Zou Chuan, Wu Yu-Chi, Lin Qi-Zhan
Department of Nephropathy, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510120.
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2012 Sep;32(9):1192-5.
To assess the clearance role and safety of Chinese herbal enema therapy (CHET) in clearing enterogenic uremic toxins in chronic renal failure (CRF) patients, thus providing evidence for further optimizing the comprehensive treatment.
Using nonrandomized concurrent control trial, 96 CRF inpatients of Department of Nephropathy, Guangdong Provincial Hospital of Traditional Chinese Medicine, from March 2010 to December 2010 were assigned to the treatment group and the control group according to their willingness. All patients were treated with basic treatment referring to clinical plans in the non-dialysis phase, while those in the treatment group were additionally treated with CHET, once daily, 2 weeks as one therapeutic course. The symptoms, serum enterogenic uremic toxin levels [including indoxyl sulfate (IS), blood urea nitrogen (BUN), and uric acid (UA)], and serum creatinine (SCr) were observed in the two groups between and after treatment. The adverse reactions were also monitored during the treatment period. The clinical efficacy and safety were also assessed.
Totally 84 patients completed this clinical observation, 48 in the treatment group and 36 in the control group. The levels of SCr, BUN, and IS were obviously lower in the treatment group after treatment, showing statistical difference when compared with before treatment (P<0.01). There was no statistical difference in each index in the control group between before and after treatment (P>0.05). The post-treatment the IS level was lower in the treatment group than in the control group with statistical difference (P<0.05). Symptoms like fatigue, soreness of waist and knees, constipation and edema were partially relieved in both groups (P<0.05, P<0.01). The ratios of anorexia and nausea in patients of the treatment group was lowered after treatment (P<0.05). Besides, patients in the treatment group could defecate for more than once daily during the enema treatment period, dominated as rotten and soft feces. No severe adverse event occurred during the treatment period.
CHET combined basic treatment could lower the serum levels of enterogenic uremic toxins (IS and BUN) of CRF patients in a short period.
评估中药灌肠疗法(CHET)对慢性肾衰竭(CRF)患者肠道源性尿毒症毒素的清除作用及安全性,为进一步优化综合治疗提供依据。
采用非随机同期对照试验,选取2010年3月至2010年12月在广东省中医院肾病科住院的96例CRF患者,根据其意愿分为治疗组和对照组。所有患者均参照非透析期临床方案进行基础治疗,治疗组在此基础上采用CHET治疗,每日1次,2周为1个疗程。观察两组治疗前后的症状、血清肠道源性尿毒症毒素水平[包括硫酸吲哚酚(IS)、血尿素氮(BUN)和尿酸(UA)]以及血清肌酐(SCr)。治疗期间监测不良反应,并评估临床疗效和安全性。
共84例患者完成本临床观察,治疗组48例,对照组36例。治疗组治疗后SCr、BUN和IS水平明显降低,与治疗前比较差异有统计学意义(P<0.01)。对照组各指标治疗前后比较差异无统计学意义(P>0.05)。治疗组治疗后IS水平低于对照组,差异有统计学意义(P<0.05)。两组患者的疲劳、腰膝酸痛、便秘和水肿等症状均有部分缓解(P<0.05,P<0.01)。治疗组患者治疗后厌食和恶心的比例降低(P<0.05)。此外,治疗组患者在灌肠治疗期间每日排便次数多于1次,以溏软便为主。治疗期间未发生严重不良事件。
CHET联合基础治疗可在短期内降低CRF患者血清肠道源性尿毒症毒素(IS和BUN)水平。