尿毒营养膏对维持性血液透析营养不良患者血清瘦素水平的影响  

Effects of “Niaodu Yingyang Ointment” on serum leptin in maintenance hemodialysis patients with malnutrition

作　　者：李正胜[1] 孙波[1] 卢晶晶[1] 王泽兰[1] 谢娟[1] 黄波[1] 王叶[1] 程晓娟[1] 

机构地区：[1]贵阳中医学院第二附属医院肾内科,贵州贵阳520003

出　　处：《上海中医药杂志》2013年第10期31-33,共3页Shanghai Journal of Traditional Chinese Medicine

基　　金：贵州省中医药管理局资助项目(2011)

摘　　要：目的观察尿毒营养膏对维持性血液透析患者血清瘦素及营养状态的影响,进一步阐明瘦素与营养状态的关系。方法将60例患者随机分为治疗组和安慰剂组,每组30例。两组均予低盐、低脂、优质低蛋白、低磷、高热量饮食,积极治疗原发病及并发症,控制炎症及维持水电解质平衡,维持规律血液透析;治疗组同时予尿毒营养膏治疗,安慰剂组予尿毒营养膏安慰剂治疗。两组疗程均为6个月,观察主要症状体征、营养状况(SGA)评分以及血红蛋白、血清白蛋白、胆固醇等指标的变化情况。同时以30例健康人为健康对照组,观察维持性血液透析营养不良患者血清瘦素(IP)水平,以及治疗组和安慰剂组干预措施对其的影响。结果①治疗组治疗后主要症状体征及SGA积分明显减少(P<0.05),安慰剂组均无明显变化(P>0.05);组间治疗后比较,主要症状体征及SGA积分差异均有统计学意义(P<0.05)。②治疗组、安慰剂组血清LP水平明显高于健康对照组(P<0.05);治疗组治疗后血清LP水平显著下降(P<0.05),安慰剂组无明显变化(P>0.05);治疗组、安慰剂组试验后比较,血清LP水平差异有统计学意义(P<0.05)。③治疗后治疗组Alb、CHOL明显降低(P<0.05),安慰剂组各指标均无变化(P>0.05);组间治疗后比较,Alb、CHOL差异有统计学意义(P<0.05)。结论尿毒营养膏能够改善维持性血液透析患者的营养状态,降低瘦素水平。Objective To observe the clinical efficacy of ＂Niaodu Yingyang Ointment＂ on serum leptin （LP） and state of nutrition in maintenance hemodialysis patients, and to explain the ralationship between LP and state of nutrition. Methods Sixty cases were randomized into treatment group and placebo group, 30 cases in each group. The patients in the two groups were taken low salt, low fat, low protein, low-phosphorous and high calorie diet. The protopathy and complications were treated. Control the inflammation and maintain the water electrolyte balance, maintain the regular hematodialysis. Patients in treatment group were treated with ＂Niaodu Yingyang Ointment＂, and patients in placebo group were treated with placebo, with the course of 6 months. The symptoms and signs, SGA score, hemoglobin, ALB and cholesterol were observed. Thirty healthy patients were enrolled in control group. The serum leptin level, intervening measures in treatnlent group and placebo group were observed. Results （1） After treatment, the scores of symptoms and slgns, SGA were reduced in treatment group （ P 〈 0. 05 ） , but without significant difference in placebo group （ P 〉 0.05 ） ; There was a significant difference in scores of symptoms and signs, SGA between the two groups（ P 〈 0.05 ）. （1）The LP level in treatment group and placebo group were higher that of the control group（P 〈 0.05） ; （2） After treatment, the Alb and CHOL in treatment group were decreased markedly（ P 〈 0.05 ） , and no significant difference was found in all indicators in placebo group （P 〉 0.05 ） ; After treatment, there were significant difference in Alb and CHOL between treatment group and placebo group（P 〈 0.05 ）. Conclusion ＂Niaodu Yingyang Ointment＂ can improve the state of nutrition and decrease the LP level in maintenance hemodialysis patients.

关 键 词：慢性肾衰竭 维持性血液透析 营养不良 尿毒营养膏 瘦素 

分 类 号：R692.5[医药卫生—泌尿科学] R589.2[医药卫生—外科学]