生大黄联合活性炭对血液透析高磷血症患者的影响

Effects of Raw Dahuang and Medicinal Activated Carbon on Hyperphosphatemia of the Patients after Hemodialysis

目的:探讨生大黄联合药用活性炭对血液透析高磷血症患者的影响。方法:将血液透析高磷血症患者86例随机分为对照组44例和观察组42例,对照组患者给予低磷饮食、磷结合剂、活性维生素等常规治疗,并口服药用活性炭;观察组患者在对照组治疗的基础上口服生大黄。比较两组患者治疗前后血清血磷(phosphorous,P)、血钙(calcium,Ca)、Ca-P乘积、甲状旁腺激素(parathyroid hormone,PTH)水平以及血红蛋白(hemoglobin,Hb)、α-Klotho、肌酐(serum creatinine,SCr)、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)水平,观察两组患者不良反应发生情况。结果:治疗后两组患者血清P、Ca-P乘积、PTH、α-Klotho水平均低于治疗前,差异均有统计学意义(P<0.05),观察组低于对照组,差异有统计学意义(P<0.05),血清Ca、Hb、SCr、TC、TG两组治疗前后组内比较及治疗后组间比较差异均无统计学意义(P>0.05)。观察组患者不良反应总发生率低于对照组,差异有统计学意义(χ^2=4.607,P=0.032)。结论:生大黄联合药用活性炭可改善血液透析高磷血症患者高磷状态,改善患者不良反应发生情况。

Objective:To explore the effects of raw Dahuang(rhubarb)and medicinal activated carbon on hyperphosphatemia of the patients after hemodialysis.Methods:All 86 patients were randomized into 44 cases of the control group and 42 cases of the observation group,the patients in the control group accepted conventional therapy including low phosphorus diet,phosphate binder,active vitamin and others,oral medicinal activated carbon;the observation group took raw Dahuang orally based on the therapy the control group accepted.To compare serum P,Ca,Ca-P product,the levels of PTH,Hb,α-Klotho,SCr,TC,TG before and after treating between both groups,and observe the incidence of adverse reaction in both groups.Results:After treating,P,Ca-P product,PTH,α-Klotho levels of both groups were lower than these before treating,and the difference had statistical meaning(P<0.05),the observation group was lower than the control group,and the difference showed statistical meaning(P<0.05),the difference had no statistical meaning in serum Ca,Hb,SCr,TC and TG within two groups before and after treating,and between both groups after treating(P>0.05).Total incidence of adverse reaction of the observation group was lower than that of the control group(P<0.05),and the difference presented statistical meaning(χ^2=4.607,P=0.032).Conclusion:Raw Dahuang and medicinal activated carbon could improve high phosphorus status and the incidence of adverse reaction in treating hyperphosphatemia of the patients after hemodialysis.