| 引用本文:郑鑫1，邓跃毅2，严梦婷1，归楚滢2，林钐1.中药结肠透析治疗慢性肾脏病3～4期湿浊证患者的临床效果及作用机制研究[J].世界中医药,2023,(17):. |
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| 中药结肠透析治疗慢性肾脏病3～4期湿浊证患者的临床效果及作用机制研究 |
| Clinical Effect and Mechanism of Colon Dialysis with Chinese Medicine Decoction on Stage 3 to 4 Chronic Kidney Disease Patients with Dampness Turbidity Syndrome |
| 投稿时间：2021-10-31 |
| DOI：10.3969/j.issn.1673-7202.2023.17.018 |
| 中文关键词: 慢性肾脏病 血清 代谢组学 中药 结肠透析 湿浊证 能量代谢 氨基酸代谢 |
| English Keywords:Chronic kidney disease Serum Metabolomics Chinese medicine decoction Colon dialysis Dampness turbidity syndrome Energy metabolism Amino acid metabolism |
| 基金项目:国家中医临床研究基地业务建设第二批科研专项课题（JDZX2015097）；上海市科学技术委员会科研计划项目（17401934500）；上海市卫生和计划生育委员会科研课题计划项目（201840299）；2023年度上海市虹口区卫生健康委员会中医药科研课题（HKQGYQY-ZYY-2023-06）；2023年度上海中医药大学科技发展项目（自然科学类，23KFL086） |
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| 中文摘要: |
| 目的：运用代谢组学方法研究中药结肠透析对慢性肾脏病3~4期湿浊证患者临床效果及作用机制研究。方法：通过上海中医药大学附属龙华医院肾科门诊及病房，收集符合辨证分型为湿浊证的CKD3~4期患者60例。采用随机对照方法分为对照组和观察组，在慢肾衰一体化治疗基础上，给予中药结肠透析治疗，治疗后对中医证候积分、有效性、生化指标等实验室指标进行观察，判定疗效。并采用血清代谢组学技术对健康组及CKD3~4期湿浊证患者进行代谢组学分析。分析内容主要包括：单变量统计分析、多元变量统计分析、差异代谢物的层次聚类分析及差异代谢物的代谢通路分析。结果：对照组有效率为30.00%，观察组为60.00%，差异有统计学意义（P<0.05）；观察组血肌酐、尿素氮较治疗前降低，肾小球滤过率较治疗前升高，差异均有统计学意义（均P<0.05）。对照组与观察组治疗后血肌酐、尿素氮及肾小球滤过率，差异均有统计学意义（均P<0.05）。共鉴定出6个生物学标志物，涉及2条主要代谢通路。结论：中药结肠透析可以提升CKD3~4期湿浊证患者肾小球滤过率，延缓疾病进展、改善临床症状。 |
| English Summary: |
| To study the clinical effect and mechanism of colon dialysis with Chinese medicine decoction on stage 3 to 4 chronic kidney disease(CKD) patients with dampness turbidity syndrome by using metabonomics.Methods:Sixty patients with stage 3 to 4 CKD(dampness turbidity syndrome) treated in the outpatient and ward of Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine were enrolled in this study.The patients were randomized into a control group and an observation group.On the basis of integrated treatment of chronic renal failure，the patients were treated with colon dialysis with Chinese medicine decoction.After treatment，the TCM syndrome scores，response rate，and biochemical indicators were measured to determine the efficacy.In addition，serum metabolomics was employed to analyze the metabolomics in the healthy volunteers and the patients.Univariate statistical analysis，multivariate statistical analysis，hierarchical cluster analysis of differential metabolites，and metabolic pathway analysis of differential metabolites were performed.Results:The response rate in the control group was 30.00%，significantly different from that(60.00%) in the observation group.The treatment in the observation group lowered the blood creatinine and urea nitrogen levels and increased the glomerular filtration rate(P<0.05).Moreover，the blood creatinine，urea nitrogen，and glomerular filtration rate had significant differences between the control and observation groups after treatment(P<0.05).A total of 6 biomarkers were identified，involving 2 main metabolic pathways.Conclusion:Colon dialysis with Chinese medicine decoction can increase the glomerular filtration rate，delay disease progression，and alleviate symptoms in patients with stage 3 to 4 CKD(dampness turbidity syndrome). |
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