健脾养肾益气法对维持性血液透析疲劳(脾肾气虚证)的效果

Effect of the Method of Invigorating the Spleen,Nourishing the Kidney and Replenishing Qi on Maintenance Hemodialysis Fatigue Patients(Spleen and Kidney Qi Deficiency Syndrome)

目的:探讨健脾养肾益气法对维持性血液透析疲劳患者(脾肾气虚证)的治疗作用。方法:选取本院收治的90例MHD疲劳(脾肾气虚证)患者,收治时间为2020年4月~2022年4月。采用随机数字表分组,各45例。对照组实施西医疗法,观察组实施中医健脾养肾益气法联合西医疗法。将两组治疗前后中医症状评分、疲劳度评分、营养状态、微炎症状态与不良反应作为观察指标。结果:治疗后观察组主症、次症评分和疲劳度评分均下降(P<0.05),且观察组均低于对照组(P<0.05);治疗后观察组体质量指数(BMI)、三头肌皮褶厚度(TSF)、血清前白蛋白(PA)、白蛋白(ALB)均升高(P<0.05),且观察组均高于对照组(P<0.05);治疗后两组血清肿瘤坏死因子-α(TNF-α)、Toll样坏死因子-4(TLR4)、白介素-6(IL-6)水平均下降(P<0.05),且观察组均低于对照组(P<0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:对MHD疲劳患者(脾肾气虚证)采用健脾养肾益气法治疗可减轻症状和疲劳度、改善营养状态、减轻微炎症反应,且安全。

Objective To explore the therapeutic effect of the method of invigorating the spleen,nourishing the kidney and replenishing qi on maintenance hemodialysis fatigue patients(spleen and kidney qi deficiency syndrome).Methods 90 cases of MHD fatigue(spleen and kidney qi deficiency syndrome)were selected and treated in our hospital from April 2020 to April 2022.A randomized number table was used to group,with 45 cases in each.The control group was treated with western medicine,while the observation group was treated with the combination of traditional Chinese medicine of invigorating the spleen,nourishing the kidney and replenishing qi and western medicine.The TCM symptom scores,fatigue scores,nutritional status,micro inflammatory status before and after treatment and adverse reactions of the two groups were taken as the observation indicators.Results After treatment,the scores of main symptoms,secondary symptoms and fatigue in the observation group decreased(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).After treatment,body mass index(BMI),triceps skinfold thickness(TSF),serum prealbumin(PA)and albumin(ALB)in the observation group increased(P<0.05),and the levels in the observation group were lower than those in the control group(P<0.05).After treatment,serum tumor necrosis factor after treatment-α(TNF-α),Toll like necrosis factor-4(TLR4)and interleukin-6(IL-6)in both groups were decreased(P<0.05),and the levels in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the incidences of adverse reactions between the two groups(P>0.05).Conclusion It can reduce symptoms and fatigue,improve nutritional status,and reduce micro inflammatory reaction to treat MHD fatigue patients(spleen and kidney qi deficiency syndrome)with the method of invigorating the spleen,nourishing the kidney and supplementing qi,and it is safe.