刘美英 姜晨 黄鑫 陈欣 杨洪涛

[摘要] 目的 观察扶肾颗粒治疗慢性肾衰竭腹膜透析相关肠功能障碍的临床效果。 方法 将2014年1月～2015年1月在天津中医药大学第一附属医院肾内科门诊就诊的40例已确诊的慢性肾衰竭腹膜透析肠道功能障碍患者按随机数字表法分为观察组和对照组，各20例。两组均给予基础治疗，对照组加用西药对症处理；观察组加用扶肾颗粒口服治疗，20 g/次，3次/d。治疗1个月后检测两组患者血红蛋白（HGB）、血浆白蛋白（ALB）、肠功能评分及中医证候积分，并评价其疗效。 结果 观察组总有效率为65%，对照组总有效率为10%，差异有高度统计学意义（P < 0.01）。与对照组比较，观察组能明显升高HGB、ALB（P < 0.05），降低肠功能评分（P < 0.05）及中医证候积分（P < 0.01）。 结论 扶肾颗粒能明显改善腹膜透析肠功能障碍患者的营养状态和肠功能障碍情况。

[关键词] 扶肾颗粒；腹膜透析；肠道功能障碍；临床疗效

[中图分类号] R242；R459.5 [文献标识码] A [文章编号] 1673-7210（2016）03（c）-0173-04

[Abstract] Objective To observe the clinical effect of Fushen Granules in the treatment of chronic renal failure peritoneal dialysis related to intestinal dysfunction. Methods According to the random digital table method， the 40 cases confirmed of chronic renal failure peritoneal dialysis bowel dysfunction patients who were treated in the Department of Nephrology of the First Hospital Affiliated to Tianjin Medical University from January 2014 to January 2015 were randomly divided into observation group and control group， with 20 cases in each group. Two groups were given basic treatment， while the control group was symptomatically treated with western medicine； the observation group was treated with Fushen Granules with 20 g per time and 3 times/d. After 1 month of treatment， hemoglobin （HGB）， plasma albumin （ALB）， bowel function score and TCM syndrome integral of the two groups were detected and the curative effects were evaluated. Results The total efficiency of observation group and control group was 65% and 10%， the difference was highly statistically significant （P < 0.01）. Compared with the control group， the observation group significantly increased the HGB， ALB （P < 0.05）， decreased the bowel function score （P < 0.05） and the TCM syndrome score （P < 0.01）. Conclusion Fushen Granules can significantly improve the nutritional status and intestinal dysfunction of peritoneal dialysis patients with intestinal dysfunction.

[Key words] Fushen Granules； Peritoneal dialysis； Intestinal dysfunction； Clinical effect

我国终末期肾衰竭者超过200万人[1]，已成为严重危害人类生命的疾病之一。作为替代肾脏治疗的腹膜透析（peritoneal dialysis，PD），因其操作简便，不影响患者工作及日常生活，而且透析比较平稳，能够更好地保护残余肾功能，故应用范围比较广泛，然而肠功能障碍作为腹膜透析并发症之一日益突出。肠功能障碍是指肠实质和/或功能的损害，导致消化、吸收营养和/或屏障功能发生障碍[2]，严重影响了腹膜透析患者的透析效能及生存质量，因此改善肠道功能障碍对于腹膜透析患者意义重大。天津中医药大学第一附属医院（以下简称“我院”）肾病科运用扶肾颗粒治疗腹膜透析肠功能障碍取得了良好的效果，现报道如下：

1 資料与方法

1.1 一般资料