Objective:To investigate the clinical efficacy and safety of alprostadil combined with Bailing Capsule in the treatment of chronic renal failure,and the influence of alprostadil combined with Bailing Capsule on residu...Objective:To investigate the clinical efficacy and safety of alprostadil combined with Bailing Capsule in the treatment of chronic renal failure,and the influence of alprostadil combined with Bailing Capsule on residual renal function,renal hemodynamics,immune indexes and nutritional status.Methods 86 patients with chronic renal failure(CRF)hospitalized in Wuhan integrated traditional Chinese and Western Medicine Hospital Affiliated to Tongji Medical College of Huazhong University of science and technology from January 2018 to June 2019 were selected as the study objects.They were randomly divided into control group and case group with 43 cases in each group.Two groups were given peritoneal dialysis treatment,the control group was given bailing capsule,the case group was given alprostadil injection on the basis of the control group.To observe the clinical effect of the two groups before and after treatment,and the changes of residual renal function,renal hemodynamics,immune index and nutritional status.Results The total effective rate of the case group was 97.68%,higher than 83.73%of the control group,the difference was statistically significant(P<0.05).After treatment,the levels of bun,SCR,GFR,24h urinary protein quantity,resistance index,CRP,IL-6,TNF,CD8+and SGA in the two groups were lower than those before treatment;the levels of renal blood flow,RRF,CD3+,CD4+,ALB,PA,TRF and Hb were higher than those before treatment;moreover,the improvement of serum inflammatory cytokines,residual renal function and renal hemodynamic indexes,immune indexes and nutritional status in the case group were significant The difference was statistically significant(P<0.05).The incidence of adverse reactions in the control group was 16.28%,higher than 6.98%in the case group,with no significant difference(P>0.05).Conclusion Alprostadil combined with Bailing capsule can significantly improve the residual renal function,hemodynamics,immune index,reduce the degree of inflammatory response in patients with chronic renal failure.展开更多
Objective: To evaluate whether the combination of Uremic clearance granule with Alprostadil is superior to Alprostadil alone for CRF. Methods: Relevant RCTs were searched through March 2019. Data were analyzed by Stat...Objective: To evaluate whether the combination of Uremic clearance granule with Alprostadil is superior to Alprostadil alone for CRF. Methods: Relevant RCTs were searched through March 2019. Data were analyzed by Stata 15.0. Results: Nine articles involving 726 patients were enrolled in this study. Meta-analysis showed that the total effective rate [OR = 3.68 (2.44, 5.55), P < 0.001], Scr [SMD =-2.34 (-3.49,-1.19), P < 0.001], BUN [SMD =-1.80 (-2.73,-0.87), P < 0.001], Ccr [SMD = 0.71 (0.44, 0.97), P < 0.001] were better in the experimental group. But there were no significant difference in UA, CysC, 24h-Upro and incidence of adverse reactions (all P > 0.05) between two groups. No serious adverse reactions were found. Conclusions: The effect of the integrated medicine on CRF was better than Alprostadil alone. Uremic clearance granule is safe and has no obvious adverse reactions.展开更多
Background The role of alprostadil and statins in contrast-induced acute kidney injury （CI-AKI） is controversial. The purpose of this study was to explore the efficacy of combined therapy with alprostadil and statin...Background The role of alprostadil and statins in contrast-induced acute kidney injury （CI-AKI） is controversial. The purpose of this study was to explore the efficacy of combined therapy with alprostadil and statins in protecting renal function and preventing contrast-induced nephropathy （CIN） in patients undergoing coronary angiography. Methods A total of 156 consecutive patients with mild to moderate renal failure who underwent coronary angiography were enrolled in our study, and randomly categorized into two groups. In the statins group, 80 patients were treated with statins before and after coronary angiography. In the alprostadil plus statins group, 76 patients were treated with statins and alprostadil before and after coronary angiography. Serum creatinine （SCr）, serum cystatin （CysC） and neutrophil gelatinase-associated lipocalin （NGAL） were detected after administration of contrast media, and adverse events were evaluated within six months. Results In both groups, the SCr, CysC and NGAL significantly increased after coronary angiography and peaked at 48, 24 and 6 hours, respectively. SCr, CysC and NGAL were significantly lower in the alprostadil plus statins group than in the statins group （P〈0.05）. The incidence of CIN in the alprostadil plus statins group was slightly lower than in the statins group. The incidence of adverse events within six months in the alprostadil plus statins group was significantly lower than in the statins group （P=0.034）. Conclusions Intravenous alprostadil in combination with oral statins is superior to statins alone for protecting renal function in patients with mild to moderate renal dysfunction who undergo coronary angiography, and can reduce the incidence of adverse events seen within six months.展开更多
目的 观察在常规慢性充血性心力衰竭（CHF）治疗基础上联合应用前列地尔对患者心功能改善情况，进一步探讨影响慢性充血性心力衰竭（心衰）患者预后的危险因素。方法 选择2013年5月~2014年6月在烟台市莱阳中心医院心内科住院的CHF患者13...目的 观察在常规慢性充血性心力衰竭（CHF）治疗基础上联合应用前列地尔对患者心功能改善情况，进一步探讨影响慢性充血性心力衰竭（心衰）患者预后的危险因素。方法 选择2013年5月~2014年6月在烟台市莱阳中心医院心内科住院的CHF患者130例，其中男性45例，女性85例，年龄53~79岁（68.5±7.8）岁。随机分为2组：对照组（n=65）和治疗组（n=65），对照组行常规心衰药物治疗，治疗组在此基础上联合应用前列地尔制剂10 μg，1/日，连用7 d。比较2组治疗前后6 min步行试验距离（6MWD）、血浆氨基末端脑钠肽前体（NT-proBNP）水平、住院时间、左室射血分数（LVEF）、左室短轴缩短率（FS）、左室舒张末期内径（LVEDD）及左室收缩末期内径（LVESD）的变化。受试者随访120 d，记录2组因心衰进展再入院治疗患者例数及时间。结果 与对照组比较，治疗组治疗后6MWD距离增加，NT-proBNP水平下降，[（359.9±144.4）m vs. （414.9±145.1）m]、[（3120.0±1811.6）ng/L vs. （2350.1±1731.1）ng/L]，差异有统计学意义（P均＜0.05）。并且治疗组第一次住院时间短于对照组[（11.2±2.6）d vs.（12.3.±3.5）d]，差异有统计学意义（P＜0.05）。与对照组治疗后比较，治疗组LVEF、FS提高，LVEDD缩小，[（42.6±7.9）% vs. （45.7±7.7）%]、[（33.3±4.1）% vs. （35.1±4.3）%]、[（52.3±5.8）mm vs. （49.9±6.0）mm]，差异有统计学意义（P＜0.05）。随访120 d，共有26例患者因心衰进展恶化再次住院治疗，其中对照组15例，治疗组11例，治疗组心衰进展恶化再入院间隔时间长于对照组，[（101.6±19.0）d vs. （69.5±16.0）d]，差异有统计学意义（P＜0.01）。NT-proBNP水平（RR=7.395，95%CI：1.881～29.073）及合并COPD（RR=7.120，95%CI：2.762～18.349）是心衰患者病情进展的危险因素，常规治疗基础上应用前列地尔可能会改善心衰患者的预后（RR=0.253，95%CI：0.096～0.666）。结论 CHF患者常规药物治疗基础上联合应用前列地尔制剂可进一步改善心功能及预后。展开更多
基金National Natural Science Foundation of China(No.81770679)
文摘Objective:To investigate the clinical efficacy and safety of alprostadil combined with Bailing Capsule in the treatment of chronic renal failure,and the influence of alprostadil combined with Bailing Capsule on residual renal function,renal hemodynamics,immune indexes and nutritional status.Methods 86 patients with chronic renal failure(CRF)hospitalized in Wuhan integrated traditional Chinese and Western Medicine Hospital Affiliated to Tongji Medical College of Huazhong University of science and technology from January 2018 to June 2019 were selected as the study objects.They were randomly divided into control group and case group with 43 cases in each group.Two groups were given peritoneal dialysis treatment,the control group was given bailing capsule,the case group was given alprostadil injection on the basis of the control group.To observe the clinical effect of the two groups before and after treatment,and the changes of residual renal function,renal hemodynamics,immune index and nutritional status.Results The total effective rate of the case group was 97.68%,higher than 83.73%of the control group,the difference was statistically significant(P<0.05).After treatment,the levels of bun,SCR,GFR,24h urinary protein quantity,resistance index,CRP,IL-6,TNF,CD8+and SGA in the two groups were lower than those before treatment;the levels of renal blood flow,RRF,CD3+,CD4+,ALB,PA,TRF and Hb were higher than those before treatment;moreover,the improvement of serum inflammatory cytokines,residual renal function and renal hemodynamic indexes,immune indexes and nutritional status in the case group were significant The difference was statistically significant(P<0.05).The incidence of adverse reactions in the control group was 16.28%,higher than 6.98%in the case group,with no significant difference(P>0.05).Conclusion Alprostadil combined with Bailing capsule can significantly improve the residual renal function,hemodynamics,immune index,reduce the degree of inflammatory response in patients with chronic renal failure.
文摘Objective: To evaluate whether the combination of Uremic clearance granule with Alprostadil is superior to Alprostadil alone for CRF. Methods: Relevant RCTs were searched through March 2019. Data were analyzed by Stata 15.0. Results: Nine articles involving 726 patients were enrolled in this study. Meta-analysis showed that the total effective rate [OR = 3.68 (2.44, 5.55), P < 0.001], Scr [SMD =-2.34 (-3.49,-1.19), P < 0.001], BUN [SMD =-1.80 (-2.73,-0.87), P < 0.001], Ccr [SMD = 0.71 (0.44, 0.97), P < 0.001] were better in the experimental group. But there were no significant difference in UA, CysC, 24h-Upro and incidence of adverse reactions (all P > 0.05) between two groups. No serious adverse reactions were found. Conclusions: The effect of the integrated medicine on CRF was better than Alprostadil alone. Uremic clearance granule is safe and has no obvious adverse reactions.
文摘Background The role of alprostadil and statins in contrast-induced acute kidney injury （CI-AKI） is controversial. The purpose of this study was to explore the efficacy of combined therapy with alprostadil and statins in protecting renal function and preventing contrast-induced nephropathy （CIN） in patients undergoing coronary angiography. Methods A total of 156 consecutive patients with mild to moderate renal failure who underwent coronary angiography were enrolled in our study, and randomly categorized into two groups. In the statins group, 80 patients were treated with statins before and after coronary angiography. In the alprostadil plus statins group, 76 patients were treated with statins and alprostadil before and after coronary angiography. Serum creatinine （SCr）, serum cystatin （CysC） and neutrophil gelatinase-associated lipocalin （NGAL） were detected after administration of contrast media, and adverse events were evaluated within six months. Results In both groups, the SCr, CysC and NGAL significantly increased after coronary angiography and peaked at 48, 24 and 6 hours, respectively. SCr, CysC and NGAL were significantly lower in the alprostadil plus statins group than in the statins group （P〈0.05）. The incidence of CIN in the alprostadil plus statins group was slightly lower than in the statins group. The incidence of adverse events within six months in the alprostadil plus statins group was significantly lower than in the statins group （P=0.034）. Conclusions Intravenous alprostadil in combination with oral statins is superior to statins alone for protecting renal function in patients with mild to moderate renal dysfunction who undergo coronary angiography, and can reduce the incidence of adverse events seen within six months.
文摘目的 观察在常规慢性充血性心力衰竭（CHF）治疗基础上联合应用前列地尔对患者心功能改善情况，进一步探讨影响慢性充血性心力衰竭（心衰）患者预后的危险因素。方法 选择2013年5月~2014年6月在烟台市莱阳中心医院心内科住院的CHF患者130例，其中男性45例，女性85例，年龄53~79岁（68.5±7.8）岁。随机分为2组：对照组（n=65）和治疗组（n=65），对照组行常规心衰药物治疗，治疗组在此基础上联合应用前列地尔制剂10 μg，1/日，连用7 d。比较2组治疗前后6 min步行试验距离（6MWD）、血浆氨基末端脑钠肽前体（NT-proBNP）水平、住院时间、左室射血分数（LVEF）、左室短轴缩短率（FS）、左室舒张末期内径（LVEDD）及左室收缩末期内径（LVESD）的变化。受试者随访120 d，记录2组因心衰进展再入院治疗患者例数及时间。结果 与对照组比较，治疗组治疗后6MWD距离增加，NT-proBNP水平下降，[（359.9±144.4）m vs. （414.9±145.1）m]、[（3120.0±1811.6）ng/L vs. （2350.1±1731.1）ng/L]，差异有统计学意义（P均＜0.05）。并且治疗组第一次住院时间短于对照组[（11.2±2.6）d vs.（12.3.±3.5）d]，差异有统计学意义（P＜0.05）。与对照组治疗后比较，治疗组LVEF、FS提高，LVEDD缩小，[（42.6±7.9）% vs. （45.7±7.7）%]、[（33.3±4.1）% vs. （35.1±4.3）%]、[（52.3±5.8）mm vs. （49.9±6.0）mm]，差异有统计学意义（P＜0.05）。随访120 d，共有26例患者因心衰进展恶化再次住院治疗，其中对照组15例，治疗组11例，治疗组心衰进展恶化再入院间隔时间长于对照组，[（101.6±19.0）d vs. （69.5±16.0）d]，差异有统计学意义（P＜0.01）。NT-proBNP水平（RR=7.395，95%CI：1.881～29.073）及合并COPD（RR=7.120，95%CI：2.762～18.349）是心衰患者病情进展的危险因素，常规治疗基础上应用前列地尔可能会改善心衰患者的预后（RR=0.253，95%CI：0.096～0.666）。结论 CHF患者常规药物治疗基础上联合应用前列地尔制剂可进一步改善心功能及预后。
