参麦注射液联合西药治疗脾肾亏虚终末期肾病随机平行对照研究  

Shenmai Injection combined with Western Medicine, Spleen and Kidney Deficiency Type Continuous Ambulatory Peritoneal Dialysis Peritoneal Transport Function Randomized Controlled Study

作　　者：彭亚平 何泽云 

机构地区：[1]湖南省中医附一院肾脏内分泌科,长沙410007

出　　处：《实用中医内科杂志》2017年第6期31-34,共4页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：[目的]观察参麦注射液联合西药治疗脾肾亏虚持续非卧床腹膜透析腹膜转运功能疗效。[方法]使用随机平行对照方法,将36例住院及门诊患者按抛硬币法简单随机分为两组,Twardowski腹膜平衡试验(PET),PET前夜行标准持续非卧床腹膜透析,腹透液存留8~12h;取坐位,引流出前腹透液,完成引流后卧位,将2L 1.5%葡萄糖腹透液注入腹腔;分别在0h、2h、4h留取腹透液并2h留取血液,检测尿素氮、肌酐、葡萄糖,最后放出腹透液,称量腹透液排出量;治疗前后行PET试验,测定4h腹透液肌酐与2h血肌酐比值(D/P0);超滤量(UF):充分引流透出液,准确计算每一透析周期透出液量与入液量差值为净出超量,观察净超滤量变化;留取24h尿液及24h腹透液,查尿肾功能、腹透液肌酐、尿素,称量体重,尿量、脱水量,根据尿素清除指数(总KT/V)和每周肌酐清除率(TCcr)(L/周)及各组腹膜转运功能;控制血压血糖、纠正贫血、纠正酸中毒电解质紊乱、加强营养等,根据肾功能、水肿及24h出入水量,调整腹膜透析的剂量及浓度。白天只在更换透析液的短暂时间内不能自由活动,其他时间可自由活动或从事日常工作。对照组18例维持透析及常规血透用药。治疗组18例静注参麦注射液,50m L/次,1次/d;其他治疗同对照组。连续治疗14d为1疗程。观测临床症状、Hb、ALB、Cr、PTH、D/P0比值、超滤量、总KT、总Ccr、尿量、腹膜转运功能改变、不良反应。治疗1疗程,判定疗效。[结果]Hb、Cr、Alb、PTH两组均有改善(P<0.05),治疗组改善优于对照组(P<0.05)。D/P0比值、超滤量、总KT/V、总Ccr、尿量两组均有改善(P<0.05),治疗组改善优于对照组(P<0.05)。两组腹膜溶质清除指数均无明显改变(P>0.05)。[结论]参麦注射液联合西药治疗脾肾亏虚型持续非卧床腹膜透析腹膜转运功能疗效满意,无严重不良反应,值得推广。[Objective] To observe Shenmai injection combined with western medicine, spleen and kidney deficiency type continuous ambulatory peritoneal dialysis peritoneal transport function effect. [Methods] random parallel control method, 36 patients hospitalized and outpatients by a coin toss method is simple randomized into two groups. The control group, 18 patients twardowski doctors peritoneal equilibration test （PET）, PET before nocturnal standard continuous ambulatory peritoneal dialysis, dialysate remaining 8~ 12h; sitting, drained dialysate ago, after the completion of drainage supine, will 2L 1.5% dextrose dialysate intraperitoneal injection; respectively at Oh, 2h, 4h 2h specimens dialysate and blood specimens, specimens of sample line urea nitrogen, creatinine, glucose testing, the final release of dialysate, weighing peritoneal dialysis liquid discharge amount. Before and after treatment PET line test, measurement and 2h 4h dialysate creatinine creatinine ratio （D/P0）; uhrafihration （UF）： adequate drainage of dialysate, to accurately calculate the amount of each dialysis period and into the dialysate fluid volume the difference between the net excess of observed changes in the net ultrafiltration volume; specimens 24h and 24h urine dialysate, check urine kidney function, dialysate creatinine, urea, weighed, urine output, the amount of dehydration, according to urea clearance index （total KT/V） and weekly ereatinine clearance （TCer） （L/week） and each group of peritoneal transport function. Blood pressure, blood sugar control, correct anemia, electrolyte imbalance correction of acidosis, nutrition, etc., according to renal function, edema and 24h access to water, adjust the dose of peritoneal dialysis and concentration. Daytime only within replacement dialysate short time can not move freely, while at other times can be freely or engage daily work. Treatment group, 18 patients intravenous Injection in, 50 mL/times, 1 times/d, intravenously; other treatment with the control group. 14d for

关 键 词：持续非卧床腹膜透析 腹膜转运功能 参麦注射液 脾肾亏虚 Hb ALB Cr PTH D/P0比值 超滤量 总KT 总Ccr 尿量 中西医结合治疗 随机平行对照研究 

分 类 号：R259.414[医药卫生—中西医结合]