益肾排毒汤辅助高通量血液透析治疗慢性肾衰竭尿毒症的临床观察

Clinical Observation on Kidney-tonifying Detoxifying Decoction as Adjunctive Therapy and High-flux Hemodialysis in Treating Uremia of Chronic Renal Failure

目的:探究益肾排毒汤辅助高通量血液透析治疗慢性肾衰竭尿毒症的临床疗效。方法:将84例慢性肾衰竭尿毒症患者根据入院顺序随机分为观察组和对照组,每组42例。对照组采取高通量血液透析法治疗,观察组在对照组基础上联合益肾排毒汤进行治疗,每日1剂。观察两组患者的临床疗效、中医证候积分和血清炎症因子水平。结果:总有效率观察组治为88.1%(37/42),对照组为69.0%(29/42),两组比较差异有统计学意义(P<0.05);治疗前,两组倦怠乏力、腰膝酸软、食少纳呆、恶心呕吐等中医证候积分比较,差异无统计学意义(P>0.05);治疗后,上述指标评分两组均显著降低,且观察组低于对照组(P<0.05);治疗前,两组血清高敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)、白细胞介素6(interleukin-6,IL-6)、肿瘤坏死因子α(tumor necrosis factorα,TNF-α)等炎症因子水平比较,差异无统计学意义(P>0.05);治疗后,上述指标两组均显著降低,且观察组降低更明显(P<0.05)。结论:益肾排毒汤辅助高通量血液透析治疗慢性肾衰竭尿毒症,可有效改善患者的临床症状,调节血清炎症因子水平,临床效果显著。

Objective: To explore clinical effects of kidney-tonifying detoxifying decoction as adjunctive therapy and high-flux hemodialysis in the treatment of uremia of chronic renal failure. Methods: All 84 patients were randomized into the observation group and the control group according to admission order, 42 cases each group. The control group adopted high-flux hemodialysis, and the observation group were treated by kidneytonifying detoxifying decoction based on Western medicine, one dose each day. To observe clinical effects, TCM syndrome integrals and the levels of serum inflammatory factors between both groups. Results: Total effective rate of the observation group was 88.1%(37/42), higher than 69.0%(29/42) of the control group, and the difference showed statistical meaning between both groups(P<0.05);before treating, the difference had no statistical meaning in TCM syndrome integrals including fatigue and weakness, lumbar debility, low food intake and poor appetite, nausea and vomiting, and others between both groups before treating(P>0.05);after treating, the scores of these indexes in both groups reduced notably, and the observation group was lower than the control group(P<0.05);before treating, the difference had no statistical meaning in hs-CRP, IL-6, TNF-α between both groups(P>0.05);after treating, these indexes reduced remarkably, and the decrease of the observation group was more notable(P<0.05). Conclusion: Kidney-tonifying detoxifying decoction as adjunctive therapy and high-flux hemodialysis in the treatment of uremia of chronic renal failure could effectively improve clinical symptoms of the patients and adjust the levels of serum inflammatory factors with notable clinical effects.