摘要
目的观察中药内外合治尿毒症维持性血液透析患者慢性腹泻的临床疗效。方法收集2020年3月-2022年3月在张家口市第一医院血液透析中心接受维持性血液透析并伴慢性腹泻的80例尿毒症期患者存档的临床资料进行回顾性分析,根据患者接受治疗药物不同分为中药组和双歧杆菌组,各40例。中药组患者给予补脾益肠丸内服与吴茱萸穴位贴敷合治,双歧杆菌组患者给予双歧杆菌三联活菌肠溶胶囊治疗。2组患者均治疗2周为1个疗程,持续治疗2个疗程。比较2组患者的临床疗效、肠道菌群菌落数、白介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、P物质(SP)、血管活性肠肽(VIP)、神经肽Y(NPY)、血肌酐(Scr)、尿素氮(BUN)、尿酸(UA)变化情况。结果治疗2个疗程后,中药组痊愈率、总有效率为50.0%、92.5%,高于双歧杆菌组的10.0%、70.0%,差异有统计学意义(P<0.05);中药组患者治疗后双歧杆菌与乳杆菌菌落水平均高于双歧杆菌组(P<0.05),肠球菌以及大肠埃希菌的菌落水平均低于双歧杆菌组(P<0.05);中药组患者治疗后IL-6、CRP、TNF-α、SP、VIP表达水平均低于双歧杆菌组(P<0.05),NPY表达水平高于双歧杆菌组(P<0.05);2组UA、BUN、Scr水平比较,差异无统计学意义(P>0.05)。结论中药内外兼治通过调节肠道菌群与胃肠激素、降低炎症因子水平等多种机制改善尿毒症维持性血液透析患者慢性腹泻症状,相比双歧杆菌治疗,中药内外兼治可获得更佳的临床疗效。
Objective To observe the clinical effect of Chinese medicines in the combined internal and external treatment of chronic diarrhea in patients with uremia receiving maintenance hemodialysis.Methods The clinical data of 80 patients with uremia who received maintenance hemodialysis combined with chronic diarrhea at the hemodialysis center of Zhangjiakou First Hospital from March 2020 to March 2022 were collected for a retrospective analysis.According to the different medicines they received,the patients were divided into a traditional Chinese medicine group and a bifidobacterium group,with 40 cases in each group.The patients in the TCM group were treated with Bupi Yichang pills and Wu Zhu Yu acupoint application,while the patients in the bifidobacterium group were given bifidobacterium triple viable enteric-soluble capsules.All the patients were treated for 2 weeks as a course of treatment,and the treatment continued for two courses.The clinical efficacy,intestinal flora count,levels of interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factorα(TNF-α),substance P(SP),vasoactive intestinal peptide(VIP),neuropeptide Y(NPY),serum creatinine(Scr),urea nitrogen(BUN)and uric acid(UA)were compared between the two groups.Results After two courses of treatment,the recovery rate and total effective rate of the TCM group were 50.0%and 92.5%,higher than those of the bifidobacterium group(10.0%and 70.0%),and the difference was statistically significant(P<0.05).The colony levels of bifidobacterium and lactobacillus in the TCM group were higher than those in the bifidobacterium group(P<0.05),while the colony levels of enterococcus and Escherichia coli in the TCM group were lower than those in the bifidobacterium group(P<0.05).After two courses of treatment,the expression levels of IL-6,CRP,TNF-α,SP and VIP in the TCM group were lower than those in the bifidobacterium group(P<0.05),while the expression level of NPY in the TCM group was higher than that in the bifidobacterium group(P<0.05).There were no differences in the levels of UA,BUN and Scr between the two groups after two courses of treatment(P>0.05).Conclusion The TCM combined internal and external treatment can improve the symptoms of chronic diarrhea in patients with uremia receiving maintenance hemodialysis via the mechanisms of regulating intestinal flora,gastrointestinal hormones,reducing the level of inflammatory factors and so on,achieving better clinical efficacy compared to the treatment with bifidobacterium.
作者
钱卫明
安丽霞
赵墨菊
王娜娜
袁志娟
QIAN Weiming;AN Lixia;ZHAO Moju;WANG Nana;YUAN Zhijuan(Zhangjiakou First Hospital,Zhangjiakou 075000,China)
出处
《吉林中医药》
2025年第4期438-442,共5页
Jilin Journal of Chinese Medicine
基金
河北省中医药管理局2023年计划项目(2023400)。
关键词
中药
内外合治
尿毒症
维持性血液透析
腹泻
Chinese medicines
combined internal and external treatment
uremia
maintenance hemodialysis
diarrhea
作者简介
钱卫明(1975-),男,副主任中医师,主要从事血液透析、中医药治疗尿毒症患者慢性肠炎疾病的临床与机制研究。
