复方崩大碗灌肠剂治疗慢性肾功能衰竭的临床研究
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摘要
背景
慢性肾衰竭(chronic renal failure, CRF)是发生在各种根底的慢性肾脏病基础上,由于肾单位严重受损,缓慢出现肾功能减退而致不可逆的肾衰竭。慢性肾衰对人类健康影响大,而且病情复杂,虽然当今的肾脏移植手术以及血液净化技术的开展大大增加了患者的生存率,但其相关的费用还是非常昂贵,给患者带来经济上的沉重负担。慢性肾衰竭在祖国医学属于“水肿”、“癃闭”、“关格”、“溺毒”、“肾风”等范畴,认为脾肾亏虚、湿浊阴滞是贯穿疾病全过程的主要病机。而现代研究发现,中药保留灌肠治疗CRF有一定疗效,是当前中医药治疗慢性肾衰竭的另一有效途径之一。
目的
观察复方崩大碗灌肠剂灌肠治疗慢性肾功能衰竭(CRF)的临床疗效并探讨其作用机制。
方法
83例CRF门诊及住院患者,随机分为治疗组41例和对照组42例。对照组采用常规对症治疗；治疗组除常规对症治疗外,加用复方崩大碗灌肠剂灌肠治疗。观察项目：主要包括(1)两组治疗前后中医证候积分；(2)血清尿素氮(BUN)、肌酐(Scr)及内生肌酐清除率(Ccr)；(3)总胆固醇(TC)、低密度脂蛋白(LDL-C)等变化。
结果
治疗8周后,两组在治疗总有效率上有非常显著性差异(P<0.01)。4、8周后,治疗组证候改善明显,与治疗前证候积分比较有显著性差异或非常显著性差异(P<0.05或P<0.01),与对照组证候积分比较有非常显著性差异(P<0.01)。肾功能改善方面,治疗组Ccr从4周开始改善,与治疗前比较有非常显著性差异(P<0.01)；治疗8周后,治疗组BUN、Scr、Ccr与对照组比较有非常显著性差异(P<0.01),两组BUN、Scr、Ccr与治疗前差值对比亦有显著性差异(P<0.05或P<0.01)。同时,治疗组TC4周后有所改善,与治疗前比较有显著性差异(P<0.05)。治疗8周后,两组LDL-C与治疗前差值对比亦有显著性差异(P<0.05)。
结论
复方崩大碗灌肠剂治疗CRF有较好的疗效。
Background
Chronic renal failure (chronic renal failure, CRF) is a disease that occurs in a variety of foundation based on chronic kidney disease, the renal failures slowly and irreversibly onset of impaired renal function because of the severely impaired renal unit. Chronic renal failure(CRF) brings a huge threat to human health, and the state of the illness is complex and serious. Although the kidney transplant operation and blood purification technology development significantly increase the survival rate of patients, its associated cost is very expensive, and is a huge economic burden bringed to the patients. Besides, CRF remains with "Edema","Retention of Urine""Block and Repulsion disease","Urinary Toxin" and "kidney wind" of traditional chinese medicine (TCM). Decay of Spleen and Kidney, and wet and muddy blocks are considered the main pathogenesis of entirety of the disease. Modern research shows that, the TCM-enema for the therapy of CRF can achieve a certain effect, so it is one of the therapies of TCM on the current status of CRF.
Objective
Observation of Bengdawan Compound enema in the treatment of chronic renal failure (CRF) and the clinical curative effect and its mechanism of action.
Methods
Methods:83cases of CRF outpatients and inpatients, were randomly divided into treatment group44cases and control group46cases. The control group adopted conventional symptomatic treatment; group therapy in addition to conventional symptomatic treatment, combined with Bengdawan Compound enema treatment. Observation of project:include (1) the two groups before and after treatment of TCM syndrome integral;(2) the Blood urea nitrogen(BUN), Serum creatinine(Scr) and endogenous creatinine clearance rate(Ccr);(3) total cholesterol (TC),low density lipoprotein (LDL-C), and other changes.
Results
8weeks after treatment, there was a very significant difference (P <0.01) between two groups of the total efficiency in treatment.4,8weeks after the treatment group improved significantly, syndromes, and treatment of anterior syndrome scoring more significant or very significant difference(P<0.05orP<0.01), and a control group of syndromes of integral comparison of a very significant difference(P<0.01). Improvement of renal function, the treatment group Ccr were from the beginning of the4week improvement compared with before treatment, there were very significant differences (P<0.01);8weeks after treatment, the treatment group, BUN, Scr, Ccr compared with the control group, there was very significant difference (P<0.01), two groups of Scr, Ccr and the difference contrast before treatment is also a significant difference (P<0.05or P<0.01). At the same time, the treatment group TC from the beginning of the4week were improved, compared with before treatment had significant difference(P<0.05);8weeks after treatment, the difference of the two groups LDL—C compared before treatment had significant difference (P<0.05).
Conclusion
Bengdawan Compound in the treatment of CRF has better curative effect.
慢性肾衰竭(chronic renal failure, CRF)是发生在各种根底的慢性肾脏病基础上,由于肾单位严重受损,缓慢出现肾功能减退而致不可逆的肾衰竭。慢性肾衰对人类健康影响大,而且病情复杂,虽然当今的肾脏移植手术以及血液净化技术的开展大大增加了患者的生存率,但其相关的费用还是非常昂贵,给患者带来经济上的沉重负担。慢性肾衰竭在祖国医学属于“水肿”、“癃闭”、“关格”、“溺毒”、“肾风”等范畴,认为脾肾亏虚、湿浊阴滞是贯穿疾病全过程的主要病机。而现代研究发现,中药保留灌肠治疗CRF有一定疗效,是当前中医药治疗慢性肾衰竭的另一有效途径之一。
目的
观察复方崩大碗灌肠剂灌肠治疗慢性肾功能衰竭(CRF)的临床疗效并探讨其作用机制。
方法
83例CRF门诊及住院患者,随机分为治疗组41例和对照组42例。对照组采用常规对症治疗；治疗组除常规对症治疗外,加用复方崩大碗灌肠剂灌肠治疗。观察项目：主要包括(1)两组治疗前后中医证候积分；(2)血清尿素氮(BUN)、肌酐(Scr)及内生肌酐清除率(Ccr)；(3)总胆固醇(TC)、低密度脂蛋白(LDL-C)等变化。
结果
治疗8周后,两组在治疗总有效率上有非常显著性差异(P<0.01)。4、8周后,治疗组证候改善明显,与治疗前证候积分比较有显著性差异或非常显著性差异(P<0.05或P<0.01),与对照组证候积分比较有非常显著性差异(P<0.01)。肾功能改善方面,治疗组Ccr从4周开始改善,与治疗前比较有非常显著性差异(P<0.01)；治疗8周后,治疗组BUN、Scr、Ccr与对照组比较有非常显著性差异(P<0.01),两组BUN、Scr、Ccr与治疗前差值对比亦有显著性差异(P<0.05或P<0.01)。同时,治疗组TC4周后有所改善,与治疗前比较有显著性差异(P<0.05)。治疗8周后,两组LDL-C与治疗前差值对比亦有显著性差异(P<0.05)。
结论
复方崩大碗灌肠剂治疗CRF有较好的疗效。
Background
Chronic renal failure (chronic renal failure, CRF) is a disease that occurs in a variety of foundation based on chronic kidney disease, the renal failures slowly and irreversibly onset of impaired renal function because of the severely impaired renal unit. Chronic renal failure(CRF) brings a huge threat to human health, and the state of the illness is complex and serious. Although the kidney transplant operation and blood purification technology development significantly increase the survival rate of patients, its associated cost is very expensive, and is a huge economic burden bringed to the patients. Besides, CRF remains with "Edema","Retention of Urine""Block and Repulsion disease","Urinary Toxin" and "kidney wind" of traditional chinese medicine (TCM). Decay of Spleen and Kidney, and wet and muddy blocks are considered the main pathogenesis of entirety of the disease. Modern research shows that, the TCM-enema for the therapy of CRF can achieve a certain effect, so it is one of the therapies of TCM on the current status of CRF.
Objective
Observation of Bengdawan Compound enema in the treatment of chronic renal failure (CRF) and the clinical curative effect and its mechanism of action.
Methods
Methods:83cases of CRF outpatients and inpatients, were randomly divided into treatment group44cases and control group46cases. The control group adopted conventional symptomatic treatment; group therapy in addition to conventional symptomatic treatment, combined with Bengdawan Compound enema treatment. Observation of project:include (1) the two groups before and after treatment of TCM syndrome integral;(2) the Blood urea nitrogen(BUN), Serum creatinine(Scr) and endogenous creatinine clearance rate(Ccr);(3) total cholesterol (TC),low density lipoprotein (LDL-C), and other changes.
Results
8weeks after treatment, there was a very significant difference (P <0.01) between two groups of the total efficiency in treatment.4,8weeks after the treatment group improved significantly, syndromes, and treatment of anterior syndrome scoring more significant or very significant difference(P<0.05orP<0.01), and a control group of syndromes of integral comparison of a very significant difference(P<0.01). Improvement of renal function, the treatment group Ccr were from the beginning of the4week improvement compared with before treatment, there were very significant differences (P<0.01);8weeks after treatment, the treatment group, BUN, Scr, Ccr compared with the control group, there was very significant difference (P<0.01), two groups of Scr, Ccr and the difference contrast before treatment is also a significant difference (P<0.05or P<0.01). At the same time, the treatment group TC from the beginning of the4week were improved, compared with before treatment had significant difference(P<0.05);8weeks after treatment, the difference of the two groups LDL—C compared before treatment had significant difference (P<0.05).
Conclusion
Bengdawan Compound in the treatment of CRF has better curative effect.
引文
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[2]丁仁华,宜建宗,司燕燕,慢性肾衰竭的中医治疗研究进展.现代中医药,2011,31(5)：73-75
[3]叶任高,陆再英.内科学.-6版[M].北京：人民卫生出版社,2004.1：542.
[4]赵湘,金李君,孙建实.慢性肾衰竭的发病机制及中西医干预策略,2005,6(12)：737-738.
[5]回学英,王志军,陈会刚等.中早期慢性肾衰竭治疗研究进展,2009.38(4)：118-121.
[6]黄玉芳等.病理学.-北京：中国中医药出版社,2003.1：319-320.
[7]Casas JP, Chua W,Loukogeorgakis S, etal, Effect of inhibitors of the renin-angiotensin system and other antihypertensivedrugs onrenal outcomes:review and meta-analysis, Lancet,2005,366:2026-2033.
[8]Marin R, Ruilope LM, Al jama P, et al.A random comparison of fosinopril and nifedipine GITS in patients with primary renal disesse.J Hypertens,2001,19(10):1871-1876.
[9]Makino H, Haneda M, Babazono T, et al. The telmisartan renoprotective study from incipient nephropathy to overt nephropathy-rationale, study design, treatment plan and baseline characterististics of the incipient to overt:angiotensin Ⅱ receptor blocker, telmisartan, Investigation on Type 2 Diabetic. Nephropathy(INNOVA-TION)Study. J Int Med Res,2005,33(6):677-686.
[10]应兄,孙红旭,薛国忠,等.戴恩来老师治疗慢性肾功能衰竭经验[J].甘肃中医,2007,20(3)：8-9.
[11]于晓瑜,刘旭生.刘旭生教授治疗慢性肾衰经验摭拾[J].四川中医,2007,25(2)：7-8.
[12]陈耀辉.慢性肾衰病机之“虚瘀湿毒”论.江西中医药.2006.37(288)：12-13.
[13]卫培峰,高宗强,郭剑.慢性肾功能衰竭之中医病因病机浅析.陕西中医学院学报,2003,26(3)：11-12.
[14]张彬,刘建国.积雪排毒汤治疗慢性肾功能衰竭33例临床疗效观察[J].四川中医,2007,25(1)：47-48.
[15]魏仲南,倪秀琴,吴强.林杰补肾祛毒汤治疗慢性肾衰竭120例临床观察[J].辽宁中医杂志,2006,33(3)：320-321.
[16]徐悦,唐建梅,高飞,等.自拟补虚活血方治疗慢性肾功能衰竭的临床研究[J].实 用医药杂志,2006,23(6)：720-721.
[17]宏琳,李德干,蒋翎,等.补肾活血排毒方延缓慢性肾功能衰竭患者肾衰竭进程的临床研究[J].中国中医药信息杂志,2009,16(6)：17—18.
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