中医药膳联合复方α-酮酸片改善维持性血液透析患者营养状况临床研究

Clinical Study on Chinese Medicine Diet Combined with Compoundα-Ketoacid Tablets in Improving Nutritional Status of Patients with Maintenance Hemodialysis

目的:观察在常规疗法基础上予中医药膳联合复方α-酮酸片对维持性血液透析脾肾阳虚证患者营养状况的改善作用。方法:将88例患者按随机数字表法分为对照组和观察组各44例。2组均予常规疗法及复方α-酮酸片治疗,观察组加予中医药膳神仙粥进行干预,2组均连续治疗8周。比较2组患者治疗前1 d及治疗8周后的血清生长激素(GH)、白蛋白(Alb)、前白蛋白(PA)、转铁蛋白(TRF)水平,营养状况[改良定量主观整体评估法(MQSGA)评分]及脾肾阳虚证症状评分。结果:治疗8周后,2组血清GH、Alb、PA、TRF水平均较治疗前1 d升高(P<0.01),观察组血清GH、Alb、PA、TRF水平均高于对照组(P<0.01)。2组MQSGA评分均较治疗前1 d降低(P<0.01),观察组MQSGA评分低于对照组(P<0.01)。2组畏寒肢冷、腰膝酸软、大便溏泄、面色?白、夜尿清长评分均较治疗前1 d减少(P<0.01),观察组5项症状评分均低于对照组(P<0.01)。结论:在常规疗法基础上加予中医药膳与复方α-酮酸片干预,能明显改善维持性血液透析脾肾阳虚证患者的营养状况和中医证候。

Objective:To observe the improvement effect of Chinese medicine diet combined with compoundα-ketoacid tablets based on routine therapy on nutritional status of patients with maintenance hemodialysis with spleen-kidney yang deficiency syndrome.Methods:A total of 88 cases of patients were divided into the control group and the observation group,44 cases in each group.Both groups were given routine therapy and treated with compoundα-ketoacid tablets,and the observation group was intervened with Chinese medicine diet Shenxian porridge.Both groups were treated for eight weeks.One day before treatment and after eight-week treatment respectively,the levels of growth hormone(GH),albumin(Alb),prealbumin(PA)and transferrin(TRF)in serum,the nutritional status[Modified Quantitative Subjective Global Assessment(MQSGA)score],and the symptom scores of spleen-kidney yang deficiency syndrome in the two groups were compared.Results:After eight-week treatment,the levels of GH,Alb,PA and TRF in serum in the two groups were increased when compared with those on one day before treatment(P<0.01),and the levels of GH,Alb,PA and TRF in serum in the observation group were higher than those in the control group(P<0.01).The MQSGA scores in the two groups were decreased when compared with those on one day before treatment(P<0.01),and the MQSGA score in the observation group was lower than that in the control group(P<0.01).The scores of chilliness and cold limbs,soreness and weakness of waist and knees,loose stool,pale complexion,long-lasting night-uria in the two groups were decreased when compared with those on one day before treatment(P<0.01),and the above five symptom scores in the observation group were lower than those in the control group(P<0.01).Conclusion:Based on routine therapy,the additional intervention of Chinese medicine diet combined with compoundα-ketoacid tablets can significantly improve the nutritional status and Chinese medicine syndromes of patients with maintenance hemodialysis with spleen-kidney yang deficiency syndrome.