Abstract:

Objective　To explore the clinical efficacy of the colon dialysis with nitrogen-lowering detoxification solution combined with urine toxin-clearing granules retention enema in the treatment of patients with early to mid-stage chronic renal failure (CRF). Methods　Carry out a prospective study.Using the simple random sampling method, 98 patients with CRF who received treatment at Xi'an Hospital of Traditional Chinese Medicine from June 2021 to August 2023 were divided into two groups, with 49 patients in each group.Control group: 27 males and 22 females, with an average age of (42.56±9.38) years and a disease duration of (6.48±2.50) years.In the early stage, there were 25 cases of CRF; in the middle stage, there were 24 cases of CRF. The treatment method was to use the Yutuzhen Granules for direct retention enema.Observation group: 29 males and 20 females, with an average age of (42.41±9.18) years and a disease duration of (6.75±2.34) years.Early cases of CRF: 23; Mid-term cases of CRF: 26.First, perform colon dialysis with the nitrogen-lowering detoxification solution, and then use the Yutuqing Granules for retention enema.The patients in both groups were treated with urine toxin-clearing granule retention enema three times a week for a total of four weeks.The clinical efficacy, occurrence of adverse reactions, and levels of blood urea nitrogen (BUN), serum creatinine (Scr), glomerular filtration rate (GFR), uric acid (UA), blood calcium (Ca), and blood phosphorus (P) before and after treatment were compared between the two groups of patients. Statistical analysis was conducted using t-test and χ² test. Results　After treatment, the total effective rate of the observation group was higher than that of the control group [93.88%(46/49) vs.63.27%(31/49)], and the difference was statistically significant (χ²=13.636; P<0.05).The BUN and Scr levels in the observation group were lower than those in the control group [(18.98±4.19) mmol/L vs.(22.37±5.71) mmol/L,(334.16±32.29) μmol/L vs.(352.05±43.01) μmol/L], and the GFR was higher than that in the control group [(44.39±6.21) mL/(min·1.73 m²) vs.(37.05±5.57) mL/(min·1.73 m²)], and the differences were statistically significant (t=3.351,2.017,6.159; all P<0.05).After treatment, the levels of UA and P in the observation group were lower than those in the control group [(382.67±57.40) μmol/L vs.(437.22±65.58) μmol/L, (1.31±0.19) mmol/L vs.(1.42±0.23) mmol/L], while the level of Ca was higher in the observation group [(2.54±0.23) mmol/L vs. (2.27±0.21) mmol/L], and the differences were statistically significant (t=4.381,2.581,6.068; all P<0.05).The comparison of adverse reaction rates between the two groups of patients [8.16%(4/49) vs.14.29%(7/49)] showed no statistically significant difference (χ²=0.922; P>0.05). Conclusion　The combined treatment of nitrogen-lowering detoxification liquid colon dialysis and urine toxin-clearing granules retention enema for patients with early to middle-stage chronic renal failure can effectively improve the renal function and metabolic indicators of the patients, and the clinical efficacy is excellent.

Key words:

Chronic renal failure；Early and middle stage；Nitrogen-lowering detoxification solution；Colon dialysis；Uremic clearance granules； , Coloclysis

摘要：

目的　探讨降氮排毒液结肠透析联合尿毒清颗粒保留灌肠治疗早中期慢性肾功能衰竭（CRF）患者的临床疗效。方法　采用前瞻性研究，按简单随机法将2021年6月至2023年8月在西安市中医医院接受治疗的98例CRF患者分为两组，每组49例。对照组：男27例，女22例，年龄（42.56±9.38）岁，病程（6.48±2.50）年；早期CRF 25例，中期CRF 24例；采用尿毒清颗粒直接保留灌肠。观察组：男29例，女20例，年龄（42.41±9.18）岁，病程（6.75±2.34）年；早期CRF 23例，中期CRF 26例；先采用降氮排毒液结肠透析，然后再以尿毒清颗粒保留灌肠。两组患者尿毒清颗粒保留灌肠治疗每周均3次，共治疗4周。比较两组患者临床疗效、不良反应发生情况，以及治疗前后血尿素氮（BUN）、血肌酐（Scr）、肾小球滤过率（GFR）、尿酸（UA）、血钙（Ca）及血磷（P）水平。采用t检验、χ²检验进行统计分析。结果　治疗后，观察组总有效率高于对照组［93.88%（46/49）比63.27%（31/49）］，差异有统计学意义（χ²=13.636，P<0.05）；观察组BUN、Scr均低于对照组［（18.98±4.19）mmol/L比（22.37±5.71）mmol/L、（334.16±32.29）μmol/L比（352.05±43.01）μmol/L］，GFR高于对照组［（44.39±6.21）mL/（min·1.73 m²）比（37.05±5.57）mL/（min·1.73 m²）］，差异均有统计学意义（t=3.351、2.017、6.159，均P<0.05）。治疗后，观察组UA、P均低于对照组［（382.67±57.40）μmol /L比（437.22±65.58）μmol /L、（1.31±0.19）mmol/L比（1.42±0.23）mmol/L］，Ca高于对照组［（2.54±0.23）mmol/L比（2.27±0.21）mmol/L］，差异均有统计学意义（t=4.381、2.581、6.068，均P<0.05）。两组患者不良反应发生率比较［8.16%（4/49）比14.29%（7/49）］，差异无统计学意义（χ²=0.922，P>0.05）。结论　降氮排毒液结肠透析联合尿毒清颗粒保留灌肠治疗早中期CRF患者，可有效改善患者肾功能及代谢指标，临床疗效优良。

关键词:

慢性肾功能衰竭, 早中期, 降氮排毒液, 结肠透析, 尿毒清颗粒, 灌肠