通过营养状态评估肾康宁灌肠液治疗慢性肾脏病3-5期的临床疗效
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摘要
目的：
慢性肾脏病(CKD)患者从肾小球滤过率(GFR)<60ml/min起即易发生营养不良,其发生率约为30-60%。慢性肾脏病患者的营养不良严重影响其生存质量,增加并发症的发生率和死亡率。肾康宁灌肠液一方面减少毒素的产生,另一方面促进毒素的排出,减轻毒素对胃肠道的刺激等,从根本上祛除加重肾衰的各种因素而改善患者临床症状及营养状态以延缓肾功能进行性恶化。故本文主要通过主观综合营养评估(SGA)及相关血生化指标检测观察肾康宁灌肠液治疗慢性肾脏病3-5期的临床疗效。
方法：
1.临床资料：所有病例均来自湖北省襄阳市中医院肾病科住院患者,且均符合西医慢性肾脏病3-5期(其中处CKD-5期未行血透、腹透者)的诊断标准。
2.观察方法：选取84例患者按其就诊顺序随机分为两组：对照组42例,采取中西医常规治疗；治疗组42例,在对照组的治疗基础上,加用肾康宁灌肠液,每日1剂；所有患者均观察1个疗程(30天)。入院时及1个疗程之后,每一例均记录其主观综合营养评估(SGA)分级及相关血生化指标[包括尿素(BUN)、血肌酐(SCr)、血红蛋白(HGB)、血清白蛋白(ALB)及二氧化碳(CO2)等]。
3.统计学方法：用SPSS13.0统计软件进行统计分析。各种组间计量资料采用t检验,数据均以(均数±标准差)即(x±S)表示；组间计数资料用x2检验；以P<0.05为差异有统计学意义
结果：
1.治疗组治疗前后尿素(BUN)、血肌酐(SCr)、血红蛋白(HGB)、血清白蛋白(ALB),及二氧化碳(CO2)检测对照统计经t检验均有统计学差异(P<0.05),具体表现为尿素(BUN)、血肌酐(SCr)明显下降,血红蛋白(HGB)、血清白蛋白(ALB)及二氧化碳(CO2)明显上升；而对照组差异则无统计学意义(P>0.05)。
2.经X2检验,治疗组与对照组治疗前主观综合营养评估(SGA)分级比较差异无统计学意义(P>0.05),而经治疗后,治疗组与对照组主观综合营养评估(SGA)分级比较差异具有统计学意义(P<0.05)；治疗组主观综合营养评估(SGA)等级明显提高。
结论：
肾康宁灌肠液治疗慢性肾脏病(CKD)疗效较好,能促进慢性肾脏病(CKD)3-5期患者营养状态的改善,提高生命质量。
Purpose:
Chronic kidney disease (CKD) patients from the glomerular filtration rate (GFR)<60ml/min from the prone to malnutrition, the incidence rate is about 30-60%.Malnutrition in chronic kidney disease seriously affect their quality of life and increase the incidence of complications and mortality. Shen-kangning enema hand to reduce the production of toxins, while promoting excretion of toxins, reduce toxin stimulation of the gastrointestinal tract, fundamentally eliminate the aggravating factors of renal failure in patients with clinical symptoms and to improve nutritional status in order to delay progressive deterioration of renal function. Therefore, this assess- ment of nutritional status by Subjective (SGA) and serum biochemical par- ameters related to renal Corning enema 3-5 chronic kidney disease on the clinical efficacy.
Method:
1. Clinical data:All the cases were from the Chinese medicine hospital in Xiangfan City, Hubei Province, inpatient renal disease, and chronic kidney disease are in line with Western 3-5 period (which fail to CKD-5 at the line of hemodialysis, peritoneal dialysis were) the diagnosis standards and standards of TCM syndrome.
2. Observation Methods:84 patients randomly divided into two groups according to their treatment:control group, 42 patients taking conventional therapy in Western medicine; treatment group,42 patients in the control group on the basis of treatment, plus Shenkangning enema,1 day; all patients were observed in a course of treatment (30 days). Admission and after a course of treatment, each patients were recorded Subjective global assessment (SGA) classification and the related blood biochemistry [including urea (BUN), creatinine (SCr), hemoglobin (HGB), serum albumin (ALB) and carbon dioxide (CO2), etc.].
3. Statistical Methods:Using SPSS 13.0 statistical software for statistical analysis. Various groups using t test between the measurement data, the data are (mean±standard deviation) or (x±S) said; group count data with aχ2 test; to P<0.05 was considered statistically significant.
Results:
1. Before and after treatment, urea (BUN), creatinine (SCr), hemoglobin (HGB), serum albumin (ALB), and carbon dioxide (C02) were detected by the t test statistics were statistically significant (P<0.05), the specific performance of urea (BUN), creatinine (CREA) decreased, hemoglobin (HGB), serum albumin (ALB) and carbon dioxide (CO2) increased significantly; and there was no significant difference between the control group (/> 0.05).
2. Theχ2 test, treatment group and control group before treatment Subjective global assessment (SGA) classification was no significant difference (P> 0.05), but after treatment, the treatment group and control group Subjective global assessment (SGA) classification, the difference being statistically significant (P<0.05); treatment group Subjective nutritional assessment (SGA) level was significantly increased.
Conclusion:
Corning enema treatment of renal chronic kidney disease (CKD) better effect, can promote chronic kidney disease (CKD) 3-5 to improve the nutritional status of patients and improve the quality of life.
慢性肾脏病(CKD)患者从肾小球滤过率(GFR)<60ml/min起即易发生营养不良,其发生率约为30-60%。慢性肾脏病患者的营养不良严重影响其生存质量,增加并发症的发生率和死亡率。肾康宁灌肠液一方面减少毒素的产生,另一方面促进毒素的排出,减轻毒素对胃肠道的刺激等,从根本上祛除加重肾衰的各种因素而改善患者临床症状及营养状态以延缓肾功能进行性恶化。故本文主要通过主观综合营养评估(SGA)及相关血生化指标检测观察肾康宁灌肠液治疗慢性肾脏病3-5期的临床疗效。
方法：
1.临床资料：所有病例均来自湖北省襄阳市中医院肾病科住院患者,且均符合西医慢性肾脏病3-5期(其中处CKD-5期未行血透、腹透者)的诊断标准。
2.观察方法：选取84例患者按其就诊顺序随机分为两组：对照组42例,采取中西医常规治疗；治疗组42例,在对照组的治疗基础上,加用肾康宁灌肠液,每日1剂；所有患者均观察1个疗程(30天)。入院时及1个疗程之后,每一例均记录其主观综合营养评估(SGA)分级及相关血生化指标[包括尿素(BUN)、血肌酐(SCr)、血红蛋白(HGB)、血清白蛋白(ALB)及二氧化碳(CO2)等]。
3.统计学方法：用SPSS13.0统计软件进行统计分析。各种组间计量资料采用t检验,数据均以(均数±标准差)即(x±S)表示；组间计数资料用x2检验；以P<0.05为差异有统计学意义
结果：
1.治疗组治疗前后尿素(BUN)、血肌酐(SCr)、血红蛋白(HGB)、血清白蛋白(ALB),及二氧化碳(CO2)检测对照统计经t检验均有统计学差异(P<0.05),具体表现为尿素(BUN)、血肌酐(SCr)明显下降,血红蛋白(HGB)、血清白蛋白(ALB)及二氧化碳(CO2)明显上升；而对照组差异则无统计学意义(P>0.05)。
2.经X2检验,治疗组与对照组治疗前主观综合营养评估(SGA)分级比较差异无统计学意义(P>0.05),而经治疗后,治疗组与对照组主观综合营养评估(SGA)分级比较差异具有统计学意义(P<0.05)；治疗组主观综合营养评估(SGA)等级明显提高。
结论：
肾康宁灌肠液治疗慢性肾脏病(CKD)疗效较好,能促进慢性肾脏病(CKD)3-5期患者营养状态的改善,提高生命质量。
Purpose:
Chronic kidney disease (CKD) patients from the glomerular filtration rate (GFR)<60ml/min from the prone to malnutrition, the incidence rate is about 30-60%.Malnutrition in chronic kidney disease seriously affect their quality of life and increase the incidence of complications and mortality. Shen-kangning enema hand to reduce the production of toxins, while promoting excretion of toxins, reduce toxin stimulation of the gastrointestinal tract, fundamentally eliminate the aggravating factors of renal failure in patients with clinical symptoms and to improve nutritional status in order to delay progressive deterioration of renal function. Therefore, this assess- ment of nutritional status by Subjective (SGA) and serum biochemical par- ameters related to renal Corning enema 3-5 chronic kidney disease on the clinical efficacy.
Method:
1. Clinical data:All the cases were from the Chinese medicine hospital in Xiangfan City, Hubei Province, inpatient renal disease, and chronic kidney disease are in line with Western 3-5 period (which fail to CKD-5 at the line of hemodialysis, peritoneal dialysis were) the diagnosis standards and standards of TCM syndrome.
2. Observation Methods:84 patients randomly divided into two groups according to their treatment:control group, 42 patients taking conventional therapy in Western medicine; treatment group,42 patients in the control group on the basis of treatment, plus Shenkangning enema,1 day; all patients were observed in a course of treatment (30 days). Admission and after a course of treatment, each patients were recorded Subjective global assessment (SGA) classification and the related blood biochemistry [including urea (BUN), creatinine (SCr), hemoglobin (HGB), serum albumin (ALB) and carbon dioxide (CO2), etc.].
3. Statistical Methods:Using SPSS 13.0 statistical software for statistical analysis. Various groups using t test between the measurement data, the data are (mean±standard deviation) or (x±S) said; group count data with aχ2 test; to P<0.05 was considered statistically significant.
Results:
1. Before and after treatment, urea (BUN), creatinine (SCr), hemoglobin (HGB), serum albumin (ALB), and carbon dioxide (C02) were detected by the t test statistics were statistically significant (P<0.05), the specific performance of urea (BUN), creatinine (CREA) decreased, hemoglobin (HGB), serum albumin (ALB) and carbon dioxide (CO2) increased significantly; and there was no significant difference between the control group (/> 0.05).
2. Theχ2 test, treatment group and control group before treatment Subjective global assessment (SGA) classification was no significant difference (P> 0.05), but after treatment, the treatment group and control group Subjective global assessment (SGA) classification, the difference being statistically significant (P<0.05); treatment group Subjective nutritional assessment (SGA) level was significantly increased.
Conclusion:
Corning enema treatment of renal chronic kidney disease (CKD) better effect, can promote chronic kidney disease (CKD) 3-5 to improve the nutritional status of patients and improve the quality of life.
引文
[1]Coresh J, Selvin E, Stevens LA, et al. Prevalence of Chronic Kidney Disease in the United States. JAMA,2007,298:2038-2047.
[2]Zhang L, Zhang P, Wang F, et al. Prevalence and factors associated with chronic kidney disease:a population study from Beijing. Am J Kidney Dis,2008,51:373-384.
[3]张机主编.伤寒论[M].上海：上海科学技术出版社,1983：60.
[4]梅全喜主编.药海撷菁[M].北京：中医古籍出版社,2004：260.
[5]Sacks GS, Dearman K, Replogle WH, et al. Use of subjective global assessment to identify nutrition-associated complications and death in geriatric long-term care facility residents [J].J Am Coll Nutr,2000,19 (5):570-577.
[6]叶任高,姜宗培,阳晓主编. 《肾脏病手册》[M].北京：中医古籍出版社,2001：462-463,497-498.
[7]王海燕主编.肾脏病学[M]第3版.北京：人民卫生出版社,2009：1816,1854.
[8]邹香国,郭亚琴,金冬霞.等.大黄治疗慢性肾衰氮质血症临床疗效观察[J].河南中医,1999,,19(4)：33.
[1]张爱兰.中西医结合治疗慢性肾病[J].中医临床研究,2010,2(12)：121-122.
[2]魏明刚,周栋,高坤,等.慢性肾脏病的基本病机探讨和益肾清利和络泻浊法应用的分析[J].辽宁中医杂志,2010,37(4)：642-644.
[3]裘怡,永钧.从湿论治慢性肾病的经[J]验.浙江中医杂志,2009,44(7)：472-473.
[4]张再康,杨霓芝,冯瑞雪,等.析慢性肾病湿热蕴结病因病机的演变规律[J].新中医,2007,39(11)：3-4.
[5]吴进仕,艾军.慢性肾病温热之邪致瘀证治初探[J].中医杂志,2008,49(10)：952-953.
[6]张勉之.补肾活血法在慢性肾脏疾病中的应用[J].创新技术,2010,2：18-19.
[7]李平.谈活血化瘀法在肾病中的运用体会[J].中国医药指南,2008,6(19)：128-129.
[8]段小军.杨霓芝教授治疗慢性肾脏病验案4则[J].新中医,2010,42(6)：143-144.
[9]张仕玉,镇东鑫.绍琴治疗慢性肾病的经验[J].光明中医,2007,22(9)：36-37.
[10]卢立新.清利活血益气法治疗慢性肾脏病1-3期疗效观察[J].社区医学杂志,2010,8(5)：18-19.
[11]胡燕.“轻以去实法”在慢性肾病治疗中的运用[J].中医药通报,2010,9(1)：55-57.
[12]李芳.黄春林运用仙芪地黄汤加减治疗慢性肾病经验[J].辽宁中医杂志,2007,34(7)：877-878.
[13]聂玲.六味地黄丸对实验性慢性肾病动物的保护作用[J].中医药临床杂志,2009,21(4)：321-322.
[14]董飞侠,程锦国,黄蔚霞,等.固本祛毒益肾汤治疗慢性肾病Ⅲ期60例临床研究[J].上海中医药杂志,2008,42(3)：29-30.
[15]肖相如.慢性肾病合并感染的中医治疗体会[J].中国中西结合肾病杂志,2005,6(5)：292-293.
[16]刘晓琰,陆国红.中药治疗慢性肾病研究现状[J].中国药师,2007,10(6)：590-591.
[17]梅全喜主编.药海撷菁[M].北京：中医古籍出版社,2004：260.
[18]庞蕾蕾,梅全喜,侯连兵.中药灌肠剂治疗慢性肾衰竭的研究概况[J].中国药房,2010,21(11)：1051-1052.
[19]何兴伟.中药穴位敷贴疗法探析[J].江西中医药,1999,30(6)：36-38.
[20]贺淑文,刘晶岩.常晓强,等.温针灸治疗慢性肾小球肾炎的疗效观察[J].上海针灸杂志,1999,18(5)：8-9.
[21]谭远忠,徐奔,李希平.中药敷贴对慢性肾病干预治疗的临床观察[J].湖北中医杂志,2009,31(2)：40-41.
[22]张琳,赵菁莉,杨波.川芎嗪穴位注射联合针灸治疗慢性肾脏 病临床研究[J].中国中西医肾病杂志,2010,8(11)：724-725.
[23]王少华,郭华伟,关光普.中医系统干预综合治疗慢性肾脏病思路与方法[J].辽宁中医杂志,2010,37(2)：250-251.
[24]朱伟,丘小惠,徐筱杰.治疗慢性肾病中药计算机网络药理学研究[J]。中国科学：化学,2010,40(8)：1085-1090.
[2]Zhang L, Zhang P, Wang F, et al. Prevalence and factors associated with chronic kidney disease:a population study from Beijing. Am J Kidney Dis,2008,51:373-384.
[3]张机主编.伤寒论[M].上海：上海科学技术出版社,1983：60.
[4]梅全喜主编.药海撷菁[M].北京：中医古籍出版社,2004：260.
[5]Sacks GS, Dearman K, Replogle WH, et al. Use of subjective global assessment to identify nutrition-associated complications and death in geriatric long-term care facility residents [J].J Am Coll Nutr,2000,19 (5):570-577.
[6]叶任高,姜宗培,阳晓主编. 《肾脏病手册》[M].北京：中医古籍出版社,2001：462-463,497-498.
[7]王海燕主编.肾脏病学[M]第3版.北京：人民卫生出版社,2009：1816,1854.
[8]邹香国,郭亚琴,金冬霞.等.大黄治疗慢性肾衰氮质血症临床疗效观察[J].河南中医,1999,,19(4)：33.
[1]张爱兰.中西医结合治疗慢性肾病[J].中医临床研究,2010,2(12)：121-122.
[2]魏明刚,周栋,高坤,等.慢性肾脏病的基本病机探讨和益肾清利和络泻浊法应用的分析[J].辽宁中医杂志,2010,37(4)：642-644.
[3]裘怡,永钧.从湿论治慢性肾病的经[J]验.浙江中医杂志,2009,44(7)：472-473.
[4]张再康,杨霓芝,冯瑞雪,等.析慢性肾病湿热蕴结病因病机的演变规律[J].新中医,2007,39(11)：3-4.
[5]吴进仕,艾军.慢性肾病温热之邪致瘀证治初探[J].中医杂志,2008,49(10)：952-953.
[6]张勉之.补肾活血法在慢性肾脏疾病中的应用[J].创新技术,2010,2：18-19.
[7]李平.谈活血化瘀法在肾病中的运用体会[J].中国医药指南,2008,6(19)：128-129.
[8]段小军.杨霓芝教授治疗慢性肾脏病验案4则[J].新中医,2010,42(6)：143-144.
[9]张仕玉,镇东鑫.绍琴治疗慢性肾病的经验[J].光明中医,2007,22(9)：36-37.
[10]卢立新.清利活血益气法治疗慢性肾脏病1-3期疗效观察[J].社区医学杂志,2010,8(5)：18-19.
[11]胡燕.“轻以去实法”在慢性肾病治疗中的运用[J].中医药通报,2010,9(1)：55-57.
[12]李芳.黄春林运用仙芪地黄汤加减治疗慢性肾病经验[J].辽宁中医杂志,2007,34(7)：877-878.
[13]聂玲.六味地黄丸对实验性慢性肾病动物的保护作用[J].中医药临床杂志,2009,21(4)：321-322.
[14]董飞侠,程锦国,黄蔚霞,等.固本祛毒益肾汤治疗慢性肾病Ⅲ期60例临床研究[J].上海中医药杂志,2008,42(3)：29-30.
[15]肖相如.慢性肾病合并感染的中医治疗体会[J].中国中西结合肾病杂志,2005,6(5)：292-293.
[16]刘晓琰,陆国红.中药治疗慢性肾病研究现状[J].中国药师,2007,10(6)：590-591.
[17]梅全喜主编.药海撷菁[M].北京：中医古籍出版社,2004：260.
[18]庞蕾蕾,梅全喜,侯连兵.中药灌肠剂治疗慢性肾衰竭的研究概况[J].中国药房,2010,21(11)：1051-1052.
[19]何兴伟.中药穴位敷贴疗法探析[J].江西中医药,1999,30(6)：36-38.
[20]贺淑文,刘晶岩.常晓强,等.温针灸治疗慢性肾小球肾炎的疗效观察[J].上海针灸杂志,1999,18(5)：8-9.
[21]谭远忠,徐奔,李希平.中药敷贴对慢性肾病干预治疗的临床观察[J].湖北中医杂志,2009,31(2)：40-41.
[22]张琳,赵菁莉,杨波.川芎嗪穴位注射联合针灸治疗慢性肾脏 病临床研究[J].中国中西医肾病杂志,2010,8(11)：724-725.
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