益肾补脾方对维持性血液透析肾性贫血患者生活质量及微炎症状态的影响

Effect of Yishen Bupi Recipe(益肾补脾方)on Quality of Life and Micro-inflammatory State in Patients with Renal Anemia Undergoing Maintenance Hemodialysis

目的探究益肾补脾方对维持性血液透析肾性贫血患者生活质量及微炎症状态的影响。方法以来该院诊断并治疗维持性血液透析肾性贫血患者76例作为观察对象,将入组患者按照随机数字表法,分为两组,各38例。对照组予以常规治疗;治疗组在对照组基础上联合益肾补脾法为原则的中药汤剂,1剂/d,两组患者均治疗4周。比较两组患者的血红蛋白(Hb)、血清铁蛋白(SI)、转铁蛋白饱和度(TSAT)及红细胞压积(Hct)血象指标及血清白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、人核转录因子(NF-kB)及超敏C反应蛋白(CRP)微炎症指标、生活质量及临床疗效。结果经治疗,两组患者Hb、Hct、SI及TSAT均有所提高,且治疗组各项指标改善均显著高于对照组(P<0.05);经治疗,两组患者IL-6、IL-8、NF-kB及CRP均有所改善,且治疗组各项指标降低均显著优于对照组(P<0.05);经治疗,两组患者WHOQOL-BREF评分(生理领域、心理领域、环境领域、社会关系领域)均升高(P<0.05),组间比较,治疗组WHOQOL-BREF评分高于对照组(P<0.05);对照组临床总有效率为71.43%(25/38)低于治疗组92.11%(35/38)(P<0.05)。结论益肾补脾法为指导原则的中药煎剂在治疗维持性血液透析肾性贫血方面取得较为满意的临床疗效,具有益肾补脾、调和气血之功效,改善肾性贫血临床症状、肾功能相关指标及微炎症状态,提高患者生活质量,值得临床推广应用。

Objective The purpose of this study was to investigate the effect of Yishen Bupi Recipe(益肾补脾方)on quality of life and micro-inflammatory state in patients with renal anemia undergoing maintenance hemodialysis.Methods Seventy-six patients with renal anemia undergoing maintenance hemodialysis diagnosed and treated in our hospital were taken as the observation objects,and they were randomly divided into two group with 38 cases in each group according to the table of random number.The control group was administered with conventional western treatment,while the treatment group was administered with Yishen Bupi Recipe(1 dose per day)based on the principle of reinforcing kidney and spleen on the basis of the control group.The patients in both groups were treated for 4 weeks.The hemogram indexes such as hemoglobin(Hb),serum ferritin(SI),transferrin saturation(TSAT)and hematocrit(Hct),microinflammatory indexes such as serum interleukin-6(IL-6),interleukin-8(IL-8),human nuclear factor-Kappa B(NF-kB)and hypersensitive C-reactive protein(CRP),as well as the quality of life and clinical efficacy of the two groups were compared.Results After treatment,Hb,Hct,SI and TSAT of the two groups increased,and the improvement degree of each index in the treatment group was obviously higher than that in the control group(P<0.05).The levels of IL-6,IL-8,NF-kB and CRP in the two groups were improved after treatment.Each index in the treatment group decreased significantly more than that in the control group(P<0.05).When compared with the scores before treatment,the scores of quality of life in the two groups were improved after treatment.The scores of quality of life in the treatment group were improved more significantly than that of the control group(P<0.05).The total clinical effective rate was 92.11%(35/38)(treatment group)and 71.43%(25/38)(control group),respectively.In terms of clinical efficacy,the results of the treatment group were significantly better than those of the control group,with statistically significant differences(P<0.05).Conclusion The TCM decoction based on the principle of reinforcing kidney and spleen has achieved relatively satisfactory clinical effect in treating renal anemia requiring maintenance hemodialysis.Yishen Bupi Recipe has the effects of invigorating kidney and reducing turbid,fortifying spleen and eliminating dampness,can improve the clinical symptoms of renal anemia,renal function related indicators and microinflammatory state,improve the quality of life of patients,and is worthy of clinical popularization and application.