健脾益肾汤对尿毒症腹膜透析患者营养情况的影响

Effect of Jianpi Yishen Tang on Nutritional Status of Uremic Patients Undergoing Peritoneal Dialysis

目的:观察健脾益肾汤对尿毒症腹膜透析患者营养情况的影响。方法:将104例行腹膜透析的脾肾气虚型尿毒症患者随机分为对照组和观察组各52例。2组患者均予高能量、优质蛋白饮食治疗,药用重组人促红素注射液、骨化三醇胶丸,观察组加用健脾益肾汤治疗,2组疗程均为4个月。治疗前后检测白蛋白(Alb)、前白蛋白(PA)、血红蛋白(Hb)和转铁蛋白(TF)水平,以主观全面评定法(SGA)评估患者的营养情况,并评价脾肾气虚证评分。结果:治疗后,2组Hb、PA、Alb和TF水平均较治疗前升高(P<0.01),观察组Hb、PA、Alb和TF水平均高于对照组(P<0.01)。2组SGA评分和脾肾气虚证评分均较治疗前下降(P<0.05),观察组SGA评分和脾肾气虚证评分均低于对照组(P<0.05)。结论:健脾益肾汤的使用有助于改善尿毒症腹膜透析患者的营养不良情况,减轻临床症状,从而有利于提高腹膜透析患者的生活质量。

Objective:To observe the effect of Jianpi Yishen tang on nutritional status of uremic patients undergoing peritoneal dialysis.Methods:A total of 104 cases of uremic patients of spleen-kidney qi deficiency type undergoing peritoneal dialysis were randomly divided into the control group and the observation group,52 cases in each group.Both groups were given diet with high energy and high-quality protein,and were treated with recombinant human erythropoietin injection and calcitriol soft gelatin capsules;the observation group was additionally treated with Jianpi Yishen tang.Both groups were treated for four months.Before and after treatment,the levels of albumin(Alb),prealbumin(PA),hemoglobin(Hb) and transferrin(TF) in the two groups were detected;the nutritional status of patients was evaluated by Subjective Global Assessment(SGA),the scores of spleen-kidney qi deficiency syndrome were assessed.Results:After treatment,the levels of Hb,PA,Alb and TF in the two groups were increased when compared with those before treatment(P<0.01),and the above levels in the observation group were higher than those in the control group(P<0.01).The scores of SGA and spleen-kidney qi deficiency syndrome in the two groups were decreased when compared with those before treatment(P<0.05),and the above scores in the observation group were lower than those in the control group(P<0.05).Conclusion:The application of Jianpi Yishen tang is helpful to improve the malnutrition of uremic patients undergoing peritoneal dialysis and alleviate clinical symptoms,thus improving their quality of life.