润肺益肾饮对维持性血液透析脾肾两虚型患者微炎症的影响

Effect of Runfei Yishen Decoction(润肺益肾饮)on Microinflammation in Maintenance Hemodialysis Patients with Deficiency of Spleen and Kidney Syndrome

目的:观察润肺益肾饮对维持性血液透析脾肾两虚型患者微炎症指标的影响。方法:纳入脾肾两虚型规律血液透析患者80例,随机分为治疗组40例和对照组40例。另选健康对照组10人(健康志愿者)。对照组给予常规透析治疗,治疗组在对照组的基础上口服润肺益肾饮治疗,疗程12周。检测两组治疗前后及健康对照组hs-CRP、IL-6、TNF-α指标变化,同时检测两组治疗前后血红蛋白、白蛋白、尿素氮、肌酐等指标,并对治疗前hs-CRP与血红蛋白、白蛋白、尿素氮、肌酐进行相关性分析;观察治疗前后中医证候积分变化及不良反应。结果:治疗组和对照组hs-CRP、IL-6、TNF-α指标均高于健康对照组;治疗组在治疗后hs-CRP、IL-6、TNF-α较治疗前明显下降(P<0.05),且低于对照组(P<0.05);两组患者血红蛋白、白蛋白等营养指标与微炎症因子hs-CRP呈负相关,但相关性较弱;治疗组治疗后血红蛋白、白蛋白指标较治疗前增高(P<0.05),且高于对照组(P<0.05);两组治疗前后肌酐、尿素氮指标无明显变化;治疗组治疗后中医证候积分下降明显(P<0.05),未见不良反应。结论:润肺益肾饮可改善脾肾两虚型维持性血液透析患者的微炎症状态,并能纠正贫血、改善血清白蛋白等营养指标。

Objective:To investigate the effect of Runfei Yishen decoction on microinflammation in maintenance hemodialysis patients with spleen and kidney deficiency syndrome.Methods:A total of 80 regular hemodialysis patients with spleen and kidney deficiency syndrome were randomly divided into treatment group and control group,40 cases in each group.Another 10 healthy control group(healthy volunteers)were selected.The control group was given routine dialysis treatment,and the treatment group was treated with Runfei Yishen decoction on the basis of the control group for 12 weeks.Detect the changes of hs-CRP,IL-6,TNF-αindexes before and after treatment in the two groups and in the healthy control group.At the same time,hemoglobin,albumin,urea nitrogen,creatinine and other indicators were detected before and after treatment,and the correlation analysis between hs-CRP and hemoglobin,albumin,urea nitrogen,and creatinine before treatment was performed.Observe the changes of TCM syndrome points and adverse reactions before and after treatment.Results:The levels of hs-CRP,IL-6 and TNF-αindexes of the treatment group and the control group were higher than those of the healthy control group.After treatment,the levels of hs-CRP,IL-6,and TNF-αin the treatment group were significantly lower than before treatment(P<0.05),and lower than that in the control group(P<0.05).Nutritional indicators such as hemoglobin and albumin in the two groups were negatively correlated with the microinflammatory factor hs-CRP,but the correlation was weak.The indexes of hemoglobin and albumin in the treatment group increased after treatment(P<0.05),and were higher than those in the control group(P<0.05).There was no significant change in creatinine and urea nitrogen indexes before and after treatment in both groups.The TCM syndrome score decreased significantly after treatment in the treatment group(P<0.05),and no adverse reactions were found.Conclusion:Runfei Yishen decoction can improve the micro-inflammatory state of maintenance hemodialysis patients with spleen and kidney deficiency syndrome,and can correct anemia,improve serum albumin and other nutritional indicators.