尿毒康合剂对腹膜透析患者腹膜透析效能及腹膜纤维化影响的临床观察

Study on Effect of Peritoneal Dialysis Efficiency and Peritoneal Fibrosis in Peritoneal Dialysis Patients Treated with Uremic Mixture

目的:探讨尿毒康合剂对腹膜透析患者的透析效能及腹膜纤维化的影响。方法:选取本院符合标准的终末期肾脏病腹膜透析患者82例,为2013年7月—2015年11月的病例。经伦理委员会批准并签订知情同意书,按随机对照设计、根据入选标准分为两组,分别41例,对照组采用维持性腹膜透析方案;研究组在此基础上采用尿毒康合剂治疗,均持续治疗3个月。治疗前和治疗3月时测定腹透液FN、TGF-β1值及血清HMGB-1、Hs-CRP、IL-6值,将Vu、RRF、KT/V、Vd作为评价透析效能的指标,同时对比两组间临床疗效,记录不良反应。结果:与治疗前比,两组治疗3月时腹透液FN、TGF-β1值降低,腹透液Vu、RRF、KT/V降低,Vd升高,血清HMGB-1、Hs-CRP、IL-6值降低(P<0.05);与对照组比,研究组治疗3月时腹透液FN、TGF-β1值较低,腹透液Vu、RRF、KT/V较低,血清HMGB-1、HsCRP、IL-6值较低(P<0.05);对照组有效率73.17%低于研究组90.24%(P<0.05)。结论:尿毒康合剂能提高腹膜透析患者的透析效能,延缓肾功能恶化,具有抑制腹膜纤维化和肾脏微炎症的作用,是一种有效的治疗方案。

Objective：To investigate the effect of uremic mixture on the peritoneal dialysis efficiency and peritoneal fibrosis in peritoneal dialysis patients.Methods：A total of 82 patients with end-stage renal disease and peritoneal dialysis in our hospital were selected,which were from July 2013 to November 2015.By ethical committee approval,the patients signed informed consent,and according to a randomized controlled design were divided into 2 groups.Forty-one cases in control group were treated with peritoneal dialysis solution and those in study group were treated more with Niaodukang mixture treatment,and 2 groups were treated for 3 months.Determination of peritoneal fluid FN,TGF-β1 and levels of serum HMGB-1,Hs-CRP,IL-6 were compared before and after treatment,and clinical efficacy,adverse reactions were also compared.Results：Compared with before treatment,levels of FN and TGF-β1 in dialysate decreased,Vu,RRF and KT/V decreased,VD increased,levels of serum HMGB-1,Hs-CRP and IL-6 decreased（P〈0.05）.Compared with the control group,levels of FN and TGF-β1 in dialysate in the study group were lower,Vu,RRF and KT/V were lower,VD was higher,and levels of serum HMGB-1,Hs-CRP and IL-6 were lower（P〈0.05）,and the effective rate was lower（P〈0.05）.Conclusion：Uremic mixture can improve the dialysis efficiency of peritoneal dialysis patients,delay the deterioration of renal function,inhibit peritoneal fibrosis and renal micro inflammation,and is an effective treatment plan.