| Objective:Based on conventional treatment, to retrospectively observe the short-term effects of retention enema of niaoduqing granule on chronic kidney disease(CKD) stage 4 and 5. Compare curative effects of retention enema using niaoduqing granule with Tongfuxiezhuo prescription, and finish the follow-up of patients entering into dialysis in each groups.Method:(1)Literature research:The EMbase,PubMed,CNKI,VIP,Wanfang,sinoMed databases were used to search data, enrolled randomized controlled trials on retention enema of niaoduqing granule in the treatment of CKD. Treatment group is defined as group using retention enema of niaoduqing granule,and the control group is the one without retention enema of niaoduqing granule. Followed by removing repetitions、 data extraction、quality assessment, data analyses were performed according to the Cochrane standards. RevMan 5.2 was used to synthesize informations about the total effective rate、Scr、BUN between the two groups.(2)clinical research:115 patients of CKD stage 4 and 5 accorded to the inclusion criteria were reviewed from 2015.4 to 2016.2 in Nephrology of Jiangsu Provincal Hospital of TCM,including 39 cases in niaoduqing group,39 in Chinese herb group,and 37 in control group.Besides basic therapy using in control group, patients in niaoduqing group received retention enema of niaoduqing granule and Chinese herb group received retention enema of Tongfuxiezhuo prescription.Curative effect,laboratory index,the symptoms and TCM syndrome score,adverse reaction,and follow-up of patients entering into the dialysis are observed in three groups before and after 14 days’therapy.Result:(1)Literature research:① the treatment group has a higher the total effective rate than the blank control group and the aixite group[OR=3.30,95% CI(1.81,6.03), P=0.0005,I2=0%]; ② The level of Scr and BUN were found to be lower in the treatment group, as compared to the blank control group and aixite group[Scr:MD=-40.03,95%CI (-64.55,-15.50), P=0.005,12=82%(compared to the blank control group); MD=-66.74,95%CI (-101.47.04,-32.01), P=0.0002,12=17%(compared to the aixite group)]; [BUN:MD=-1.99,95%CI(-3.33,-0.65), P=0.004, I2=88% (compared to the blank control group); MD=-5.35,95%CI(-6.45,-4.25), P=0.0001, I2=0%(compared to the aixite group)].(2)clinical research: ①Compared to the control group, the total effective rate were found to be higher in the niaoduqing group (.P<0.05), however, no significant difference was observed between the niaoduqing group and Chinese herb group (P>0.05). Subgroup analysis:no significant difference was observed between the niaoduqing group and control group in patients with the Syndrome of Non-dampness-turbid (P>0.05). ② The level of BUN、Scr、UA was significantly lower in niaoduqing group (P<0.05), compared to the control group, which were similar to those observed in Chinese herb group (P>0.05). ③ Compared to the control group and Chinese herb group, the TCM syndrome score was significantly lower in niaoduqing group (P<0.05).④ Compared to the control group, these symptoms,such as fatigue,soreness and weakness of waist and knees, poor appetite, dizziness, nausea and vomiting,are improved in niaoduqing group (P<0.05), and these symptoms like poor appetite, dizziness, nausea and vomiting are in Chinese herb group (P<0.05).⑤ The difference of number of dialysis patients is too small to be no statistical significance among the three groups (P>0.05). The first three common cause,in turn,is infection, heart failure, high potassium which bring patients into receiving dialysis.⑥Some common adverse reactions like mild diarrhea, abdominal pain were observed in niaoduqing group and Chinese herb group.Conclusion:(1)The application of retention enema of niaoduqing granule contribute to removal of uremic toxins, stabilization of renal function, however fail to slow down the disease progression in patients with CKD middle-late stages, which were similar to those observed using Tongfuxiezhuo prescription. (2)The application of retention enema of niaoduqing granule also help release symptoms such as fatigue,soreness and weakness of waist and knees, poor appetite, dizziness, nausea and vomiting in patients with CKD middle-late stages. The curative effect is better than the application of Tongfuxiezhuo prescription and there is no obvious adverse reactions within short-term period.(3)As a granular dosage used in clinical for many years, niaoduqing granule is more convenient than water decoctum which was applied in the enema treatment. |
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