Clinical Observation On Effect Of Multiple Centella Decoction Enema In The Treatment Of Chronic Renal Failure

BackgroundChronic renal failure(CRF) brings a huge threat to human health, and makes a high morbidity, and the state of the illness is complex and serious, so the clinical therapy on CRF is very difficult. At present, the main means of clinical therapy is to make secondary precaution of chronic kidney disease (CKD) and renal replacement therapy (RRT).Besides, CRF remains with "Edema", "Retention of Urine", "Block and Repulsion disease", "Urinary Toxin" and "Consumptive Disease" of traditional chinese medicine (TCM). Decay of Spleen and Kidney, failure of three Jiao and stagnancy of damp and blood stasis are considered the main pathogenesis of entirety of the disease. Modern research shows that, the TCM-enema for the therapy of CRF can achieve a certain effect, so it plays a positive role on the therapy of TCM on the current status of CRF, and deserves to be studied further.ObjectiveTo observe the clinical effect of multiple Centella Decoction-enema in the treatment of CRF, to enrich treatment of TCM, to give full play to the role of medicine in the treatment of CRF.MethodsTo collect 60 cases of inpatients and outpatients of 20～70 years old matching up to the diagnostic criteria for azotemia period and renal failure period. The patients were randomly divided into treatment group and control group. Control group(30 cases) were given high-quality low-protein diet,and blood pressure control, blood sugar control, anti-infection and general symptomatic treatment according to the condition. Treatment group (30 cases) were given multiple Centella Decoction-enema besides the control group's treatment. The therapeutic effect was evaluated 4 weeks and 8 weeks after the therapies, through calculating the total score with Microsoft Excel 2003 and carrying out statistic analysis with SPSS 11.5, describing measurement data with(x±s), applying Chi-square test(X2 test) to test the integrated effect, sex and disease stages, applying t test to test renal function and data of clinical symptoms of TCM and general measurement data, applying One-Way ANOVA test to test the comparison of the difference before and after treatment of kidney function, applying Nonparametric test to compare the data related indicators.Results1.Integrated efficacy evaluation:After 8 weeks, the treatment group's results are better than the control group's. When comparing the proportion of marked effect and effect,the group of azotemia is higher than the group of renal failure;2. Comparison of the clinical symptom score of TCM:Although after 4 weeks and 8 weeks, in both of the two groups, the scores decrease significantly (the 4 weeks:Ptreament<0.01, Pcontrol＜0.01;the 8 weeks:Preament<0.01, Pcontrol＜0.01), the treament group is superior in improving the symptoms of TCM compared with the control group(the 4weeks:Ptreament:control<0.05; the 8 weeeks:Ptreament:control<0.05);3. Comparison of serum creatinine (Scr),serum urea nitrogen (BUN)and creatinine clearance(Ccr) before and after treatment:In both of two groups, Scr and BUN decrease and Ccr increase after treatment. After 8 weeks, the treatment group have significant improvement compare with before treatment (P Scr<0.01, PBUN<0.01, PCcr<0.05), the rest of the data show no significant difference (P> 0.05); when comparing the difference between the two groups about Scr (before treatment-after treatment) , BUN (before treatment-after treatment) and Ccr (after treatment-before treatment) , the treatment group improved Scr,BUN and Ccr is significantly better than the control group's after 8 weeks (P Scr(before treatment-after treatment)＜0.05, PBUN (before treatment-after treatment)＜0.01, PCcr (after treatment-before treatment)＜0.05);4. Comparison of hemoglobin (Hb), red blood cell (RBC), serum albumin (ALB), total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol (LDL-C), high-density lipoprotein(HDL-C), K+, Na+,P, andCa2+ in two groups before and after treatment:Compared with before treatment, the treatment group's HDL-C and the control group's Na+ are significantly different after 4 weeks (P<0.05), Compared between the two groups, Pis significantly different after 4 weeks (P<0.05),the rest of the data compare with before treatment or the comparison between the two groups show no significant difference(P> 0.05).In treatment group, TC, TG, LDL-C decrease and HDL-C increases after treatment, which indicates that the treatment group can improve the TC, TG, LDL-C and HDL-C targets to a certain extent.The K+ decreases after treatment in the treatment group, but increases in the control group, which indicates that the treatment group can reduce the K+ in blood to a certian extent.Conclusion1.The scores of the treament group decrease significantly compared with the before treament or control group, suggest Multiple Centella Decoction enema can improve clinical symptoms of TCM in CRF patients;2. The treatment group can improve the Scr, BUN, Ccr, targets to a certain extent, indicates that Multiple Centella Decoction enema can reduce the toxins of body, protect renal function, delay the worsening of renal function;3. It can improve serum lipids, lipid protein, K+ at the same time. to a certain extent, show that it can prevent hyperlipidemia and Hyperkalemia at a certain extent;4. Hb, RBC decreased slightly compared with before treatment, show that it can not improve the anemia.