中药透析液对维持性血液透析患者并发感染的影响

Effect of Herbal Medicine Dialysate on Complicated Infection in Maintenance Hemodialysis Patients

【目的】研究中药透析液对维持性血液透析患者(maintenance hemodialysis,MHD)并发感染的影响。【方法】将145例MHD患者随机分为常规透析组(使用标准的碳酸氢盐透析液透析)60例、中药透析组(使用中药透析液———益气固肾液加入常规碳酸氢盐透析B液透析)44例、常规透析液+中药静滴组(简称静滴+透析组,使用标准的碳酸氢盐透析液透析和中药益气固肾液静脉滴注)41例。以3个月为1个疗程,连续观察2个疗程。观察各组在观察期间感染的发生情况及治疗前后免疫球蛋白IgG、IgA、IgM和补体C3、C4、CH50的变化情况。【结果】中药透析组在人均感染次数上较其他两组有明显减少(P<0.05)。而且中药透析组能改善补体C3、C4、CH50水平,治疗前后比较差异有显著性意义(P<0.05或P<0.01)。组间比较也显示,中药透析组在提高补体水平低下方面优于常规透析组及静滴+透析组(P<0.05或P<0.01)。【结论】中药透析液能防治血透患者并发感染,这可能与其增加了患者补体的生成,或避免了补体的活化,减少补体的损耗等有关。

Objective To observe the effect of herbal medicine dialysate on complicated infection in maintenance hemodialysis （MHD） patients. Methods One hundred and forty-five MHD patients were randomized into 3 groups. Group A （ N = 60） received routine dialysate of standard bicarbonate dialysate, group B （N = 41 ） received routine dialysate and intravenous drip of Yiqi Gushen Injection （YGI） with the actions of strengthening Qi and tonifying kidney, and group C （N = 44） received herbal medicine dialysate （YGI with routine dialysate B added）. Three months constituted one treatment course, and the treatment lasted 2 courses. The incidence of complicated infection was examined, and the serum immunoglobulin levels of IgG, IgA and IgM, as well as the complement levels of C3, C4 and CHS0 were observed before and after treatment. Results The average infection times in each patient was decreased in group C as compared the other two groups （ P 〈 0. 05 ）, and the serum levels of C3, C4 and CHS0 were improved in group C after treatment （ P 〈 0.05 or P 〈 0. 01 compared with those before treatment）. The effect on regulating the low levels of complements in group C was superior to that in the other two groups （ P 〈 0. 05 or P 〈 0.01 ）. Conclusion Herbal medicine dialysate has protective and therapeutic effect on complicated infection in MHD patients, and its mechanism may be related with the increase of complement formation, or reduction of complement activation and consumption.