不同中药结肠透析方式对慢性肾功能衰竭患者营养评估和生活质量的影响

Influence of different traditional Chinese medicine colon dialysis methods on nutritional assessment and living quality of patients with chronic renal failure

关键词:  结肠透析  保留灌肠  营养评估  生活质量  慢性肾功能衰竭

Key words:  colon dialysis  retention enema  the condition assessment of nutrition  living quality  chronic renal failure

摘要:

[目的]通过对不同中药结肠透析方式治疗慢性肾功能衰竭患者临床疗效、生活质量和营养状况评估比较，探究最佳中药结肠透析方式。[方法]选择慢性肾功能衰竭患者106例，随机分为Ⅰ组33例、Ⅱ组38例和Ⅲ组35例，分别予以中药保留灌肠、高位中药结肠透析及两种方式相结合治疗，疗程均为4周，完成96例，观察3组患者治疗前后肾功能指标、营养指标和生活质量评分的变化。[结果] 3组患者治疗后肾功能指标、血清白蛋白（ALB）、前白蛋白（PA）、转铁蛋白（TRF）和生活质量评分均较治疗前有明显改善（P<0.05，P<0.01），Ⅱ组和Ⅲ组主观综合性营养评估（SGA）较治疗前改善明显（P<0.01）；治疗后Ⅱ组和Ⅲ组肾功能指标较Ⅰ组改善显著（均P<0.01）；Ⅱ组和Ⅲ组血ALB、PA、TRF和SGA较Ⅰ组改善显著（P<0.05；P<0.01）；治疗后Ⅲ组生活质量评分优于Ⅱ组和Ⅰ组（均P<0.05）；Ⅱ组的不良反应发生率大于Ⅲ组和Ⅰ组（P<0.05）。[结论]从临床疗效、营养评估和患者生活质量方面比较，中药保留灌肠与高位中药结肠透析结合是治疗CRF非透析阶段较理想的结肠透析方式。

Abstract:

[Objective] To obtain the best Chinese medicine colon dialysis methods, different treatment methods are compared in three aspects of CRF patients, clinical effect, living quality and the condition assessment of nutrition.[Methods] One hundred six cases of CRF patients were investigated, which were divided into three groups:group Ⅰ(33 cases), group Ⅱ(38 cases) and group Ⅲ (35 cases) by randomly numerical table. The patients in group Ⅰ will be treated by traditional Chinese medicine retention enema and the patients in group Ⅱ will be treated by high-position colon. The combination of the above two treatments will be applied to the group Ⅲ. Finally, 96 cases were completed the study. The renal function, nutrition index and the quality of Living score of all patients before and after the treatments were observed after 4 weeks.[Results] The renal function index, the blood level of ALB, PA, TRF in nutrition index and the quality of Living score of all patients have improved clearly after treatments(P<0.01, P<0.05).The SGA of group Ⅰ and group Ⅱ are significantly better than group Ⅲ(P<0.01). However the quality of Living score of group Ⅲ is significantly better than group Ⅰ and group Ⅱ(P<0.05). The incidence of adverse reactions of group Ⅱ is higher than group Ⅲ(P<0.05).[Conclusion] It is concluded that the combination of traditional Chinese medicine retention enema and high-position colon dialysis is an ideal way in curing CRF patients, by comparing in clinical effect, living quality and the condition of nutrition.