尿毒清颗粒对血液透析患者蛋白质—能量消耗状态的影响

THE EFFECT OF NIAODUQING GRANULES ON MAINTENANCE HEMODIALYSIS PATIENTS WITH PROTEIN-ENERGY WASTING

目的：观察尿毒清颗粒对维持性血液透析（MHD）患者蛋白质—能消耗状态（PEW）的影响,并对其可能机制进行探讨。方法：选取2015年5~8月在广东省广州市红十字会医院MHD并符合PEW状态的患者36例,随机分为观察组和对照组,每组各18例。观察组在常规治疗基础上给予尿毒清颗粒治疗（1袋/次,3次/d,口服,连续服用3个月）,对照组仅给予常规治疗,检测干预前、后营养状态、微炎症情况等指标。结果：观察组血清白蛋白（Alb）、血清前白蛋白（PA）、转铁蛋白（TRF）、血红蛋白（Hb）均有提高,与治疗前及对照组治疗后相比差异均有统计学意义（均P〈0.05）;观察组治疗后患者超敏C反应蛋白（Hs-CRP）、白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）水平降低,与治疗前及对照组治疗后比较,差异均有统计学意义（均P〈0.05）,观察组治疗前、后尿素清除指数（Kt/V）比较差异均有统计学意义（均P〈0.05）。结论：尿毒清颗粒可以通过减轻患者的微炎症状态从而改善PEW状态。

Objective To investigate the effect and mechanism of Niaoduqing granules on protein-energywasting （PEW ） in maintenance hemodialysis patients. M ethods： 36 cases of maintenance hemodialysis patientswith PEW in our hospital from May 2015 to August 2015 were selected and randomly divided into theobservation group and the control group （18 cases per group）. The patients in the observation group weregiven Niaoduqing granules, and those in the control group were given the conventional treatm ent. The nutritionalindexes and micro-inflammatory responses were tested before and after treatm ent. Results： Aftertreatm ent, the serum levels of albumin （Alb ）, prealbumin （PA）, transferrin （TRF ） and hemoglobin（ Hb） were increased, while the high sensitivity c-reactive protein （ H s-CRP） , tum or necrosis factor（TNF）-α and interleukin （IL）-6 were decreased in the observation group when compared with those beforetreatm ent and the control group （ P 〈0. 05）. A significant difference in the urea clearance index （Kt/Vvalue） was found in the observation group at pretreatm ent and post-treatm ent （ P 〈0. 05）. Conclusion：Niaoduqing granules might improve the nutritional state of hemodialysis patients with PEW through inhibitingthe micro-inflammatory response.