祛风固肾汤对血液透析皮肤瘙痒患者钙磷代谢、血清IL-31、CRP水平的影响

Effect of Qufeng Gushen Decoction on calcium and phosphorus metabolism,serum IL-31,CRP levels in patients with skin pruritus undergoing hemodialysis

目的探讨祛风固肾汤对血液透析皮肤瘙痒患者钙磷代谢、血清白细胞介素-31(IL-31)、C反应蛋白(CRP)水平的影响。方法选择2019年4月至2022年4月安康市中医医院高新分院肾病—血液净化中心收治的100例血液透析皮肤瘙痒患者纳入研究,采用随机数表法将患者分为观察组和对照组各50例。对照组患者给予常规药物治疗,观察组患者在此基础上联合祛风固肾汤治疗,均治疗28 d。比较两组患者治疗前后的皮肤瘙痒情况、钙磷代谢[血钙(Ca)、血磷(P)、甲状旁腺素(iPTH)]和炎症因子[IL-31、CRP、肿瘤坏死因子-α(TNF-α)]水平,并统计其不良反应发生情况。结果治疗后,两组患者的瘙痒程度、瘙痒频率、瘙痒部位评分均降低,且观察组分别为(1.21±0.18)分、(0.89±0.11)分、(1.03±0.17)分,明显低于对照组的(1.98±0.21)分、(1.41±0.18)分、(1.73±0.19)分,差异均有统计学意义(P<0.05);治疗后,两组患者的Ca水平均升高,且观察组为(3.24±0.37)mmol/L,明显高于对照组的(2.61±0.32)mmol/L,而P和iPTH水平明显降低,且观察组分别为(1.02±0.12)mmol/L、(181.14±17.45)ng/L,明显低于对照组的(1.42±0.11)mmol/L、(194.31±17.89)ng/L,差异均有统计学意义(P<0.05);治疗后,两组患者的IL-31、CRP、TNF-α均降低,且观察组分别为(81.34±7.21)pg/L、(3.10±0.32)mg/L、(78.31±9.21)pg/L,明显低于对照组的(97.31±7.24)pg/L、(4.21±0.30)mg/L、(97.82±9.42)pg/L,差异均有统计学意义(P<0.05);治疗期间,观察组患者的不良反应总发生率为4.00%,略低于对照组8.00%,但差异无统计学意义(P>0.05)。结论祛风固肾汤可有效缓解血液透析患者皮肤瘙痒症状,调节钙磷代谢水平,抑制机体炎症反应,安全性高,具有临床应用价值。

Objective To investigate the effects of Qufeng Gushen Decoction on calcium and phosphorus metabolism,serum interleukin-31(IL-31),C-reactive protein(CRP)levels in patients with skin pruritus undergoing hemodialysis.Methods One hundred patients with skin pruritus on hemodialysis admitted to Nephropathy—Blood Purification Center,High-tech Branch of Ankang City Hospital of Traditional Chinese Medicine from April 2019 to April 2022 were selected for the study.The patients were divided into observation group and control group(each with 50 patients)using a random number table method.Patients in the control group were treated with conventional drugs,while patients in the observation group were treated with Qufeng Gushen Decoction on this basis for 28 days.The skin itching,calcium and phosphorus metabolism[blood calcium(Ca),blood phosphorus(P),parathyroid hormone(iPTH)],and inflammatory factors[IL-31,CRP,tumor necrosis factor-α(TNF-α)]levels of the two groups of patients before and after treatment were compared,and the occurrence of adverse reactions was statistically analyzed.Results After treatment,the itching degree,itching frequency,and itching site scores of the two groups of patients decreased,and the scores of the observation group were(1.21±0.18)points,(0.89±0.11)points,and(1.03±0.17)points,which were significantly lower than(1.98±0.21)points,(1.41±0.18)points,and(1.73±0.19)points of the control group(P<0.05).After treatment,the level of Ca in both groups increased,and the level of Ca in the observation group was(3.24±0.37)mmol/L,which was significantly higher than(2.61±0.32)mmol/L in the control group;the levels of P and iPTH were significantly lower,and the levels in the observation group were(1.02±0.12)mmol/L and(181.14±17.45)ng/L,which were significantly lower than(1.42±0.11)mmol/L and(194.31±17.89)ng/L in the control group,with statistically significant differences(P<0.05).After treatment,the levels of IL-31,CRP,and TNF-αin both groups decreased,and the levels were(81.34±7.21)pg/L,(3.10±0.32)mg/L,and(78.31±9.21)pg/L in the observation group,significantly lower than(97.31±7.24)pg/L,(4.21±0.30)mg/L,and(97.82±9.42)pg/L in the control group,with statistically significant differences(P<0.05).During the treatment period,the total incidence of adverse reactions in the observation group was slightly lower than that in the control group(4.00%vs 8.00%),but the difference was not statistically significant(P>0.05).Conclusion Qufeng Gushen Decoction can effectively alleviate skin itching symptoms in patients undergoing hemodialysis,regulate calcium and phosphorus metabolism levels,inhibit inflammatory reactions in the body,with high safety,which has clinical application value.