参苓白术颗粒联合替米沙坦对尿毒症及血清β_2-MG和OPG的影响

Effect of Shenling Baizhu Granules combined with telmisartan on uremia and serumβ2-microglobulin and osteoprotegerin

目的研究参苓白术颗粒联合替米沙坦治疗尿毒症的疗效,以及对患者血清β_2-微球蛋白(β_2-MG)和骨保护蛋白(OPG)水平的影响。方法研究对象为142例尿毒症患者,根据随机数字表法均分为对照组(给予替米沙坦)和观察组(给予参苓白术颗粒联合替米沙坦),各71例。比较2组患者治疗后的临床疗效、并发症发生率、营养状态、肾脏功能以及血清β_2-MG和OPG水平。结果观察组有效率(94.37%)明显高于对照组(83.10%),P<0.05。治疗后2组患者白蛋白含量显著增加,β_2-MG、OPG水平,血清尿素、肌酐含量,24 h尿量以及炎性因子细胞白细胞介素-8(IL-8)、白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平均显著降低,观察组各水平显著优于对照组(P<0.05)。2组患者治疗后生活质量综合评定量表(GQOL-74)评分明显升高,主观综合营养评分(SGA)显著降低,且观察组各评分明显优于对照组(P<0.05)。2组患者不良反应发生率比较差异无统计学意义。结论参苓白术颗粒联合替米沙坦治疗尿毒症疗效显著,能有效改善患者的营养状态和肾功能指标,从而降低血清β_2-MG和OPG水平,提高治疗效率和患者生活质量。

Objective To study the effects of Shenling Baizhu Granules and telmisartan in the treatment of uremia and the effect on serumβ2-microglobulin(β2-MG)and osteoprotegerin(OPG)levels.Methods The subjects were 142 uremic patients,and were randomly divided into observation group(treated with Shenling Baizhu Granules and telmisartan)and control group(treated with telmisartan),71 cases in each group.The clinical efficacy,incidence of complications,nutritional status,renal function and serumβ2-MG and OPG levels were compared between the 2 groups after treatment.Results The effective rate of observation group(94.37%)was significantly higher than that of control group(83.10%)(P<0.05).After treatment,the albumin content increased significantly,the serum urea,creatinine content,24 h urine volume and the serum levels ofβ2-MG,OPG and inflammatory factors[interleukin-8(IL-8),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)]of the 2 groups decreased significantly,and the level of the observation group was significantly better than the control group(P<0.05).The GQOL-74 scores of the 2 groups were significantly increased,while the SGA scores were significantly decreased,and the scores of each observation group were significantly better than those of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the 2 groups.Conclusion Shenling Baizhu Granules combined with telmisartan is effective in the treatment of uremia.It can effectively improve the nutritional status,renal function and inflammatory status of the patients,thereby reduce the level of serumβ2-MG and OPG and ultimately improve the treatment efficiency and quality of life.