| Background:In recent years,the incidence of chronic kidney disease(CKD)has gradually increased,and the number of patients entering chronic renal failure has also increased.Gastrointestinal dysfunction is the most common complication of end-stage Renal Disease(ESRD).Studies have found that the occurrence of gastrointestinal symptoms and gastrointestinal metabolic hormone metabolism disorders,damage to the gastrointestinal mucosal membrane barrier.Among them,gastrin(GAS)and somatostatin(SS)are important members of gastrointestinal peptide hormones,and their changes have an important influence on the production of gastrointestinal symptoms of chronic renal failure.Studies have found that changes in gastrointestinal hormone levels can lead to dyspepsia,nausea,vomiting,constipation and other manifestations of spleen and stomach syndrome.Studying the correlation between serum GAS and SS expression in patients with chronic renal failure and spleen and stomach syndrome is of great significance for the treatment of gastrointestinal symptoms of chronic renal failure.Studies have found that Dahuang Gancao Decoction can reduce the levels of gastrointestinal hormones such as serum gastrin,thereby improving gastrointestinal symptoms,adjusting the function of spleen and stomach,and improving gastrointestinal dysfunction.To study the effectiveness of Dahuang Gancao Decoction in the treatment of gastrointestinal symptoms in patients with chronic renal failure,and to explore its effect on the symptoms of spleen and stomach syndrome of slow renal failure and improve the mechanism of gastrointestinal dysfunction,which has far-reaching significance.Objectives:1.To determine the occurrence and distribution of various gastrointestinal symptoms in patients with chronic kidney disease,to study the expression of serum GAS and SS,and to explore its correlation with spleen and stomach syndrome in patients with chronic renal failure.2.To reveal the role of gastrointestinal hormones in spleen and stomach syndrome,to explore the essence of spleen and stomach syndrome,and to provide experimental basis and theoretical basis for early diagnosis and treatment of spleen and stomach syndrome in patients with chronic renal failure.3.To clarify the efficacy of Dahuang Gancao Decoction in the treatment of gastrointestinal symptoms in patients with chronic renal failure,and to provide reference and reference for the treatment of gastrointestinal disorders in patients with chronic renal failure.Research methods:(1)Using the TCM Spleen and Stomach Syndrome Score Table and Gastrointestinal Symptom Rating Scale(GSRS)to assess the general subjective gastrointestinal symptoms of patients with end-stage renal disease(hemodialysis,peritoneal dialysis),and determine the type of spleen and stomach syndrome.Serum was taken for determination of gastrin(GAS)and somatostatin(SS)and compared.(2)Patients with gastrointestinal symptoms associated with CKD stage 5 at the Dongzhimen Hospital from February 2017 to February2019.Give Dahuang licorice soup a small package of tea,treatment for a total of 1 week.Before and after treatment,the spleen and stomach syndrome score table and the gastrointestinal symptom classification scale(GSRS)were used to evaluate the gastrointestinal symptoms and evaluate the efficacy.Results:(1)Study 1:1.The age,dialysis age,GAS,diabetes,and dialysis methods of different spleen and stomach syndrome patients were not significantly different(P>0.05);there was statistical difference in SS(P<0.05).The SS of patients with gastrointestinal qi stagnation was significantly higher than that of other patients with symptoms.2.There was no correlation between spleen and stomach syndrome scores and dialysis age and GAS(P>0.05);there was a positive correlation with the age of patients(r=0.263,P=0.016);there was a positive correlation with SS(r=0.446,P<0.001).There was a significant difference in the distribution of spleen and stomach syndrome scores(total score)in dialysis mode and whether or not there was diabetes(P<0.05).Patients with peritoneal dialysis were significantly higher than those with hemodialysis,and patients with diabetes were significantly higher than those without diabetes.3.The diarrhea patients with high incidence of spleen and stomach syndrome were severely numb,pale complexion or dullness,sticky mouth,odor in the mouth,poor appetite,and abdominal distension.Hemodialysis is different from peritoneal dialysis.Patients with peritoneal dialysis have more prominent symptoms such as poor appetite,abdominal distension,and nausea and vomiting.4.According to the GSRS scale survey,the incidence of gastrointestinal symptoms in dialysis patients from high to low is:indigestion,constipation,abdominal pain,diarrhea,reflux.There was a positive correlation between the age of patients and constipation(P<0.05).There was a positive correlation between SS and total GSRS,abdominal pain symptoms,reflux symptoms,dyspepsia symptoms and constipation symptoms(P<0.05).There was a negative correlation between GAS and symptoms of abdominal pain and constipation(P<0.05).There was no correlation between GSRS score and dialysis age(P>0.05).5.Different dialysis methods,GSRS total score,abdominal pain symptom score,reflux symptom score,dyspepsia symptom score were significantly different(P<0.05),GSRS total score of abdominal peritoneal,abdominal pain symptom score,reflux symptom score,digestion The scores of adverse symptoms were higher than those of hemodialysis;there was no significant difference in the scores of diarrhea and constipation symptoms between different dialy sis methods(P>0.05).6.There were differences in dyspepsia scores between diabetic and non-diabetic patients(P<0.05).Patients with diabetes have significantly higher dyspepsia scores than non-diabetics.There was no statistically significant difference in gastrin GAS and somatostatin SS between diabetic and non-diabetic patients(P>0.05).7.There was no correlation between 7GAS and SS and patient gender,age and dialysis age(P>0.05).There was no significant difference in GAS between the patients’ dialysis methods(P>0.05).There were significant differences in SS dialysis methods.(P<0.05),the SS of patients with peritoneal dialysis was significantly higher than that of patients with hemodialysis.(2)Study 2:1.Before and after treatment,the effective rate was found to be 95.16%.Among them,the symptomatic efficacy evaluation,the basic control rate of symptoms was 85.5%.There was a significant difference between the spleen and stomach syndrome scores before and after treatment.The scores after treatment were significantly smaller than the pretreatment scores(P<0.001).There were significant differences in the total score,total mean score and the scores of each dimension of the GSRS scale before and after treatment.The score after treatment was significantly less than the score before treatment(P<0.001).2.After treatment,the spleen and stomach syndrome scores and GSRS scale scores of dialysis and non-dialysis patients were significantly lower(P<0.05);there was no significant difference between the dialysis and non-dialysis patients(P>0.05).3.After treatment,the scores of spleen and stomach syndrome and GSRS scores of diabetic and non-diabetic patients were significantly lower(P<0.05);the therapeutic effects of diabetic patients and non-diabetic patients were significantly different(P<0.05),compared with In non-diabetic patients,the GSRS score of diabetic patients decreased more.4.There were no statistical differences in the changes of spleen and stomach syndrome scores and total scores of GSRS scales in patients with different spleen and stomach syndromes,indicating that there was no difference in treatment effects(P>0.05).5.A variety of gastrointestinal symptoms scores were significantly reduced after treatment(P<0.05).And the score of nausea and vomiting is the most obvious,indicating the best effect on the treatment of nausea and vomiting.Conclusion:1.Gastrin GAS,somatostatin SS is associated with spleen and stomach syndrome and gastrointestinal symptoms in patients with chronic renal failure.2.Diabetic and non-diabetic patients have different spleen and stomach syndrome scores and gastrointestinal symptoms;and the degree of diabetes is more severe.3.End-stage renal disease dialysis patients,the highest incidence of gastrointestinal symptoms are:indigestion,constipation,abdominal pain,diarrhea,reflux.4.Dahuang Gancao Decoction has a certain curative effect on gastrointestinal symptoms in patients with chronic renal failure.And the best effect on the treatment of nausea and vomiting symptoms.The gastrointestinal symptoms of diabetic patients are more effective than non-diabetics. |
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