高通量透析对维持性血液透析患者中医证候的影响  

The Influnence of High-flux Hemodialysis on TCM Syndrome in Maintenance Hemodialysis Patients

作　　者：龚春水[1] 沈淑琼[1] 蔡辉[1] 梁萌[1] 许树根[1] 孙琪[1] 胡玉清[1] 

机构地区：[1]厦门大学附属成功医院(解放军第174医院)肾内科,厦门361003

出　　处：《中国中西医结合肾病杂志》2011年第11期988-990,共3页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：厦门市社会发展科技计划项目(No.3502Z20084032);2010年度南京军区医学科技创新项目(No.10MA064)

摘　　要：目的:观察高通量透析(HFHD)对维持性血液透析(MHD)患者中医证候以及营养不良和微炎症状态的影响。方法:采用随机对照,A组应用高通量透析,B组应用普通透析,比较治疗前及治疗后中医证候积分(TCM syndromes cores),及治疗后血红蛋白(Hb、血浆白蛋白(Alb)、前白蛋白(PAB)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、肱三头肌皮皱厚度(TSF)、上臂中段肌肉周径(MAMC)等指标变化。结果:(1)治疗4周、8周后,A组中医实证积分、虚证积分、总积分与治疗前相比有降低趋势,但差异尚无统计学意义(P>0.05)。12周后与治疗前比较,A组中医证候积分均明显下降(P<0.05),B组证候积分与治疗前相比差异无统计学意义(P>0.05)。治疗12周A组临床疗效优于B组(P<0.01)。(2)治疗12周时,A组Hb、Alb、PAB明显上升(P<0.05),hs-CRP、IL-6、TNF-α水平与治疗前相比明显下降(P<0.01),TSF升高(P<0.01),MAMC有升高趋势,但差异尚无统计学意义。B组患者Hb、Alb、PAB、hs-CRP、IL-6、TNF-α水平与治疗前相比差异无统计学意义(P>0.05),两组治疗12周后,A组IL-6水平低于B组患者(P<0.05)。结论:HFHD可减少MHD患者中医证候临床积分,改善患者营养不良及微炎症状态。Objective：To observe the effect of high -flux hemodialysis（HFHD） on TCM syndrome scores and malnutrition - inflammation status in maintenance hemodialysis patients. Methods：Fifty cases of chronic hemodialysis patients were randomly di- vided into treatment group（ group A） and control group（ group B）. Each group had 25 patients and they were followed up for 12 weeks. The high - flux polysulphone dialyzer was used in group A, while the low - flux common dialyzer was used in group B. Concen- tration of TCM syndrome scores were determined pre - dialysis after treatment. Serum concentration of hemoglobin （ HGB）, albumin （ Alb）, prealbumin （ PAB）, high - sensitivity C - reactive protein （ hs - CRP）, interleukin - 6 （ IL - 6 ）, tumor necrosis factor - ct （TNF- or）and triceps skin -fold thickness（TSF） ,mid -arm muscle circumference（MAMC） were determined pre -dialysis after treatment. Results： （ 1 ） 4 weeks and 8 weeks after therapy, the deficiency score,the excess score and the total score were decreased in group A, but the difference was not statistically significant. 12 weeks after therapy,those score were markedly reduced in group A, but those index had no apparent changes in group B. （2） 12 weeks after therapy, the level of HGB, ALB, PAB, TSF were markedly el- vated and the level of hs - CRP,IL - 6,TNF - a were markedly reduced in group A. but those index had no apparent changes in group B. Conclusion：HFHD is highly efficacious for reducing TCM syndrome scores and improving nutritional status and microinflammatory state in MHD patients.

关 键 词：高通量透析 中医证候积分 营养不良-炎症复合体综合征 

分 类 号：R259[医药卫生—中西医结合]