大黄䗪虫胶囊联合厄贝沙坦对腹膜透析患者腹膜纤维化进程的影响

The Effect of Dahuang Zhechong Capsules Combined with Irbesartan on Peritoneal Dialysis Patients on the Process of Peritoneal Fibrosis

目的观察大黄䗪虫胶囊联合厄贝沙坦对腹膜透析临床疗效及腹膜纤维化相关指标的影响。方法选取在行CAPD治疗的70例腹透患者随机分为对照组和治疗组,每组35例患者,对照组予一体化CAPD治疗方案和厄贝沙坦口服治疗,观察组在对照组治疗基础上加用大黄䗪虫胶囊治疗,观察周期为180天,观察2组干预前后临床疗效及相关腹膜纤维化指标。结果本研究干预后治疗组中医证候积分较前明显下降(P<0.05);治疗组中医证候疗效总有效率为88.57%,对照组中医证候疗效总有效率31.42%(P<0.01);治疗组体质量下降(P<0.05),对照组无显著变化(P>0.05);干预后治疗组血压、服用降压药物种类较前下降(P<0.05);干预后治疗组BUN、Scr、β_(2)-MG指标较前下降(P<0.05);干预后治疗组D/P Cr较前下降,KT/V、总Ccr指标较前上升(P<0.05),对照组无明显变化(P>0.05);干预后治疗组血Ca上升幅度及血P、i PTH指标下降幅度明显(P<0.05);干预后治疗组HGB、ALB、PAB指标较前升高(P<0.05);干预后治疗组SGA评分降低(P<0.05);干预后治疗组TGF-β;、α-SMA、E-cadherin指标较前下降(P<0.05)。结论大黄䗪虫胶囊联合厄贝沙坦治疗可改善PD患者临床疗效,改善营养不良,改善钙磷代谢,改善患者营养状态,延缓腹膜纤维化进程。

Objective To observe the effect of Dahuang Tuochong capsules combined with irbesartan on the clinical efficacy of peritoneal dialysis and related indicators of peritoneal fibrosis.Methods 70 cases of peritoneal dialysis patients who underwent CAPD treatment in our hospital were randomly divided into control group and treatment group,with 35 patients in each group.The control group received integrated CAPD treatment plan and irbesartan oral treatment.The observation group was Dahuang Tuochong capsules on the basis of control group.The observation period was 180 days.The clinical efficacy and related peritoneal fibrosis indexes of the two groups were observed before and after intervention.Results After intervention in this study,the scores of TCM syndromes in the treatment group were significantly lower than before(P<0.05),the total effective rate of TCM syndromes in the treatment group was 88.57%,and the total effective rate of TCM syndromes in the control group was 31.42%(P<0.01),weight loss in the treatment group(P<0.05),no significant change in the control group(P>0.05),blood pressure and types of antihypertensive drugs in the treatment group decreased after the intervention(P<0.05),BUN,Scr in the treatment group after the intervention,Β2-MG index decreased compared with the previous(P<0.05),after the intervention,D/P Cr decreased in the treatment group,KT/V and total Ccr index increased compared with the previous(P<0.05),and there was no significant change in the control group(P>0.05).After the intervention,the increase in blood Ca and the decrease in blood P and i PTH indexes in the treatment group were significantly(P<0.05),the HGB,ALB,and PAB indexes in the treatment group after the intervention were higher than before(P<0.05);the treatment group after the intervention SGA score decreased(P<0.05),TGF-β1,α-SMA,and E-cadherin indexes in the treatment group decreased after intervention(P<0.05).Conclusion Dahuang Tuochong capsule combined with Irbesartan can improve the clinical efficacy of PD patients,improve malnutrition,improve calcium and phosphorus metabolism,improve patient nutritional status,and delay the process of peritoneal fibrosis.