清热渗湿汤治疗糖尿病肾病维持性血液透析合并皮肤瘙痒的临床研究  

Clinical Study of Using Qingre Shenshi Decoction in the Treatment of Diabetic Nephropathy Combined with Skin Pruritus after Maintenance Hemodialysis

作　　者：黄小琴[1] 刘群英[1] 詹云[2] 解德琼[1] 刘丽媛 王芳[1] 袁夏禹 张映华[3] HUANG Xiaoqin;LIU Qunying;ZHAN Yun(The Second People's Hospital of Yibin City,Nephrology Department of Yibin Hospital Affilliated to West China Hospital of Sichuan University,Yibin Sichuan 644000,China;The Second People's Hospital of Yibin City\Department of Traditional Chinese Medicine,Yibin Hospital Affilliated to West China Hospital of Sichuan University,Yibin Sichuan 644000,China)

机构地区：[1]宜宾市第二人民医院·四川大学华西医院宜宾医院肾病内科,四川宜宾644000 [2]宜宾市第二人民医院·四川大学华西医院宜宾医院肾病内科中医科,四川宜宾644000 [3]宜宾市第二人民医院·四川大学华西医院宜宾医院肾病内科检验科,四川宜宾644000

出　　处：《四川中医》2022年第11期134-137,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：四川省科技厅应用基础项目(编号:2019YJ0711)蛇床子素阻断核内HMGB1释放的机制及其在肾缺血再灌注损伤的保护作用研究

摘　　要：目的:观察清热渗湿汤治疗糖尿病肾病维持性血液透析合并皮肤瘙痒的临床效果。方法:选取2020年2月~2021年2月于本院接诊的糖尿病肾病且接受维持性血液透析治疗期间合并皮肤瘙痒的患者76例,按照随机数表法分为观察组和对照组,每组38例。两组患者均接受内科基础治疗及维持血液透析治疗,其中对照组还应给予口服氯雷他定片,观察组加用清热渗湿汤治疗。观察两组症状积分评价其疗效,并于治疗前后评定改良Dou评分,测定超氧化物歧化酶(SOD)、丙二醇(MDA)、血清晚期氧化蛋白产物(AOPP)、肿瘤坏死因子α(TNF-α)、白介素8(IL-8)及白介素γ(IL-γ)水平。结果:观察组患者的临床疗效为92.11%,显著高于对照组的73.68%(P<0.05);治疗后两组改良Dou评分均降低(P<0.05),但观察组明显低于对照组(P<0.05);治疗后观察组患者SOD水平显著高于对照组,MDA、AOPP水平显著低于对照组(P<0.05);治疗后观察组患者血清TNF-α、IL-8显著低于对照组,IL-γ水平显著高于对照组(P<0.05)。结论:清热渗湿汤治疗糖尿病肾病维持性血液透析合并皮肤瘙痒,不仅能有效缓解皮肤瘙痒症状,还能降低炎症反应,改善氧化应激水平,疗效确切,具有临床应用前景。Objective:To observe the clinical curative effect of Qingre Shenshi Decoction on diabetic nephropathy combined with skin pruritus after maintenance hemodialysis.Methods:A total of 76 patients with diabetic nephropathy and skin pruritus undergoing maintenance hemodialysis in the hospital were enrolled between February 2020 and February 2021.According to random number table method,they were divided into a practice group and a controlled group,38 cases in each group.Both groups underwent basic medical treatment and maintenance hemodialysis.On this basis,the controlled group was given oral Loratadine Tablets,while the practice group was additionally given Qingre Shenshi Decoction.The scores of symptoms in both groups were observed to evaluate the curative effect.Before and after treatment,modified Dou score was evaluated.The levels of superoxide dismutase(SOD),malondialdehyde(MDA),serum advanced oxidation protein product(AOPP),tumor necrosis factorα(TNF-α),interleukin 8(IL-8)and interleukinγ(IL-γ)were detected.Results:The clinical response rate in the practice group was significantly higher than that in the controlled group(92.11%vs 73.68%)(P<0.05).After treatment,modified Dou scores in both groups were decreased(P<0.05),which were significantly lower in the practice group than the controlled group(P<0.05).After treatment,SOD level in the practice group was significantly higher than that in the controlled group,while levels of MDA and AOPP were significantly lower than those in the controlled group(P<0.05).After treatment,levels of serum TNF-αand IL-8 in the practice group were significantly lower than those in the controlled group,while IL-γlevel was significantly higher than that in the controlled group(P<0.05).Conclusion:Qingre Shenshi Decoction can not only effectively relieve skin pruritus,but also reduce inflammation response and improve oxidative stress in diabetic nephropathy combined with skin pruritus after maintenance hemodialysis,with significant curative effect.

关 键 词：清热渗湿汤 糖尿病肾病 维持性血液透析 皮肤瘙痒 炎症反应 氧化应激 

分 类 号：R259[医药卫生—中西医结合] R277.5[医药卫生—中医内科学]