自拟芪黄活血汤联合血液净化治疗尿毒症周围神经病变疗效及对毒素、致炎因子水平的影响

Effect of Qihuang Huoxue Decoction combined with blood purification on uremia with peripheral neuropathy and its effect on the levels of toxins and inflammatory factors

目的探讨自拟芪黄活血汤联合血液净化治疗尿毒症周围神经病变疗效及对毒素、致炎因子水平的影响。方法将86例尿毒症周围神经病变患者随机分为对照组和观察组,每组43例。对照组采用血液净化治疗,观察组在此基础上加用自拟芪黄活血汤治疗,疗程均为3个月。观察2组治疗前后感觉神经传导速度、肌电诱发电位起始潜伏期、肌电诱发电位峰-峰波幅值、交感神经皮肤反应异常率及血清甲状旁腺激素、β2-微球蛋白、瘦素、同型半胱氨酸、C反应蛋白、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、IL-8水平变化情况,比较2组中医证候疗效。结果 2组治疗后感觉神经传导速度和峰-峰波幅值均显著提高(P均<0.05),起始潜伏期明显缩短(P均<0.05),交感神经皮肤反应异常率及血清甲状旁腺激素、β2-微球蛋白、瘦素、同型半胱氨酸、C反应蛋白、TNF-α、IL-6及IL-8水平均显著降低(P均<0.05),且观察组各指标改善情况均明显优于对照组(P<0.05);观察组中医证候疗效显著优于对照组(P<0.05)。结论自拟芪黄活血汤联合血液净化治疗尿毒症周围神经病变可有效改善临床证候,促进感觉神经功能和交感神经皮肤反应复常,调节肌电诱发电位水平,加快机体毒素清除,并有助于下调致炎因子表达。

Objective It is to investigate the effect of self-made Qihuang Huoxue Decoction combined with blood purification on uremia with peripheral neuropathy and its effect on the levels of toxins and inflammatory factors. Methods Eighty-six patients with uremia and peripheral neuropathy were randomly divided into control group and observation group, with 43 cases in each group. The control group was treated with blood purification, and the observation group was treated with Qihuang Huoxue Decoction, both groups were treated for 3 months. The changes of sensory nerve conduction velocity, the initial latency of myoelectric evoked potential, the peak amplitude of the electromyographic evoked potential, the abnormal rate of sympathetic skin reaction, and the levels of serum parathyroid hormone,β2-microglobulin, leptin, homocysteine, C-reactive protein, tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) and IL-8 were observed before and after treatment in the two groups, the curative effects of traditional Chinese medical syndrome were compared. Results The sensory nerve conduction velocity and peak-to-peak amplitude were significantly increased(P<0.05), initial latency was significantly shortened(P<0.05), sympathetic skin reaction rate and the levels of serum parathyroid hormone,β2-microglobulin, leptin, homocysteine, C-reactive protein, TNF-α, IL-6 and IL-8 were significantly decreased(P<0.05), and the improvement of each index in the observation group was better than that in the control group(P<0.05);the curative effect of TCM symptom in the observation group was significantly better than that in the control group(P<0.05). Conclusion Self-made Qihuang Huoxue Decoction combined with blood purification can effectively improve clinical symptoms, promote sensory nerve function and sympathetic skin reaction, regulate myoelectric evoked potential level, accelerate the body’s toxin clearance, and help to down-regulate the expression of proinflammatory factors in the treatment of uremia with peripheral neuropathy.