健脾补肾活血泄浊法对慢性肾衰患者肠道屏障功能的影响

目的观察肾康合剂联合中药灌肠液治疗慢性肾衰的临床疗效,评价健脾补肾活血泄浊法对慢性肾衰患者肠道屏障功能的影响,初步探讨其延缓慢性肾衰的机制。方法 60例中医辩证属于脾肾气虚,湿瘀内阻型的慢性肾衰患者分为治疗组与对照组,每组各30例。对照组采用基础治疗,治疗组在常规基础治疗的基础上加用肾康合剂口服及中药灌肠液灌肠,观察治疗组和对照组治疗前后血肌酐、尿素氮、内毒素、D-乳酸、硫酸吲哚酚等指标的前后变化。结果治疗组及对照组在相应治疗后血肌酐及尿素氮值均有下降,但治疗组改善更为明显。在肠道屏障功能改变方面,结果显示内毒素、D-乳酸、硫酸吲哚酚均明显下降,与治疗前比较有统计学差异(P0.05),与对照组比较也有统计学差异(P0.05)。结论肾康合剂联合中药灌肠治疗可以在一定程度上减少机体肠源性毒素的产生,恢复肠道屏障功能,改善临床症状,稳定肾脏功能。

EFFECT ON INTESTINAL BARRIER FUNCTION IN CHRONIC RENAL FAILURE WITH THE THERAPY OF INVIGORATING THE SPLEEN-KIDNEY AND ACTIVATING BLOOD CIRCULATION AND REMOVING TURBIDITY

Objective:To observe the clinical curative effect of Shenkang Decoction combined with Chinese medicine enema on chronic renal failure, evaluate the effects of the therapy of invigorating the spleen-kidney and activating blood circulation and removing turbidity in patients with chronic renal failure, explore the mechanism of delaying chronic renal failure. Methods:60 cases of TCM belongs to the spleen and kidney qi deficiency, dampness and blood stasis resistance type of chronic renal failure patients were divided into treatment group and control group, 30 cases in each group. The control group received basic treatment, the treatment group based on routine treatment combined with Shenkang Decoction of oral medicine and enema, before and after treatment, the changes of the index of serum creatinine, urea nitrogen, endotoxin, D-lactic acid and indoxyl sulfate in the treatment group and the control group were observed. Results:The blood urea nitrogen and serum creatinine values in treatment group and control group were decreased, but it was improved more obvious in the treatment group. For the change in intestinal barrier function, results showed that endotoxin, D-lactic acid, indoxyl sulfate significantly decreased, there were significant differences compared with those before treatment (P<0.05) and with the control group (P<0.05). Conclusion:The combination of Shenkang Decoction with Chinese medicine enema can reduce the production of intestinal toxin, restore the intestinal barrier function, improve the clinical symptoms and stabilize the renal function.