The Ancient Source Of Chronic Renal Failure And The Meta-analysis Of Traditional Chinese Medicine Retention Enema In The Treatment Of Chronic Renal Failure

Purpose: Traditional Chinese medicine(TCM)retention enema is one of the traditional treatment strategy of chronic renal failure.The purpose of our study is to explore the effectiveness of retention enema with TCM in the treatment of chronic renal failure.。 Material and method: 1.The research consulted the ancient literature of TCM about “diarrhea”,“uroschesis” and “renal wind sydrome”,organized the discussions by medical practitioners from the Spring and Autumn period to the Qing dynasty about the definition,etiology,pathogenesis,treatment and prescriptions of chronic renal failure,and elaborate on literature and theories level.2.China National Knowledge Infrastructure,Wanfang,and VIP databases were searched electronically to collect all randomized controlled trials about TCM retention enema for the treatment of chronic renal failure.“Chinese medicine”,“enema”,and “renal failure” were the search terms to identify all the related articles.。 Results: 1.Chronic renal failure can be evolved in the concepts of “diarrhea”,“uroschesis” and “renal wind sydrome”,with a basic pathogenesis of spleen and kidney deficiency and manifestation of damp-heat and phlegm-stasis above which the most basic pathogenesis is kidney deficiency.The treatment by a principle of holism and syndrome differentiation is to invigorating the spleen and benefiting the kidney side with clearing dampness and turbidity,invigorate the circulation of blood,removing blood stasis,and eliminating phlegm.2.A total of 29 articles were included in this study,including 1214 patients in the experimental group,and 1146 patients in the control group.The total effective rate was significantly higher in the experimental group than the control group(OR=3.60,95%CI=2.95-4.41,p<0.00001).。 3.Twenty-three articles used blood urea nitrogen(BUN)as the outcome measure.And the experimental group had a significantly lower BUN than the control group(MD=3.65,95%CI=2.74-4.55,P<0.00001).。 4.Twenty-four articles used serum creatinine(SCr)as the outcome measure.The experimental group had a significantly lower serum Cr than the control group(MD=71.24,95%CI=55.94-86.53,P<0.00001)。 Conclusion: 1.Though no exact disease name was found to describe chronic renal failure in TCM,the furthest records of the disease dates back to more than two thousand years ago.A number of classic prescriptions were created by medical practitioners of all time with continuous study on etiology,pathogenesis and treatment,which provided reliable practical and theoretical value to modern medicine.2.Traditional Chinese medicine retention enema combined with conventional western medicine had a higher effective rate,lower BUN,and lower SCr than western medicine alone in the treatment of chronic renal failure.