标题：结肠透析治疗慢性肾衰竭常见证候要素及常用中药的分布研究

      作者：赵仁伟 1，张万芳 1，王悦彤 3，尹继瑶 1，席少卿 1，李晓琪 1，沈霞 1，张楠 2，屈凯 1，2    1.陕西中医药大学，陕西 咸阳 712046；2.陕西省中医药研究院，陕西 西安 710003；3.陕西省中医医院，陕西 西安 710003；

      卷次： 2023年34卷21期

      【摘要】 目的 运用咨询问卷的方式提取结肠透析治疗慢性肾衰竭的常见证候要素及常用中药分布情况。方法 基于前期的文献研究，制订咨询问卷，对全国11家三级甲等医院进行咨询问卷，将结果导入SPSS19.0软件，通过均数、等级和、不重要百分比、变异系数等梳理问卷人员对结肠透析治疗慢性肾衰竭常见的证候要素及常用中药的分布情况，提取结肠透析治疗慢性肾衰竭常见的证候要素与常用中药。结果 本次咨询问卷发放39份，回收39份，回收率为100%，有效率为100%；根据统计的证候要素的常见程度，将同时满足均数≥0.8、变异系数≤50%的结果作为结肠透析治疗慢性肾衰竭常见的证候要素，病位类证候要素属脏者有肾、脾、心、肺，属腑者有胃、大肠、膀胱，病性类证候要素属实者有瘀血、湿浊、浊毒、湿热，属虚者有气虚、阳虚、血虚、阴虚；根据常用药的评价情况，将同时满足均数≥1.5、等级和≥60、不重要百分比≤50%、变异系数≤50%作为结肠透析治疗慢性肾衰竭的常用中药，共得出15味单味药，19对常用中药对，其中单味中药大黄、煅牡蛎、蒲公英、丹参，药对中煅牡蛎-大黄、煅牡蛎-蒲公英-大黄、丹参-大黄、蒲公英-大黄、牡蛎-丹参-蒲公英-大黄、丹参-煅牡蛎-大黄的协调程度最高。结论 通过咨询问卷调查，进一步探明了结肠透析治疗慢性肾衰竭常见的证候要素及常用中药，为进一步建立以证候要素为基础的慢性肾衰竭诊断标准提供客观依据。
      【关键词】 结肠透析；慢性肾衰竭；咨询问卷；证候要素；常用中药；分布
      【中图分类号】 R692.5 【文献标识码】 A 【文章编号】 1003—6350（2023）21—3056—04

Common syndrome elements and distribution of commonly used traditional Chinese medicine in colon dialysistreatment of chronic renal failure.
ZHAO Ren-wei 1, ZHANG Wan-fang 1, WANG Yue-tong 3, YIN Ji-yao 1, XIShao-qing 1, LI Xiao-qi 1, SHEN Xia 1, ZHANG Nan 2, QU Kai 1,2. 1. Shaanxi University of Chinese Medicine, Xianyang712046, Shaanxi, CHINA; 2. Shaanxi Provincial Hospital of Chinese Medicine, Xi'an 710003, Shaanxi, CHINA; 3. ShaanxiAcademy of Traditional Chinese Medicine, Xi'an 710003, Shaanxi, CHINA
【Abstract】 Objective To extract common syndrome elements and distribution of commonly used traditional Chi?nese medicine for colon dialysis treatment of chronic renal failure using a consultation questionnaire. Methods Based onprevious literature research, a consultation questionnaire was developed and conducted in 11 upper first?class hospitalsacross the country. The results were imported into SPSS19.0 software. The questionnaire personnel analyzed the commonsyndrome elements and distribution of commonly used traditional Chinese medicine for colon dialysis treatment of chronickidney failure through mean, rank sum, unimportant percentage, coefficient of variation. The common syndrome ele?ments and commonly used traditional Chinese medicine for colon dialysis treatment of chronic kidney failure were ex?tracted. Results Thirty?nine questionnaires were distributed and 39 were collected, with a response rate of 100% and aneffective rate of 100%. According to the statistical analysis of the common degree of syndrome elements, the results that si?multaneously meet the mean ≥0.8 and coefficient of variation ≤50% were considered as common syndrome elements forcolon dialysis treatment of chronic kidney failure. For disease location type, the syndrome elements belonging to the visceraincluded the kidney, spleen, heart, and lung, and the syndrome elements belonging to viscera included the stomach, large in?testine, and bladder. For the disease nature type, the syndrome elements belonging to excess type included blood stasis,dampness, turbidity, toxin, and dampness heat, and the syndrome elements belonging to deficiency type included qi defi?ciency, yang deficiency, blood deficiency, and yin deficiency. Based on the evaluation of commonly used drugs and the cri?teria of mean≥1.5, grade sum≥60, unimportant percentage≤50%, and coefficient of variation≤50%, 15 single herbs and19 pairs of commonly used Chinese herbs were selected as common Chinese herbs for colon dialysis treatment of chronickidney failure. Among them, four single herbs (rhubarb, calcined oyster, dandelion, and Salvia miltiorrhiza) and six pairs ofherbs (calcined oysters?rhubarb, calcined oysters?dandelion?rhubarb, Salvia miltiorrhiza?rhubarb, dandelion?rhubarb, oys?ters?Salvia miltiorrhiza?dandelion?rhubarb, Salvia miltiorrhiza?calcined oyster?rhubarb) had the highest level of coordina?tion. Conclusion Through the consultation questionnaire, the common syndrome elements and commonly used tradi?tional Chinese medicine in the treatment of chronic renal failure by colon dialysis are explored, which provides an objec?tive basis for further establishing the diagnostic criteria of chronic renal failure based on syndrome elements.
      【Key words】 Colonic dialysis; Chronic renal failure; Consultation questionnaire; Syndrome elements; Common?ly used traditional Chinese medicine; Distribution