Chinese Herbal Enema Combined with Fumigation as Adjunctive Therapy for 60 Cases of Non-dialysis Chronic Kidney Disease Patients of Stage 3-5 with Spleen-kidney Yang Deficiency and Turbid Toxin Blood Stasis Pattern：A Randomized Controlled Trial

HUANG Xueying; ZHANG Ning; LI Xiangyu; ZHANG Qian; SHI Kaifeng; YAN Pu; LI Tongxia

doi:10.13288/j.11-2166/r.2024.07.008

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Chinese Herbal Enema Combined with Fumigation as Adjunctive Therapy for 60 Cases of Non-dialysis Chronic Kidney Disease Patients of Stage 3-5 with Spleen-kidney Yang Deficiency and Turbid Toxin Blood Stasis Pattern：A Randomized Controlled Trial

更新时间：2024-04-09

- Chinese Herbal Enema Combined with Fumigation as Adjunctive Therapy for 60 Cases of Non-dialysis Chronic Kidney Disease Patients of Stage 3-5 with Spleen-kidney Yang Deficiency and Turbid Toxin Blood Stasis Pattern：A Randomized Controlled Trial
- Journal of Traditional Chinese Medicine Vol. 65, Issue 7, Pages: 703-709(2024)
- 作者机构：
  
  中国中医科学院望京医院，北京市朝阳区望京中环南路6号，100102
- 作者简介：
- 基金信息：
- DOI：10.13288/j.11-2166/r.2024.07.008
  CLC：
- Received：31 August 2023，
  
  Revised：2024-01-10，
  
  Published：02 April 2024
- 稿件说明：
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黄雪莹,张宁,李翔宇等.中药灌肠联合熏蒸辅助治疗脾肾阳虚、浊毒血瘀型慢性肾脏病3~5期非透析患者60例随机对照试验[J].中医杂志,2024,65(07):703-709.

HUANG Xueying,ZHANG Ning,LI Xiangyu,et al.Chinese Herbal Enema Combined with Fumigation as Adjunctive Therapy for 60 Cases of Non-dialysis Chronic Kidney Disease Patients of Stage 3-5 with Spleen-kidney Yang Deficiency and Turbid Toxin Blood Stasis Pattern：A Randomized Controlled Trial[J].Journal of Traditional Chinese Medicine,2024,65(07):703-709.
黄雪莹,张宁,李翔宇等.中药灌肠联合熏蒸辅助治疗脾肾阳虚、浊毒血瘀型慢性肾脏病3~5期非透析患者60例随机对照试验[J].中医杂志,2024,65(07):703-709. DOI： 10.13288/j.11-2166/r.2024.07.008.

HUANG Xueying,ZHANG Ning,LI Xiangyu,et al.Chinese Herbal Enema Combined with Fumigation as Adjunctive Therapy for 60 Cases of Non-dialysis Chronic Kidney Disease Patients of Stage 3-5 with Spleen-kidney Yang Deficiency and Turbid Toxin Blood Stasis Pattern：A Randomized Controlled Trial[J].Journal of Traditional Chinese Medicine,2024,65(07):703-709. DOI： 10.13288/j.11-2166/r.2024.07.008.

摘要

目的

观察中药灌肠联合熏蒸辅助治疗脾肾阳虚、浊毒血瘀型CKD3~5期非透析患者的临床疗效及安全性。

方法

将120例脾肾阳虚、浊毒血瘀型CKD3~5期非透析治疗患者随机分为治疗组和对照组各60例。对照组给予西医基础治疗，治疗组在对照组基础上联合中药肾衰灌肠方滴注保留灌肠及肾衰熏蒸方进行熏蒸，中药熏蒸和中药灌肠交替进行，均两日1次，每周3次。两组疗程均为4周。比较两组患者治疗前后血肌酐（Scr）水平、估计肾小球滤过率（eGFR）及中医症状总积分，治疗后比较两组中医症状疗效和临床疗效。治疗期间观察两组患者不良反应。

结果

与本组治疗前比较，两组治疗后中医症状总积分明显降低（

＜0.01）。与对照组治疗后比较，治疗组Scr、中医症状总积分明显下降，eGFR明显升高（

＜0.05）。治疗组中医症状疗效总有效率（96.67%）高于对照组（46.67%，

＜0.01），治疗组临床疗效总有效率（75.00%）高于对照组（28.33%，

＜0.01）。治疗期间两组患者生命体征平稳，治疗后血常规、尿常规、便常规、肝功能指标及心电图较治疗前无明显异常改变。

结论

中药灌肠联合熏蒸辅助治疗脾肾阳虚、浊毒血瘀型CKD3~5期非透析治疗患者可以明显减轻临床症状，改善肾功能，且安全性较好。

Abstract

Objective

To observe the clinical efficacy and safety of Chinese herbal enema combined with fumigation as adjunctive therapy for non-dialysis chronic kidney disease （CKD） patients of stage 3

5 with spleen-kidney

yang

deficiency and turbid toxin blood stasis pattern.

Methods

A total of 120 non-dialysis CKD，patients of stage 3

5 with spleen-kidney

yang

deficiency and turbid toxin blood stasis pattern were randomly divided into treatment group and control group， with 60 cases in each group. The control group received conventional western medical treatment， while the treatment group additionally received Chinese herbal enema combined with fumigation， with enema and fumigation performed alternately， once every other day， three times a week. The treatment course for both groups was 4 weeks. The levels of serum creatinine （Scr）， estimated glomerular filtration rate （eGFR）， and the total score of traditional Chinese medicine symptoms were compared before and after treatment in both groups. The efficacy of traditional Chinese medicine symptoms and clinical efficacy were compared between the two groups after treatment. Adverse reactions in both groups were observed during the treatment period.

Results

The total score of traditional Chinese medicine symptoms was significantly reduced after treatment in both groups （

＜0.01）. Compared to the control group after treatment， the treatment group showed significant decreases in Scr and the total score of traditional Chinese medicine symptoms， and a significant increase in eGFR （

＜0.05）. The total effective rate of traditional Chinese medicine symptoms in the treatment group （96.67%） was higher than that in the control group （46.67%，

＜0.01）， as well as the total effective rate of clinical efficacy in the treatment group （75.00%） versus that in the control group （28.33%，

＜0.01）. During the treatment period， the vital signs of patients in both groups remained stable， and there were no significant abnormalities in blood routine， urine routine， stool routine， liver function indicators， and electrocardiogram after treatment.

Conclusion

Chinese herbal enema combined with fumigation as adjunctive therapy can significantly alleviate clinical symptoms， improve renal function， and demonstrate good safety for non-dialysis CKD patients of stage 3

5 with spleen-kidney

yang

deficiency and turbid toxin blood stasis pattern.

关键词

Keywords

references

LARANJINHA I ， MATIAS P ， MATEUS S ， et al . Diabetic kidney disease： Is there a non-albuminuric phenotype in type 2 diabetic patients？［J］. Nefrologia ， 2016 ， 36 （ 5 ）： 503 - 509 .

郝思嘉，赵璐，邬碧波，等 . 2016-2018年上海市慢性肾脏病高风险人群流行病学调查［J］. 陆军军医大学学报， 2023 ， 45 （ 1 ）： 86 - 92 .

袁喆平，魏丽，汤志奇，等 . 川黄方联合中医外治法治疗2~4期慢性肾脏病的临床研究［J］. 现代中西医结合杂志， 2023 ， 32 （ 1 ）： 45 - 49 .

廖国华，俞立强 . 中药熏蒸联合海昆肾喜胶囊治疗慢性肾脏病临床观察［J］. 中医临床研究， 2017 ， 9 （ 26 ）： 61 - 62 .

张舒洋，王圣治 . 中医外治法治疗慢性肾脏病研究进展［J］. 中医临床研究， 2021 ， 13 （ 24 ）： 83 - 85 .

张晓雷，马家驹，王玉光 . 试论“开鬼门，洁净府”当为“打开门户，祛除府之邪气 ”［J］. 北京中医药， 2015 ， 34 （ 7 ）： 551 - 552 .

田海刚 . 慢性肾脏病中医证候学研究［M］. 北京：北京中医药大学， 2009 ： 74 - 75 .

王宇阳，马放，占永立 . 基于“浊毒”理论论治慢性肾脏病［J］. 中医杂志， 2019 ， 60 （ 16 ）： 1374 - 1377 .

EKNOYAN G ， LEVIN NW . Impact of the new K/DOQI guidelines ［J］. Blood Purif ， 2002 ， 20 （ 1 ）： 103 - 108 .

中华中医药学会肾病分会 . 慢性肾衰竭的诊断、辨证分型及疗效评定（试行方案）［J］. 上海中医药杂志， 2006 ， 40 （ 8 ）： 8 - 9 .

陈香美，倪兆慧，刘玉宁，等 . 慢性肾衰竭中西医结合诊疗指南［J］. 河北中医， 2016 ， 38 （ 2 ）： 313 - 317 .

郑晰 . 泄浊灌肠方治疗湿浊瘀阻型慢性肾功能衰竭的临床观察［D］. 广州：广州中医药大学， 2017 .

郭雅琼 . 中药保留灌肠对慢性肾脏疾病4-5期患者的短期疗效观察［D］. 广州：广州中医药大学， 2012 .

CHOW SC ， SHAO J ， WANG H . Sample size calculation in clinical research ［M］. New York ： Marcel Dekker ， 2008 ： 89 .

LEVIN A ， STEVENS PE ， BILOUS RW ， et al . Kidney disease：Improving global outcomes （KDIGO） CKD work group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease ［J］. Kid Inter Sup ， 2013 ， 3 （ 1 ）： 5 - 6 .

张倩，李同侠，黄雪莹，等 . 中药结肠透析法对慢性肾脏病3~4期湿浊血瘀证患者肠道“微生态”的影响［J］. 中国医药导报， 2023 ， 20 （ 5 ）： 155 - 159 .

贾一江 . 当代中药外治临床大全［M］. 北京：中国中医药出版社， 1991 ： 101 - 112 .

INKER LA ， SCHMID CH ， TIGHIOUART H ， et al . Estimating glomerular filtration rate from serum creatinine and cystatin C ［J］. N Engl J Med ， 2012 ， 367 （ 1 ）： 20 - 29 .

国家药品监督管理局药品审评中心 . 中药新药临床研究一般原则［EB/OL］.（ 2015-11-03 ）［ 2023-04-10 ］. https：//www.cde.org.cn./zdyz/domesticinfopage？zdyzId-CODE=c1e508cf80c961a4ede520fed397cfc9 https://www.cde.org.cn./zdyz/domesticinfopage?zdyzId-CODE=c1e508cf80c961a4ede520fed397cfc9 .

刘正平 . 慢性肾脏病3-5期患者的人体成分、中医证型、舌象的初步研究［D］. 北京：北京中医药大学， 2021 .

吴国庆，薛松，范伟等 . 益肾化瘀解毒方对连续不卧床腹膜透析腹膜炎患者血清HMGB-1和hs-CRP水平的影响［J］. 中医杂志， 2015 ， 56 （ 2 ）： 124 - 127 .

刘兴花，宋跃飞，陈晓瑛 . 浅谈“去菀陈莝，开鬼门，洁净府”在膜性肾病水肿中的应用［J］. 中国民间疗法， 2020 ， 28 （ 12 ）： 24 - 26 .

王维英，陈顺合，杨晓媛，等 . 中药皮肤透析与结肠透析治疗慢性肾衰竭临床随机对照研究［J］. 河北中医， 2020 ， 42 （ 4 ）： 558 - 560，566 .

毕礼明，陈英兰 . 药浴辅助治疗慢性肾脏病临床研究进展［J］. 现代中西医结合杂志， 2015 ， 24 （ 14 ）： 1585 - 1587 .

易庆莲，王亿平，梁晓平 . 中药肠道疗法在慢性肾脏病治疗中的应用［J］. 中医药临床杂志， 2020 ， 32 （ 12 ）： 2213 - 2217 .

任翼，沈佳晨，郭传，饶向荣 . 基于网络药理学探究大黄延缓慢性肾脏病的作用机制［J］. 世界中西医结合杂志， 2020 ， 15 （ 10 ）： 1835 - 1840 .

曾玉群 . 大黄及其活性物质灌肠对慢性肾脏病模型大鼠作用的分子机制［D］. 广州：广州中医药大学， 2017 .

张婷婷 . 大黄牡蛎汤灌肠治疗对慢性肾衰竭各中医分型血清钙、磷水平的影响［D］. 太原：山西医科大学， 2017 .

朴静，迟继铭 . 常用治疗慢性肾脏病的方药中对肾毒性的药物解析［J］. 黑龙江中医药， 2016 ， 45 （ 6 ）： 65 - 66 .

吴玲芳，王子墨，赫柯芊，等 . 赤芍的化学成分和药理作用研究概况［J］. 中国实验方剂学杂志， 2021 ， 27 （ 18 ）： 198 - 206 .

郭凯琴，肖振卫 . 中西医治疗慢性肾脏病皮肤瘙痒的研究进展［J］. 中医临床研究， 2021 ， 13 （ 30 ）： 71 - 74 .

段连香，刘子洋，路建饶，等 . 叶氏降酐合剂结肠透析治疗湿热蕴结型慢性肾脏病4期患者的短期疗效观察［J］. 中国中西医结合肾病杂志， 2022 ， 23 （ 5 ）： 435 - 437 .

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