高位结肠透析结合中药保留灌肠对慢性肾衰合并便秘患者肠道菌群的影响

Effect of High Colon Dialysis Combined with Retention Enema with Traditional Chinese Medicine on Intestinal Flora in Patients with Chronic Renal Failure and Constipation

摘要: 目的：观察高位结肠透析结合中药保留灌肠治疗慢性肾衰合并便秘患者的临床疗效。方法：选取2021年2月至2022年8月于武汉市中医医院就诊的60例CKD 3~4期合并便秘的患者，采用随机数字表法分为对照组、观察组各30例，对照组予以西医对症及中药保留灌肠治疗，观察组在对照组的基础上加用高位结肠透析治疗，观察两组临床疗效。结果：两组治疗后在降低Bun、Scr、CRP、内毒素、便秘评分等方面与治疗前比较均有统计学意义(P < 0.05)，两组治疗后在降低肠道内大肠杆菌和肠球菌、升高乳酸杆菌和双歧杆菌菌群数量方面与治疗前比较均有统计学意义(P < 0.05)，部分指标观察组优于对照组。结论：高位结肠透析结合中药保留灌肠能有效改善肾功能、降低炎症因子、调节肠道菌群变化、提高肠道屏障功能、延缓慢性肾衰的进展。

Abstract: Objective: To observe the clinical efficacy of high colon dialysis combined with retention enema of traditional Chinese medicine in the treatment of patients with chronic renal failure (CRF) and constipation. Methods: From February 2021 to June 2022, 60 patients with constipation in phase 3~4 of CKD were selected from Wuhan Hospital of Traditional Chinese Medicine. Randomized number table method was used to divide them into control group and observation group, 30 cases in each group. The control group was treated with symptomatic Western medicine and traditional Chinese medicine retention enema, and the observation group was treated with high level colon dialysis on the basis of the control group, and the clinical efficacy of the two groups was observed. Results: After treatment, the Bun, Scr, CRP, endotoxin and constipation score in two groups were statistically significant compared with before treatment (P < 0.05), there were statistically significant differences in the reduction of intestinal Escherichia coli and Enterococcus flora, and increase of Lactobacillus and Bifidobacterium flora in two groups compared with before treatment (P < 0.05). Some indexes of the observation group were better than the control group. Conclusion: High colonic dialysis combined with traditional Chinese medicine retention enema can effectively improve renal function, reduce inflammatory factors, regulate intestinal flora, improve intestinal barrier function and delay the progression of chronic renal failure.