补脾益肾、通腑化浊法对维持性血液透析患者营养不良及微炎症状态的影响

Effect of Strengthening Spleen and Nourishing Kidney,Dredging Bowels and Turbidity-Resolving Method for Patients with Maintenance Hemodialysis,Malnutrition and Microinflammatory State

目的:观察补脾益肾、通腑化浊法对维持性血液透析患者营养不良及微炎症状态的疗效。方法:按照随机、对照原则,将60例维持性血液透析患者随机分为治疗组30例(中药治疗+血液透析)和对照组30例(单纯血液透析)。观察两组患者治疗前后营养不良-炎症评分(malnutrition-inflammation score,MIS)、人体测量学指标(BMI、TSF、MAC)、血液生化和血常规指标、炎性反应指标(IL-6、IL-10和TNF-a)等,并观察两组不良反应及副反应。结果:与治疗前比较,治疗组治疗后的MIS评分显著降低,肱三头肌皮褶厚度(triceps skinfold thickness,TSF)、上臂围(mid-upper armcir cumference,MAC)增加,血浆前白蛋白、转铁蛋白升高,均有显著性差异(P<0.05)。与对照组比较,治疗组治疗后的MIS评分显著降低,人体测量学指标显著改善,营养指标、炎性反应指标显著下降,均有显著性差异(P<0.05)。结论:补脾益肾、通腑化浊法对改善维持性血液透析患者营养不良及微炎症状态有较好的疗效。

Objective： To observe the therapeutic effect of strengthening spleen and nourishing kidney, dredging bowels and turbidity-resolving method for patients with maintenance hemodialysis, malnutrition and microinflammatory state. Methods： 60patients with maintenance hemodialysis were randomly divided into 30cases of treatment group （ Chinese Traditional Medicine treatments＋hemodialysis） and 30cases of controlled group （purely hemodialysis） according to the rule of randomization and control. Malnutrition-inflammation score （MIS）, anthropometric indicators, blood biochemical and routine blood indexes, inflam- matory response （IL-6, IL-10and TNF-α） etc. were observed in both groups before and after treatment, and adverse reactions and side effects were observed in the two groups. Results： Compared with before treatment, the treatment group after treatment of MIS score significantly reduced, triceps skinfold thickness （TSF）, mid-upper armcir cumferenee （MAC）, elevated serum prealbumin, transferrin, all had significant difference （P〈0. 05）. Compared with the controlled group, the treatment group af- ter treatment of MIS score significantly reduced, anthropometry index （BMI, TSF, MAC） improved significantly, nutrition in- dex, inflammatory reaction index dropped significantly, all had significant difference （P〈0. 05 ）. Conclusion： Strengthening spleen and nourishing kidney, dredging bowels and turbidity-resolving method has a good therapeutic effect for patients with maintenance hemodialysis, malnutrition and microinflammatory state.