肾衰方对维持性血液透析患者残余肾功能和营养状况的影响  

Influence of Shenshuai Formula on Maintaining the Residual Renal Function and Nutriture of Patients Underwent Hematodialysis

作　　者：迪丽努尔.吐尔洪 

机构地区：[1]新疆维吾尔自治区中医医院,新疆乌鲁木齐830000

出　　处：《河南中医》2015年第11期2710-2713,共4页Henan Traditional Chinese Medicine

基　　金：新疆医科大学科研创新基金(编号:XJC201184)

摘　　要：目的：观察肾衰方对维持性血液透析患者残余肾功能和营养状况的影响。方法：所有患者给予优质蛋白、低钠低磷饮食。采用透析器碳酸盐透析，透析液流量均为500mL·min-1，透析血流量为200～300mL·min-1，每次透析时间为4h，每周透析3次，超滤量参考千体质量。于透析后使用重组促红细胞生成素10000U皮下注射，每周1次，0．9％生理盐水100mL加左卡尼汀1g静脉滴注，每周2次。观察患者中医临床证候及各项化验指标及营养指标。结果：治疗后患者怠倦乏力、气短懒言、面色不华、恶心纳呆、畏寒肢冷、皮肤瘙痒均明显改善，与治疗前比较有统计学意义（P〈0．01）；用药3个月与用药1个月相比诸证候进一步改善，有统计学意义（P〈0．01）。血红蛋白较治疗前明显升高，有统计学意义（P〈0．01）；用药3个月较用药1个月血红蛋白明显升高，有统计学意义（P〈0．01）；尿素氮、肌酐较用药前明显降低，有统计学意义（P〈0．01）；用药3个月较用药1个月尿素氮、肌酐降低，有统计学意义（P〈0．01）；用药3个月较用药1个月血钾、血磷降低，有统计学意义（P〈0．01）Kt／v指标明显下降，有统计学意义（P〈0．01）。瘦素水平明显下降，有统计学意义（P〈0．01）；用药3个月较用药1个月瘦素水平降低，有统计学意义（P〈0．01）。主观营养评估SGA评分升高，有统计学意义（P〈0．01）。结论：肾衰方具有保护残余肾功能，增加毒素排出的作用，使维持性血液透析患者的营养状况明显改善，提高患者生存质量。Objective： To observe the influence of Shenshuai Formula on maintaining the residual renal function and nutriture of pa- tients underwent hematodialysis. Methods ： All patients were given diet of quality protein, lower natrium and lower phosphorum. Carbonate dialysis by a dialyzer was performed with rate of flow of the dialyzate 500 mL · min -1 and blood flow volume of 200 - 300 mL · min- 1 ,4 h for each dialysis,3 times per week and the Uhrafihration volume referred to dry weight. After dialysis, subcu- taneous injection of 10 000 U recombinant erythropoietin was performed, once per week, intravenous dripping of 100 mL 0.9% normal saline plus 1 g Levocarnitine, twice each week. The various indicators of TCM clinical symptoms and nutrition were ob- served. Results：There was significant improvement in the listlessness,shortness of breath,lusterless complexion,nausea and poor appetite,cold limbs and itchy skin;there was statistical significance when compared with before treatment（ P 〈 0.01 ）. The symp- toms in the 3rd month of administration got further improvement when compared the 1st month of administration,with statistical significance（ P 〈0.01 ）. The hemoglobin got increased after treatment,with statistical significance（ P 〈0.01 ）. The hemoglobin in the 3rd month of administration got marked increase compared the 1 st month of administration,with statistical significance（P 〈 0.01 ）. The urea nitrogen, creatinin, serum potassium, serium inorganic phosphorus and level of leptin greatly decreased after ad- ministration,with statistical significance （ P 〈 0.01 ）. The urea nitrogen, creatinin, serum potassium, serium inorganic phosphorus and level of leptin got decreased in the 3rd month of administration when compared with that after 1st month of administration, with statistical significance （ P 〈 O. 01 ）. The SGA score increased with statistical significance （ P 〈 0.01 ）. Conclusion ： Shenshuai Formula can protect the residual renal function,increace the dischar

关 键 词：血液透析 肾衰方 残余肾功能 营养状况 

分 类 号：R259.926[医药卫生—中西医结合]