Discussion On The Clinical Efficacy Of Colonic Dialysis Using Chinese Medicine In The Treatment Of Chronic Kidney Disease Stage 4 Based On The Gut-kidney Axis Theory

Objective:Based on the theory of "Gut-Kidney Axis",we observed the clinical efficacy of colonic dialysis using Chinese medicine in the treatment of chronic kidney diseasein stage 4(CKD4)and explored the possible mechanism of colonic dialysis using Chinese medicine in the treatment of CKD,in order to provide a theoretical basis for further application of colonic dialysis using Chinese medicine in the treatment of CKD in clinical practice in the future.Methods:A total of 70 patients who were admitted to the nephrology ward and outpatient department of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from December 2020 to February 2022 were selected and randomly divided into a treatment group(n=35)and a control group(n=35).Patients in both groups were given basic treatment.On the basis of basic treatment,the patients in the control group were given Shenkang Suppository(3g/granule)for external use,5 capsules a day,1 capsule in the morning,middle and evening respectively,and 2 capsules before bedtime.In the treatment group,CTJ-A colon perfusion dialysis machine was used for colon dialysis three times a week on the basis of basic treatment.The treatment cycle of the two groups was fixed at 8 weeks.Finally,we observed the changes of renal function(serum Scr,serum BUN,serum Cys C,e GFR),blood Hb,bacterial endotoxin,blood D-lactic acid,TCM syndrome score and clinical comprehensive curative effect of the patients and statistically analyzed the results.Result:1.The colonic dialysis using Chinese medicine had better effects in the treatment of CKD patients in stage 4,with the total effective rates of 78.13%in the control group and 87.88% in the treatment group.The efficacy in the treatment group was superior to that in the control group(P<0.05).2.After treatment,the TCM syndrome scores of the two groups were decreased,and compared with the control group,the symptom relief in the treatment group was more significant(P<0.05).3.After treatment,the levels of BUN,Scr and Cys C were decreased,while e GFR was increased in the two groups.The efficacy of the treatment group was superior to that of the control group(P<0.05).The level of Hb was higher than that before treatment and there was no significant difference between the two groups(P> 0.05).4.After treatment,the levels of endotoxin and serum D-lactic acid were decreased in the two groups,and the curative effect of the treatment group was superior to that of the control group(P<0.05).Conclusion:1.The therapy of Colonic dialysis using Chinese medicine can significantly improve the clinical symptoms and signs of CKD4 patients.2.The therapy of Colonic dialysis using Chinese medicine can improve the renal function of CKD4 patients and delay the progression of renal function.3.The therapy of Colonic dialysis using Chinese medicine can protect the intestinal barrier function to a certain extent and reduce the enterogenous toxins from entering the blood circulation.4.Colonic dialysis using Chinese medicine is effective and relatively safe for CKD4.