中药高位结肠透析对慢性肾功能衰竭患者免疫功能的影响

目的:探讨中药结肠透析对慢性肾功能衰竭(CKD3⁴期)患者细胞免疫功能的影响及作用机制。方法:将50例患者随机分为治疗组和对照组,每组25例。对照组予以西药常规治疗,治疗组采用西药常规治疗联合中药高位结肠透析治疗。治疗3个月,观察临床疗效、中医证候,分析指标有治疗前后总有效率、肾功能、尿酸及外周血T细胞亚群的变化。结果:治疗3个月后,治疗组和对照组的总有效率分别为92.00%和68.00%,此差异具有统计学意义(P<0.05)。两组治疗后临床症状、中医证候、S cr和UA、较治疗前均有改善(P<0.01,P<0.05),治疗组更明显。治疗组治疗后CD+4、CD+4/CD+8较治疗前增高(P<0.05),对照组BUN、CD+4和CD4+/CD+8治疗前后未见明显差异(P>0.05),两组间比较差异有显著性(P<0.05)。结论:中药高位结肠透析联合西医常规治疗CRF(Ⅲ、Ⅳ期)疗效确切,且能够改善患者免疫功能。提示其作用机制可能与改善细胞免疫功能有关。

Effect of High-Position Colon Herbs Dialysis on Cellular Immunity in Patients with Chronic Renal Failure

Objective： To research the influence and effect on the cellular immunity of high- position colon herbs dialysis inpatients with chronic renal failure（ CRF）（ CKD Ⅲ- Ⅳ stages）. Methods： The subjects were 50 chronic renal failure（ CRF） patients selected from the inpatients of Nephrology in Chinese PLA General Hospital of Shenyang Military Area Command. They wererandomly divided into two groups： high- position colon herbs dialysis and Western medicine group（ Group A n = 25） and Western medicine control group（ Group B n = 25）. They were treated for 3 months. Clinicaleffect and syndromes of traditional Chinese medicine were compared. Analytical indexes were serum creatinine（ Scr）,blood urea nitrogen（ BUN）,UA,CD4＋and CD4＋/ CD8＋. Results： The total effective rates of the treatment group and the control group were 92. 00% and 68. 00% and he difference of the two groups was statistically significant（ P〈0. 05）. Before and after treatment,the clinical symptoms and syndromes of traditional Chinese medicine were improved. Scr and UA levels decreased（ P〈0. 01,P〈0. 05）,more obviously in Group A（ P〈0. 05）. Before and after treatment,the level of CD4 and the ratio of CD4/ CD8 increased in Group A. There was significant difference（ P〈0. 05） in Group A and BUN,CD4 and the ratio of CD4/ CD8 had no significant difference in Group B（ P〈0. 05）. Conclusion： High- position colon herbs dialysis had a good effect on the treatment of CRF at early and middle stages. High- position colon herbs dialysis can improve the cellular immunity of the patients with CRF. It suggested that the effect of high- position colon herbs dialysis was related with improvement of cellular immunity.