健脾补肾活血膏方对维持性血液透析患者营养不良状态的影响

Effect of herb paste formulas by principle of strengthening the spleen,tonifying the kidney and activating blood circulation on malnutrition in maintenance hemodialysis patients

目的:观察健脾补肾活血中药膏方对维持性血液透析(简称"血透")患者营养不良状态的影响,初步探讨中药膏方的疗效和安全性,为临床应用中医药干预维持性血透患者营养不良提供参考。方法:36例血透患者,按患者接受膏方治疗的意愿分为膏方治疗组和对照组,治疗组在规律血透、对症治疗以及饮食指导等基础上服用中药膏方3个月。观察、记录两组患者治疗前后在人体测量指标(身体质量指数、肱三头肌皮褶厚度、上臂围、上臂肌围)、实验室指标(血清白蛋白、前白蛋白、血红蛋白、蛋白分解代谢率)、主观综合性营养评估(SGA)评分、临床症状的变化等,分析和评价膏方的临床疗效。结果:健脾补肾活血膏方提高了血红蛋白、血清白蛋白、蛋白分解代谢率水平;改善了SGA评分及临床症状。结论:健脾补肾中药膏方在一定程度上改善了维持性血透患者营养不良状态。

Objective： To observe the influences of nourishing spleen and kidney and blood-activating paste on malnutrition in maintenance hemodialysis（MHD） patients, and to investigate the healing effect and safety of the paste, in order to provide the reference for traditional Chinese medicine（TCM） on undernourished MHD patients. Methods： According to the inclusion and exclusion standard, 36 patients were selected. According to whether taking the paste, the patients were divided into two groups： treatment group and control group. All the patients were given maintenance hemodialysis, basis of conventional medicine, and dietary guidance. In addition, the treatment group take the paste, 3 months for a period of treatment. Observe and record the situation before and after treatment, including anthropometric arameters （BMI, TSF, MAC, MAMC）, laboratory examination（Hb, Alb, PA, PCR）, SGA score, clinic sign change, safety observation index（hepatic function, plasma lipids, ion etc.）. Analysis and evaluate the clinical efficacy and safety of the paste. Results： The nourishing spleen and kidney and blood-activating paste can improve the malnutrition in MHD patients to some extent. Conclusion： The nourishing spleen and kidney and blood- activating paste has greatly raised the level of Alb, Hb, PCR; and it has greatly improved SGA score and clinical symptoms.