高通量透析对糖尿病肾病血液透析患者中医证候与矿物质和骨代谢的影响

Effect of High-Flux Hemodialysis on TCM Syndrome and MBD in Diabetic Kidney Disease Patients with Maintenance Hemodialysis

目的:观察高通量血液透析对糖尿病肾病维持性血液透析患者中医证候以及矿物质和骨代谢的影响。方法:选择糖尿病肾病维持性血液透析患者60例,随机分为高通量透析治疗组和低通量透析治疗组,治疗3个月,分别观察2组患者治疗前后中医证候积分,及血红蛋白、血白蛋白、血钙、血磷、碱性磷酸酶、甲状旁腺素、25羟基维生素D3等指标的变化。结果:①治疗6月后,高通量透析组能降低中医证候实证积分、虚证积分及总积分(P<0.05),其总体有效率高于低通量透析组。②治疗6月时,高通量透析组的Ca、P、PTH、25(OH)D3及Alb水平较治疗前显著变化(P<0.05),而高通量透析组的AKP及HB水平亦有下降但差异无统计学意义(P>0.05),低通量透析组治疗前后所观察指标变化均无显著性差异(P>0.05)。结论:与低通量透析相比,高通量透析可减少糖尿病肾病维持性血液透析患者中医证候临床积分,改善患者矿物质和骨代谢紊乱。

Objective：To investigate the effect of high-flux hemodialysis on TCM syndrome and MBD in diabetic kidney disease patients with maintenance hemodialysis.Methods：We recruited 60 diabetic kidney disease patients with maintenance hemodialysis and randomly divided them into two groups.Patients in each group were treated with either highflux dialyzer or low-flux dialyzer for 3 and 6 months.TCM syndrome scores and hemoglobin,albumin,Ca,P,AKP,PTH and 25（OH） D3 were determined at the start and end of the study.Result：After the treatment for 6 months,significant changes in TCM syndrome scores and total effective rate were found in the high-flux group.No changes in AKP and HB were detected in the 2 groups after the treatment for 6 months,but significant changes in Ca,P,PTH,25（OH） D3 and Alb were found in the high-flux group.Conclusions：This short-term study demonstrates that high-flux dialyser provides a better effect on TCM syndrome scores and MBD is the low-flux dialyser for diabetic kidney disease patients on maintenance hemodialysis.