,the serum endotoxin and D-lactic acid in the two groups were lower than those before treatment,and test group was lower than that control group,the differences were statistically significant(P<0.05).After treatment,the number of Escherichia coli in test group was less than that before treatment and that in control group,the differences were statistically significant(P<0.05).Before and after treatment,there was no significant difference in the inter-group and intra-group comparison of Bifidobacteria between the two groups(P>0.05).Conclusion Chinese herbal colon dialysis can effectively reduce uremic toxin,improve the intestinal“microecology”of patients with chronic kidney disease,and delay the progression of renal function.
作者
张倩
李同侠
黄雪莹
闫璞
石凯峰
王鑫
侯海玲
ZHANG Qian;LI Tongxia;HUANG Xueying;YAN Pu;SHI Kaifeng;WANG Xin;HOU Hailing(Department of Nephroendocrinology,Wangjing Hospital of China Academy of Chinese Medical Sciences,Beijing 100102,China)
出处
《中国医药导报》
CAS
2023年第5期155-159,共5页
China Medical Herald
基金
首都临床特色应用研究与成果推广项目(Z171100001017110)。
关键词
慢性肾脏病
结肠透析
中药灌肠
肠道微生态
Chronic kidney disease
Colon dialysis
Traditional Chinese medicine enema
Intestinal microecology
