大黄並びに大黄含有漢方方剤による慢性腎不全の治療に関する研究(第2報)

抄録

Twenty-two patients (11 males and 11 females) with chronic renal failure (CRF) were treated with rhubarb and traditional Chinese prescriptions. The underlying disease for CRF was 19 cases of chronic glomerulonephritis and 3 cases of polycystic kidney. The patients were placed on a standard diet for 2 weeks, then they were mainly administered decoctions of rhubarb for 4 weeks. After that traditional Chinese prescriptions containing rhubarb were given for another 4 weeks. The initial dosage of rhubarb was 0.5 g/day, and then the amounts were controlled in order to induce one or two soft bowel movements a day. The maximum dosage was 3.0 g/day in cases of rhubarb alone, and 5.0 g/day in cases of traditional Chinese prescrip-tions containing rhubarb. Adverse effects observed with rhubarb administration were abdominal distention, and increase in gurgling sound, abdominal pain, nausea and vomitting. However, these signs became less in accordance with wen-pi-tang administration, i, e., one of the traditional Chinese prescriptions containing rhubarb, ginseng, aconit, licolice and ginger. Following the administration of rhubarb and/or the Chinese prescriptions, the levels of serum methylguanidine, BUN and serum inorganic phosphorus (P) improved significantly. However, the values of serum creatinine (Cr), uric acid (UA), guanidinosuccinic acid, total protein and albumin were not changed remarkably. The amounts of urinary urea nitrogen, Cr and P were significantly reduced following the rhubarb therapy. There was no marked change in the urine volume or in the amount of urinary protein. It also became clear that in the cases whose level of each serum constituent was decreased, the urinary excretion of urea nitrogen, Cr, UA and P was more markedly decreased. The results suggest that the rhubarb therapy possesses the potential to improve azotemia not through an increase of urinary excretion of urea nitrogen, but rather through its anabolic, anti-catabolic effects on nitrogen metabolism. Rhubarb or rhubarb containing Chinese prescriptions will prove to be useful for the treatment of CRF.