益肾泻浊汤对持续性腹膜透析患者营养及免疫指标的影响

Effect of Yishen Xiezhuo Decoction on nutritional and immune indexes of patients with continuous peritoneal dialysis

目的观察益肾泻浊汤对持续性腹膜透析患者营养及免疫指标的影响。方法70例慢性肾脏病(CKD)持续性腹膜透析患者,按随机数字表法分为研究组和对照组,各35例。对照组给予常规治疗,研究组在对照组基础上加服益肾泻浊汤。比较两组治疗前后营养指标[血清白蛋白(ALB)、前白蛋白(Pre-ALB)、血红蛋白(Hb)、总胆固醇(TC)、甘油三酯(TG)、皮褶厚度(ST)]及免疫指标[免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)]水平。结果研究组治疗后ALB(33.94±5.15)g/L、Pre-ALB(34.8±6.3)mg/L、Hb(100.02±14.37)g/L、TC(3.87±1.21)mmol/L、TG(1.7±0.7)mmol/L、ST(29.90±5.45)mm均高于治疗前的(27.05±4.17)g/L、(30.9±6.3)mg/L、(80.21±13.64)g/L、(2.94±1.16)mmol/L、(1.3±0.5)mmol/L、(26.70±4.69)mm,且均高于对照组的(28.93±4.55)g/L、(31.7±6.1)mg/L、(88.05±20.45)g/L、(3.02±1.21)mmol/L、(1.3±0.6)mmol/L、(26.62±5.29)mm,差异有统计学意义(P<0.05)。两组治疗前后IgA、IgM水平组间组内比较,差异均无统计学意义(P>0.05)。治疗后,研究组患者的IgG(1.28±0.44)g/L、CD4^(+)(0.41±0.06)、CD8^(+)(0.33±0.04)、CD4^(+)/CD8^(+)(1.89±0.16)均高于本组治疗前的(0.97±0.32)g/L、(0.35±0.06)、(0.29±0.04)、(1.39±0.20)和对照组治疗后的(1.08±0.39)g/L、(0.37±0.06)、(0.31±0.04)、(1.33±0.23),差异有统计学意义(P<0.05)。结论自拟益肾泻浊汤可改善CKD持续性腹膜透析患者营养及免疫状态,有积极的影响。

Objective To observe the effect of Yishen Xiezhuo Decoction on nutritional and immune indexes of patients with continuous peritoneal dialysis.Methods A total of 70 patients with chronic kidney disease(CKD)undergoing continuous peritoneal dialysis were divided into a research group and a control group according to random numerical table,with 35 cases in each group.The control group received conventional therapy,and the research group received Yishen Xiezhuo Decoction for treatment on the basis of the control group.The levels of nutritional indexes[serum albumin(ALB),pre-albumin(Pre-ALB),hemoglobin(Hb),total cholesterol(TC),triglycerides(TG),skinfold thickness(ST)]and immune indexes[immunoglobulin G(IgG),immunoglobulin A(IgA),immunoglobulin M(IgM),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)]before and after treatment were compared between the two groups.Results After treatment,the ALB(33.94±5.15)g/L,Pre-ALB(34.8±6.3)mg/L,Hb(100.02±14.37)g/L,TC(3.87±1.21)mmol/L,TG(1.7±0.7)mmol/L and ST(29.90±5.45)mm in the research group were higher than those before treatment[(27.05±4.17)g/L,(30.9±6.3)mg/L,(80.21±13.64)g/L,(2.94±1.16)mmol/L,(1.3±0.5)mmol/L,(26.70±4.69)mm]of this group,and those of the control group[(28.93±4.55)g/L,(31.7±6.1)mg/L,(88.05±20.45)g/L,(3.02±1.21)mmol/L,(1.3±0.6)mmol/L,and(26.62±5.29)mm],and the differences were statistically significant(P<0.05).There was no statistically significant difference in IgA and IgM levels between the two groups before and after treatment(P>0.05).After treatment,the IgG(1.28±0.44)g/L,CD4^(+)(0.41±0.06),CD8^(+)(0.33±0.04),CD4^(+)/CD8^(+)(1.89±0.16)in the research group were higher than those before treatment[(0.97±0.32)g/L,(0.35±0.06),(0.29±0.04),(1.39±0.20)]in this group,and those in the control group[(1.08±0.39)g/L,(0.37±0.06),(0.31±0.04),(1.33±0.23)],and the differences were statistically significant(P<0.05).Conclusion Self-made Yishen Xiezhuo Decoction has a positive impact on improving the nutritional and immune status of patients with CKD undergoing continuous peritoneal dialysis.