| In recent years,epidemiological studies on chronic kidney disease(CKD)show that the incidence of this disease is increasing year by year.At present,the treatment of CKD in the early and middle period by Western medicine is mainly to control the risk factors of aggravating renal injury and to treat primary morbidity and complications,while the patients with End-Stage Renal Disease(ESRD)need to rely on renal replacement therapy.The renal units of patients with CKD are constantly destroyed,the renal function is declining,the toxins removed by kidney are dwindling,all kinds of uremia toxins are accumulating,leading to various complications of the body,which seriously affect the quality of life of the patients and the life safety of the patients.Therefore,removing uremic toxins plays an important role in delaying the progress of CKD.At present,there are many kinds of toxins found.Protein-binding toxins are one of the toxins found in recent years.This kind of toxin has the property of close bond with protein,and the effect of routine drug therapy and hemodialysis clearance is not good,so protein-binding toxins have become a hot topic in recent years.Indoxyl sulfate,one of the representatives of protein-binding toxin,is a particularly difficult point in many researches.traditional chinese medicine colon dialysis is based on the traditional Chinese medicine enema to add colon dialysis treatment,a large number of studies confirmed that traditional Chinese medicine colon dialysis have a good clearance of uremic toxins,meanwhile,it can ameliorate the eGFR and clinical symptoms of CKD patients.Objective:By observing the changes of uremic toxins and clinical symptoms in patients with CKD 3-5 stages by colon dialysis or low enema,to determine the effects of two treatments on the removal of uremic toxins,especially protein-binding toxins,to observe and explore its potential mechanism,so as to clarify the unique advantages of traditional Chinese medicine colon dialysis in the treatment of CKD.Methods:A parallel control method was adopted in this paper,set up inclusion and exclusion indicators,and selected 61 cases of spleen and kidney qi deficiency and dampness turbid(blood stasis)type in the Department of Renal Medicine of Nanjing traditional chinese medicine Hospital.The patients were divided into traditional Chinese medicine colon dialysis group(treatment group)and traditional Chinese medicine enema group(control group).All patients were treated with western medicine and oral Chinese medicine decoction according to TCM syndrome differentiation.The treatment group was treated with traditional Chinese medicine colon dialysis.At the same time,the control group was treated with traditional Chinese medicine enema.Two weeks were used as a course of treatment,after treatment,the clinical symptom scores,uremic toxin level(IS,Hcy,Scr,BUN)and estimated glomerular filtration rate(eGFR)changes were compared before and after treatment.SPSS21.0 statistical software was used for statistical data,and P<0.05 was considered statistically significant.Results:1)Comparison of clinical disease efficacy between two groups of patients:In the control group,30 cases were effective and 24 cases were effective.The total effective rate was 80%.31 cases were treated in the treatment group,29 cases were effective,and the total effective rate was 93.5%.The total effective rate of the treatment group was higher than that of the control group,and the difference was statistically significant(P<0.05).2)After treatment,?The results of TCM symptom score after treatment in the two groups were shown;The total score and symptom score of the two groups improved significantly after treatment compared with that of the same group before treatment,and the difference was statistically significant(P<0.05);Comparison between groups showed that the clinical symptoms of the treatment group were better than those of the control group(P<0.05);The total score of the treatment group was significantly lower than that of the control group.3)The results showed that,in the two groups,uremia toxins(IS,Hcy,Scr,BUN)were significantly lower than before treatment,the difference was statistically significant(P<0.05).The comparison between the groups showed that the IS and BUN in the treatment group were lower than those in the control group,and the difference was statistically significant(P<0.05),and the Scr and Hcy were not significantly different after treatment(P>0.05).4)The results showed that there was a significant increase in eGFR after treatment(P<0.05),and there was no statistical difference between the two groups(P>0.05)during the course of treatment.5)During the treatment,there were no obvious adverse reaction symptoms in both groups,and there was no obvious abnormality in safety indexes.Conclusions:In the treatment of patients with chronic kidney disease 3-5 stages,the unique curative effect can not only improve the TCM syndromes of patients,but also improve the level of glomerular filtration rate,reduce the level of uremia toxins(IS,Hcy,Scr,BUN),delay the progress of chronic renal disease,and improve the quality of life of patients. |
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