参苓白术散加味对持续性不卧床腹膜透析患者营养不良的影响  

Effect of Shenling Baizhu Powder on Malnutritional Status in Continuous Ambulatory Peritoneal Dialysis Patients

作　　者：张建 吕勇[2] ZHANG Jian;LV Yong(Anhui University of Chinese Medicine Anhui Hefei 230038,China;The First Affiliated Hospital of Anhui University of Chinese Medicine Anhui Hefei 230031,China)

机构地区：[1]安徽中医药大学,安徽合肥230038 [2]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《中医药临床杂志》2018年第12期2278-2282,共5页Clinical Journal of Traditional Chinese Medicine

摘　　要：目的:观察参苓白术散加味对持续性不卧床腹膜透析(CAPD)患者营养状况的影响。方法:将60例CAPD伴营养不良患者随机分成2组,2组常规治疗相同,治疗组加服参苓白术散加味组方的中药。治疗周期为12周,采用改良主观综合性营养评估法(MQSGA)及检测治疗前后患者的血红蛋白(HGB)、血浆白蛋白(ALB)、前白蛋白(PA)、超敏C反应蛋白(hs-CRP)和腹膜透析总尿素清除指数(KT/V),观察治疗前后患者主要症状积分变化。结果:在维持总体透析效能的前提下,治疗组治疗后ALB、PA水平较治疗前提高(P<0.05),hs-CRP水平较治疗前降低(P<0.05),HGB变化不显著(P>0.05),食少纳呆、恶心呕吐、脘腹胀满、肢体困重临床症状积分较治疗前降低(P<0.05),而疲倦乏力、大便不实临床症状积分变化不显著(P>0.05);对后患者的血红蛋白(HGB)、血浆白蛋白(ALB)、前白蛋白(PA)、超敏C反应照组治疗前后上述指标变化不显著(P>0.05),两组MQSGA评分均较治疗前降低(P<0.05),而两组KT/V值较治疗前变化不显著(P>0.05)。组间比较,治疗前各组上述指标比较均无显著差异(P>0.05);治疗后治疗组与对照组比较,Alb、PA水平有显著提高(P<0.05),MQSGA评分、hs-CRP水平显著降低(P<0.05),HGB、KT/V值无显著变化(P>0.05),食少纳呆、恶心呕吐、脘腹胀满、肢体困重临床症状积分较对照组显著降低(P<0.05),疲倦乏力、大便不实临床症状积分无显著变化(P>0.05)。结论:参苓白术散加味有助于改善CAPD患者的营养不良。Objective: To explore the effects of Shenling Baizhu powder on nutritional status of patients with continuous ambulatory peritoneal dialysis(CAPD)patients.Methods: 60 CAPD patients with malnutrition were randomly divided into treatment group and control group.On the basis of routine treatment,treatment group treated with herbs for invigorating the spleen and removing blood stasis,the treatment period was 12 weeks.Main symptom integral,MQSGA,HGB,ALB,PA,Hs-CRP and KT/V were detected to evaluate the malnutritional status.Results: On the premise of maintain the overall efficiency of the dialysis,comparison before and after treatment,the levels of ALB and PA were increased obviously after the treatment in treatment group(P<0.05),hs-CRP was decreased(P<0.05),HGB was increased not obviously(P>0.05),eat less,nausea and vomiting,abdominal distension,trapped limb these clinical symptom scores were decreased(P<0.05),but tired weakness,constipation,lumbar debility these clinical symptom scores were decreased not obviously(P>0.05).There was no significantly difference in control group before and after treat ment(P>0.05).MQSGA scores of two groups were decreased than before treatment(P<0.05),but KT/V without change(P>0.05).There was no significantly difference between the groups before treatment.Compared with the control group,the level of ALB and PA in the treatment group with treatment w ere significantly increased(P<0.05),MQSGA and hsCRP were decreased obviously(P<0.05),HGB and KT/V without increased(P>0.05).Eat less,nausea and vomiting,abdominal distension,trapped limb these clinical symptom scores were decreased obviously(P<0.05),but tired weakness,constipation,lumbar debility these clinical symptom scores were decreased not obviously(P>0.05).Conclusion: Subtract Shenling Baizhu powder can improve the nutritional status in CAPD patients.

关 键 词：CAPD 参苓白术散 健脾化湿祛瘀法 营养不良 

分 类 号：R259[医药卫生—中西医结合]