马来酸曲美布汀辅助治疗对老年慢性肾脏病维持性血液透析患者胃肠功能紊乱的调节作用

Effects of Adjuvant Therapy with Trimebutin Maleate on Gastrointestinal Dysfunction in Elderly Patients with Chronic Kidney Disease and Maintenance Hemodialysis

目的探究马来酸曲美布汀辅助治疗对老年慢性肾脏病维持性血液透析患者的临床价值。方法收集新乡市第一人民医院2019年3月至2022年3月76例老年慢性肾脏病维持性血液透析患者,随机分为对照组、实验组,各38例。对照组给予维持性血液透析,实验组给予马来酸曲美布汀辅助维持性血液透析。比较两组肠道菌群,胃肠功能[胃泌素(GAS)、胃动素(MOT)、生长抑素(SS)],肾功能[血清肌酐(Scr)、尿素氮(BUN)、β2-微球蛋白(β2-MG)、胱抑素C(Cys-C)],临床指标[血红蛋白(Hb)、白蛋白(Alb)、血钙、甲状旁腺激素(PTH)]和炎性因子[白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]及不良反应发生情况。结果治疗后,实验组大肠菌、肠球菌菌落数低于对照组,双歧杆菌、乳杆菌菌落数高于对照组(P<0.05);实验组SS低于对照组,MOT、GAS高于对照组(P<0.05);实验组Scr、BUN、β-MG、Cys-C低于对照组(P<0.05);实验组PTH、IL-6、TNF-α、CRP低于对照组,ALB、Hb、血钙高于对照组(P<0.05)。观察组不良反应发生率13.16%,与对照组5.26%比较,差异无统计学意义(P>0.05)。结论马来酸曲美布汀辅助治疗可改善老年慢性肾脏病维持性血液透析患者肾功能、临床指标、肠道菌群,促进患者胃肠功能恢复,并降低炎性因子表达,为临床治疗慢性肾脏病胃肠功能紊乱提供参考依据。

Objective To investigate the clinical value of trimebutin maleate adjuvant therapy in elderly patients with chronic kidney disease(CKD)and maintenance hemodialysis(MHD).Methods A total of 76 elderly patients with CKD-MHD in First People's Hospital of Xinxiang from March 2019 to March 2022 were randomly divided into control group and experimental group,with 38 cases in each group.Compare the gut microbiota,gastrointestinal function[gastrin(GAS),motilin(MOT),somatostatin(SS)],and renal function[serum creatinine(Scr),urea nitrogen(BUN)],β2-microglobulin(β2-MG),Cys-C,clinical indicators[hemoglobin(Hb),albumin(Alb),blood calcium(Ca),parathyroid hormone(PTH)],and inflammatory factors[interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)]and occurrence of adverse reactions between two groups.Results After treatment,coliform bacteria and enterococcus in experimental group were lower than those in control group,bifidobacterium and lactobacillus were higher than those in control group(P<0.05);SS in the experimental group was lower than that in the control group,MOT and GAS were higher than that in the control group(P<0.05);the Scr,BUN,β-MG and Cys-C of the experimental group were lower than those of the control group(P<0.05);PTH,IL-6,TNF-αand CRP in the experimental group were lower than those in the control group,while ALB,Hb and blood Ca were higher than those in the control group(P<0.05).The incidence of adverse reactions in the observation group was 13.16%compared to the control group of 5.26%,and the difference was not statistically significant(P>0.05).Conclusion Adjuvant treatment with trimebutine maleate can improve renal function,clinical indicators,and gut microbiota in elderly CKD-MHD patients,promote the recovery of gastrointestinal function,and reduce the expression of inflammatory factors,providing a reference for clinical treatment of gastrointestinal dysfunction in CKD.