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[目的]观察中药结肠透析灌肠联合西药治疗慢性肾功能不全疗效。[方法]使用随机平行对照方法,将60例住院患者按病志号抽签方法简单随机分为两组。对照组30例常规对症治疗,低盐、优质低蛋白(0.6~0.8g/Kg·d)、低脂、低磷饮食,控制血压、血糖、维持水、电解质及酸碱平衡,纠正贫血。治疗组30例中药结肠透析,生大黄、蒲公英、煅牡蛎各30g,水煎350m L,智立医学IMS-100A型结肠途径治疗机,治疗前,嘱患者排便,取左侧卧位。浓缩结肠冲洗液按比例配制成冲洗液进行全结肠反复冲洗,水温37~39℃,用量约10L,0.5h/次,至肠道清洁无粪便排出。然后行高位结肠保留中药灌肠,药液温度同前,保留1h,随透析3次/周;西药治疗同对照组。连续治疗15d为1疗程。观测临床症状、血肌酐、血尿素氮、内生肌酐清除率、不良反应。治疗1疗程(15d),判定疗效。[结果]治疗组显效5例,有效21例,无效4例,总有效率86.67%;对照组显效3例,有效16例,无效11例,总有效率63.33%;治疗组疗效优于对照组(P<0.05)。SCr两组均有改善(P<0.05),BUN、CCr治疗组显著改善,对照组无改善,SCr、BUN、CCr治疗组改善优于对照组(P<0.05,P<0.01)。[结论]中药结肠透析灌肠联合西药治疗慢性肾功能不全,疗效满意,无严重不良反应,值得推广。
[Objective] To observe the curative effect of traditional Chinese medicine colon dialysis enema and western medicine on chronic renal insufficiency. [Methods] Using randomized parallel control method, 60 inpatients were randomly divided into two groups randomly according to the method of lot drawing. Control group 30 patients with conventional symptomatic treatment, low salt, high quality and low protein (0.6 ~ 0.8g / Kg · d), low fat, low phosphorus diet, blood pressure, blood glucose control, maintain water, electrolyte and acid-base balance, correct anemia. The treatment group, 30 cases of Chinese medicine colon dialysis, rhubarb, dandelion, calcined oyster each 30g, decoction 350mL, Chi Li Medical IMS-100A type colon treatment machine, before treatment, Zhu Huanzhe defecation, take the left lateral position. Concentrated colon rinse solution proportionally formulated as a rinse solution for repeated washing the entire colon, the water temperature 37 ~ 39 ℃, the amount of about 10L, 0.5h / time, no intestinal excretion clean discharge. Then line high colon to retain traditional Chinese medicine enema, liquid temperature with the former, reserved 1h, with dialysis 3 times / week; western medicine treatment with the control group. Continuous treatment of 15d for a course of treatment. Clinical symptoms, serum creatinine, blood urea nitrogen, endogenous creatinine clearance, adverse reactions were observed. Treatment of a course of treatment (15d), to determine the efficacy. [Results] In the treatment group, 5 cases were markedly effective, 21 cases were effective, 4 cases were ineffective, and the total effective rate was 86.67%. In the control group, 3 cases were markedly effective, 16 cases were effective and 11 cases were ineffective. The total effective rate was 63.33% (P <0.05). (P <0.05). The levels of BUN and CCr in treatment group were significantly improved, while those in control group were not improved. The improvement in SCr, BUN and CCr treatment group was better than that in control group (P <0.05, P <0.01). [Conclusion] Chinese medicine colon dialysis enema combined western medicine in the treatment of chronic renal insufficiency, with satisfactory results, no serious adverse reactions, it is worth promoting.