| Objective:To explore the efficacy and safety of external therapy of traditional Chinese medicine in the adjuvant treatment of chronic renal failure(CRF),and to provide evidence-based medicine for clinical application of external therapy of traditional Chinese medicine in the treatment of CRF;a retrospective study of renal disease in the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine The clinical efficacy of Zhuyu Xiezhuo decoction retention enema in the treatment of CRF patients with spleen-kidney qi deficiency and blood stasis syndrome provides a basis for the overall efficacy evaluation of TCM external therapy in the treatment of CRF patients.Methods:This study retrieved randomized controlled trials(RCTs)published in the past ten years on the treatment of CRF with external treatment of traditional Chinese medicine,and extracted the data for Meta analysis.It was a retrospective study of the application of Zhuyu Xiezhuo Decoction retention enema in the treatment of CRF with spleen and kidney qi deficiency in the Department of Nephrology of our hospital.Clinical efficacy of patients with concurrent blood stasis syndrome.1.According to the guiding principles of evidence-based medicine,searched from January 1,2011,to October 31,2021,in China National Knowledge Infrastructure(CNKI),WANFANG,VIP,China Biomedical Database(CBM),National Library of Medicine Biomedical Information Database(Pub Med),Cochrane Library,Excerpta Medica Database(Embase),Web of Science and other Chinese and English literature databases.The Rev Man5.3 software was used for data merging and Meta-analysis to systematically evaluate the efficacy and safety of TCM external therapy in the treatment of CRF.2.Using the method of retrospective study,the cases of patients who were treated in the Department of Nephrology of our hospital from January 2020 to December 2020 were collected,and the cases that met the criteria were screened according to the inclusion and exclusion criteria,and reserved according to whether Zhuyu Xiezhuo Decoction was used or not.Enema treatment was divided into the enema group and the control group.Collect the general case data of the two groups of patients,serum creatinine,urea,glomerular filtration rate,TCM syndrome score,and other curative effect indicators before and after treatment,and analyze the Zhuyu Xiezhuo decoction retention enema in the treatment of CRF with spleen-kidney qi deficiency and blood stasis syndrome Clinical efficacy and safety in patients.Results:1.Meta-analysis:48 studies were finally included,with a total of 3716patients,including 1873 in the treatment group and 1843 in the control group.The interventions in the treatment group involved TCM external treatment methods including TCM retention enema,acupoint injection,herbal moxibustion,Ginger-partitioned moxibustion,acupoint application,warm acupuncture,acupoint injection,navel therapy,Chinese medicine iontophoresis,Chinese medicine skin dialysis,Chinese medicine foot bath.In the Meta-analysis of the adjuvant treatment of CRF with TCM external therapy,in terms of the total clinical effective rate,the heterogeneity test P=0.75,I~2=0%,according to the results of the study,the fixed-effect model was used to analyze,RR=1.29,95%CI[1.24,1.35],Z=12.01,P<0.00001,suggesting that the total clinical effective rate of adjuvant external therapy of traditional Chinese medicine for CRF is better than that of conventional therapy alone.In terms of reducing serum creatinine levels,adjuvant therapy of external therapy of traditional Chinese medicine was superior to conventional therapy,and the difference was statistically significant[MD=-44.65,95%CI(-53.54,-35.76),Z=9.84,P<0.00001].In terms of reducing blood urea nitrogen levels,adjuvant treatment of the external treatment of traditional Chinese medicine is better than conventional treatment,and the difference is statistically significant[MD=-2.47,95%CI(-2.86,-2.07),Z=12.32,P<0.00001].In improving the clearance rate of endogenous creatinine,the adjuvant therapy of TCM external therapy was superior to conventional therapy,and the difference was statistically significant[MD=6.25,95%CI(5.08,7.41),Z=10.51,P<0.00001].In improving the glomerular filtration rate,the adjuvant therapy of TCM external therapy was superior to conventional therapy alone,and the difference was statistically significant[MD=3.45,95%CI(2.42,4.47),Z=6.58,P<0.00001].In terms of adverse reactions,the incidence of adverse reactions was relatively low.Six of the included literature mentioned the occurrence of adverse reactions,and no serious adverse reactions were reported.2.Retrospective study:A total of 91 cases meeting the criteria were obtained,and they were divided into an enema group of 48 cases and a control group of 43 cases according to whether Zhuyu Xiezhuo decoction was used for retention enema.In terms of disease efficacy,the total effective rate of the enema group was 77.08%,and the total effective rate of the control group was53.49%,and the difference between the groups was statistically significant(P<0.05).In terms of the efficacy of TCM syndromes,the TCM syndrome scores of the two groups after treatment were both lower than those before treatment(P<0.05).In terms of laboratory indicators,the Scr and BUN of the two groups of patients after treatment were lower than those before treatment,and the difference was statistically significant(P<0.05).But there was no significant difference in the control group before and after treatment(P>0.05),and there were significant differences in Scr,BUN,and e GFR between the two groups after treatment(P<0.05).Conclusion:1.Meta-analysis:The clinical total effective rate of adjuvant TCM external therapy for CRF is better than that of conventional treatment;in terms of reducing Scr,BUN,and improving Ccr,e GFR,adjuvant TCM external therapy is better than conventional therapy alone;and adverse reactions The incidence is low.2.Retrospective study:Zhuyu Xiezhuo decoction retention enema in the treatment of CRF with spleen-kidney qi deficiency and blood stasis syndrome can reduce the patient’s TCM syndrome score,improve the patient’s clinical symptoms,reduce Scr,BUN,and improve e GFR,with high safety. |
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