| BackgroundChronic renal failure belongs to the category of "Guan Gc" and "Long Bi" in Chinese medicine.It involves the five internal organs,gastrointestinal and bladder,etc.The pathological nature is the virtual standard.The key to the pathogenesis lies in the deficiency of spleen and kidney,and the resistance of wet and turbid.Treatment should treat both the symptoms and the symptoms,and help the righteousness.The patient's condition is complicated,and it is difficult to imagine that such a complicated and variable disease can be solved by a simple one,one medicine or one method.In this regard,the master of Chinese medicine,Professor Zou Yanqin,proposed in the early 1990s the combination of oral Chinese patent medicine,intravenous drip activating blood circulation to remove phlegm,and traditional Chinese medicine enema to treat chronic renal failure.Chronic renal failure patients due to wet turbidity in the middle coke,resulting in dysfunction of the spleen and stomach,so the common "difficult to enter the soup",and better taste,reliable,easy to absorb the Chinese patent medicines to improve the above problems;patients due to the course of disease Prolonged,long-term illness into the network,blood and blood,and blood stasis syndrome throughout the onset of chronic renal failure.The drugs that are phlegm and phlegm,blood stasis and phlegm are mostly bitter cold,which is easy to hurt the stomach.It is difficult for patients to take medicine.The intravenous preparation of traditional Chinese medicine for promoting blood circulation and removing blood stasis is injected directly into the body through intravenous injection without increasing the burden on the spleen and stomach.It can be effective;the traditional Chinese medicine retention enema can reduce the turbidity and evilness by objectively venting the turbidity,and indirectly protect the stomach.In recent years,the research on the treatment of chronic renal failure by Zou's multi-channel drug therapy has been increasing.In the previous study,the author found that the"enema method" in multi-channel drug therapy has made new progress:colon dialysis as a new technology.It is proposed that,according to the principle of peritoneal dialysis,the patient's own colon wall is used as a filtration membrane,and the diffusion method is used to discharge the metabolic waste in the body,maintain the balance of water and electrolyte,and reduce the therapeutic goal of cardiopulmonary complications.The invention improves the retention of the traditional Chinese medicine enema in the intestinal tube,the drug is difficult to effectively contact with the unclean intestinal mucosa,and the patient is prone to defecation after enema.The progress of the"oral preparation" and "intravenous preparation" in the multi-channel administration of Zou's multi-channel therapy needs further study.At present,there are many varieties of Chinese patent medicines in China,and the phenomenon of homogenization is serious.The functional characteristics and strength of these drugs are not systematically compared.The efficacy of drugs with similar efficacy and indications is unclear,and the long-term efficacy of similar drugs is also lacking.Make doctors and patients at a loss when choosing drugs,do not know how to target the most important outcomes,select the best drug.PurposeTherefore,this study aims to:1.To understand the research progress of traditional Chinese medicine in the treatment of chronic renal failure,and to provide reference for further research on the clinical research of high quality traditional Chinese medicine in the treatment of chronic renal failure.2.The commonly used Chinese patent medicine for the treatment of chronic renal failure is selected from the "Clinical Pathway of Chronic Renal Failure TCM(20]7 Edition)",which is divided into three types according to the efficacy:Fuzheng medicine,turbidity medicine,and blood circulation medicine.Commonly used righting medicines are Bailing Capsule and Jinshuibao Capsule.The ingredients are all cultivated Cordyceps mycelium,so there is no meta-analysis value.Commonly used turbidity-removing drugs include Haikun Shenxi Capsule,Uremic Qing Granule,Shenshenning Oral Tablets;Huoxue Huayu Preparation mainly includes:Tanshinone Injection,Danshen Ligustrazine Injection,Dengzhan Xixin Injection,Shenkang Injection.In view of the efficacy comparison of the above various drugs,this study used the network meta-analysis(NMA)research method to evaluate and rank the efficacy,and provide evidence-based medical evidence for the popularization and application of Chinese patent medicine in the treatment of chronic renal failure.3.Using the traditional meta-analysis method,compare the clinical efficacy and safety of colorn dialysis combined with traditional Chinese medicine retention enema and traditional Chinese medicine retention enema on chronic kidney disease.Methods1.Computer search for MEDLINE(1996-December 2017),EMbase(December 2017),PubMed,CBM,WanFang Data,CNKI and other major electronic databases related to turbidity drugs(Hai Kun Shen Xi capsule,urinary clear Randomized controlled trials of granules,Shenshenning oral tablets)and blood-activating and stasis-1 ike intravenous preparations(danshen ligustrazine injection,tanshinone injection,Dengzhanxixin injection,Shenkang injection)in the treatment of chronic renal failure,and manually searching related Journals,traced back to the references included in the study.The literature quality was evaluated by two evaluators independently selecting the literature according to the inclusion and exclusion criteria and collecting the data using the method in Cochrane Reviewer's Handbook 5,1.Statistical analysis was performed using the Stata14.0 and R software GEMTC packages to compare the differences in efficacy of each treatment and to rank the effects.2.Computer search for CENTRAL(January 2017),MEDLINE(1996-January 2017),EMbase(January 2017),PubMed,CBM,WanFang Data,and CNKI for colon dialysis combined with traditional Chinese medicine for chronic kidney disease Randomized controlled trials and manual retrieval of relevant journals,retrospectively included in the study's ref-erences.Two evaluators independently selected the literature according to the inclusion and exclusion criteria,collected the data,and used the method of Cochrane Reviewer's Handbook 4.2.2 to evaluate the quality of the literature,and finally used Revman 5.3.3 software for meta-analysis.Results1.In the reticular meta-analysis of traditional Chinese medicine for treating chronic renal failure in the turbidty class,Shenshuining Oral T ablet,Haikun Shenxi Capsule,Uremic Qingqi Combined with Western Medicine in the treatment of blood creatinine and blood urea nitrogen in patients with chronic renal faiure The efficacy was better than that of traditional Western medicine alone,and the three effects were comparable,and there was no statistical difference.Among the included treatments,Shenshuining Oral Tablets combined with Western medicine in the treatment of blood creatinine and blood urea nitrogen in patients with chronic renal failure ranked first.2.In the reticular meta-analysis of traditional Chinese medicine injection for the treatment of chronic renal failure,the efficacy of tanshinone injection combined with Western medicine in the treatment of serum creatinine in patients with chronic renal failure was not statistically different from the conventional treatment with Western medicine alone.The efficacy of Shenkang injection,Danshen Ligustrazine injection,Dengzhan Xixin injection combined with Western medicine was better than that of traditional Western medicine alone,and the three effects were comparable,no statistical difference.Among the included treatments,Shenkang injection combined with conventional treatment ranked the most effective in reducing serum creatinine in patients with chronic renal failure.3.Traditional meta-analysis results show that colon dialysis combined with traditional Chinese medicine enema can further improve the general symptoms of patients with chronic kidney disease,reduce serum creatinine and blood urea nitrogen concentration,increase hemoglobin concentration,but for endogenous creatinine clearance rate.The improvement is not much different.Conclusion1.In the treatment of chronic renal failure in the treatment of turbidity,the kidney spleen oral tablets,urinary granules,Haikun Shenxi capsule combined with Western medicine in the treatment of patients with chronic renal failure reduce serum creatinine,blood urea Nitrogen levels have a certain effect,and Shenshuanning oral tablets combined with Western medicine for the treatment of chronic renal failure patients with lower blood creatinine,blood urea nitrogen levels have the highest ranking,the author speculates that the use of phlegm drugs in the Shenshenning group For more,look forward to more research to verify.In the treatment of chronic renal failure with blood stasis and phlegm Chinese medicine injection,the Danshen Ligustrazine Injection,Dengzhan Xixin Injection and Shenkang Injection combined with Western medicine in the treatment of patients with chronic renal failure have reduced serum creatinine levels.Certain curative effect,and Shenkang injection combined with Western medicine routine treatment has the highest effect on reducing serum creatinine level in patients with chronic renal failure.The authors speculate that Shenkang injection is more effective than simple blood circulation and phlegm Chinese medicine injection plus righting medicine.Look forward to more relevant tests to verify.There was no significant difference in the efficacy of tanshinone injection combined with Western medicine and conventional Western medicine.2.Mesh rmeta-analysis can not only objectively evaluate the efficacy of traditional Chinese medicine injections,blood stasis and phlegm-removing traditional Chinese medicine injections for chronic renal failure,and also rank the curative effect,thus providing guidance for clinical medication.However,due to the poor quality of the included test methodologies,such conclusions need to be carefully stated.The clinical trial design for the treatment of chronic renal failure with Chinese patent medicines and traditional Chinese medicine injections needs further regulation.In order to ensure evidence-based clinical practice,future trials need to be more strict with placebo control,pay attention to reduce the risk of bias,and strictly improve the test according to international uniform standards.quality.3.The available evidence suggests that colon dialysis combined with traditional Chinese medicine enema can further improve the general symptoms of patients and prolong the progression of slow renal disease compared with traditional Chinese medicine enema.However,due to the relatively low quality of the included studies,the above conclusions need to be verified by more high-quality related research in the future. |
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