加味香砂六君汤治疗腹膜透析营养不良临床研究

Clinical Study on Modified Xiangsha Liujun Tang for Peritoneal Dialysis Malnutrition

目的:观察加味香砂六君汤对腹膜透析(PD)患者营养状况的影响。方法:选取维持性腹膜透析营养不良患者50例,按随机数字表法分为治疗组和对照组各25例。所有患者给予常规透析治疗及对症处理,对照组给予开同营养支持,治疗组给予加味香砂六君汤口服。观察治疗前后中医证候积分、主观综合性营养评估评分(SGA)、总尿素清除指数(KT/V),并检测生化指标。结果:治疗前,2组中医证候积分比较,差异无统计学意义(P>0.05)。治疗后,2组中医证候积分较治疗前降低,且治疗组低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组血生化指标比较,差异均无统计学意义(P>0.05)。治疗后,治疗组血红蛋白(Hb)、血清白蛋白(Alb)、前白蛋白(PA)、转铁蛋白饱和度(TSAT)、血钾(K)较治疗前均显著升高(P<0.05),且Alb、PA、TSAT水平高于对照组(P<0.05);对照组Hb、Alb、PA较治疗前显著升高(P<0.05)。治疗前,2组SGA评分比较,差异无统计学意义(P>0.05)。治疗后,2组SGA评分较治疗前降低,且治疗组低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组KT/V比较,差异无统计学意义(P>0.05)。治疗后,2组KT/V较治疗前升高,差异有统计学意义(P<0.05)。结论:加味香砂六君汤能显著提高腹膜透析患者生活质量,改善营养不良,具有较好的应用前景。

Objective:To observe the effect of modified Xiangsha Liujun tang on nutritional status of peritoneal dialysis(PD) patients.Methods:Selected 50 cases of patients with maintenance peritoneal dialysis malnutrition and divided them into the treatment group and the control group according to the random number table,with 25 cases in each group.All patients were given routine dialysis and expectant treatment.The control group was given nutritional support,and the treatment group was given oral administration of modified Xiangsha Liujun tang.Observed the Chinese medicine syndrome scores,subjective global assessment scores(SGA) and total urea clearance indexes(KT/V) before and after treatment and detected the biochemical indexes.Results:Before treatment,there was no significant difference being found in the comparison of Chinese medicine syndrome scores in the two groups(P>0.05).After treatment,Chinese medicine syndrome scores in the two groups were lower than those before treatment,and the score in the treatment group was lower than that in the control group,differences being significant(P<0.05).Before treatment,there were no significant differences being found in the comparisons of blood biochemical criterion in the two groups(P>0.05).After treatment,hemoglobin(Hb),serum albumin(Alb),prealbumin(PA),transferrin saturation(TSAT) and serum potassium(K) in the treatment group were all obviously increased when compared with those before treatment(P<0.05);the levels of Alb,PA and TSAT were higher than those in the control group(P<0.05);and Hb,Alb and PA in the control group were evidently increased when compared with those before treatment(P<0.05).Before treatment,there was no significant difference being found in the comparison of SGA scores in the two groups(P>0.05).After treatment,the SGA scores in the two groups were decreased when compared with those before treatment,and the scores in the treatment group were lower than those in the control group,differences being significant(P<0.05).Before treatment,there was no significant difference being found in the comparison of KT/V in the two groups(P>0.05).After treatment,KT/V in the two groups was increased when compared with that before treatment,difference being significant(P<0.05).Conclusion:The application of modified Xiangsha Liujun tang can significantly enhance the life quality of peritoneal dialysis patients,improve malnutrition and has a good application prospect.