三仙补肾方联合西医治疗糖尿病肾衰竭透析后患者的价值评估  

Evaluation of the value of Sanxianbushen decoction combined with Western medicine in the treatment of patients with diabetic renal failure after dialysis

作　　者：李莉敏 葛玉琛 刘哲 王凤格 潘俊霞 LI Limin;GE Yuchen;LIU Zhe(Laiyuan County Hospital,Hebei,Laiyuan 074300,China)

机构地区：[1]河北省涞源县医院,074300 [2]河北省唐山海港经济开发区医院 [3]河北省定州市人民医院

出　　处：《河北医药》2018年第22期3414-3417,共4页Hebei Medical Journal

基　　金：河北省中医药管理局项目(编号:13010520181262)

摘　　要：目的探讨三仙补肾方联合西医治疗糖尿病肾衰竭透析后患者的价值评估。方法 120例糖尿病肾衰竭患者随机分为对照组和观察组,每组60例。对照组采用维持性血液透析联合西医治疗,在此基础上观察组辅助三仙补肾方治疗,比较2组患者的临床疗效、血清微炎症水平及氧化应激状态[白介素-1β(IL-1β)、IL-6、IL-17、IL-22、肿瘤坏死因子-α(TNF-α)、转化生长因子-β1(TGF-β1)、血清淀粉样蛋白酶A(SAA)、丙二醛(MDA)、血清晚期蛋白氧化产物(AOPPs)、超氧化物歧化酶(SOD)]、肾功能及血糖指标变化[尿素氮(BUW)、24 h尿蛋白、血清肌酐(Scr)、空腹血糖(BFG)、餐后2 h血糖(2 h PG)]、中医证候改善情况。结果观察组治疗有效率明显高于对照组,差异有统计学意义(P <0. 05);观察组治疗后IL-1β、IL-6、IL-17、IL-22、TNF-α、TGF-β1、SAA、MDA、AOPPs水平与对照组比较明显降低,而SOD水平较对照组明显升高,差异均有统计学意义(P <0. 05);观察组治疗后BUN、24 h尿蛋白、Scr、FBG、2 h PG与对照组相比明显改善,差异均有统计学意义(P <0. 05);观察组治疗后倦怠乏力、肢体麻木、食少纳呆、气短懒言、头晕头痛、腰痛、肌肤甲错、自汗、大便干结等中医证候积分与对照组相比明显降低,差异均有统计学意义(P <0. 05)。结论三仙补肾方联合西医治疗糖尿病肾衰竭透析后患者的价值显著,能有效改善机体微炎症状态,减轻氧化应激反应,改善血糖及肾功能各指标,促进机体代谢水平的恢复,缓解临床症状,对延长患者生命周期及改善透析后生活质量有积极的临床意义。Objective To evaluate the value of Sanxianbushen decoction combined with Western medicine in the treatment of patients with diabetic renal failure after dialysis.Methods A total of 120 patients with diabetic renal failure were randomly divided into the control group(n=60)and the observation group(n=60).The patients in the control group were treated with maintenance hemodialysis(MHD)combined with Western medicine.On this basis,those in the observation group were supplemented with Sanxianbushen decoction.The clinical efficacy,serum microinflammation level and oxidative stress status[interleukin-1β(IL-1β),IL-6,IL-17,IL-22,tumor necrosis factor-α(TNF-α),transforming growth factor-β1(TGF-β1),serum amyloid protease A(SAA),malondialdehyde(MDA),serum advanced oxidation protein products(AOPPs),and superoxide dismutase(SOD)],changes in renal function and blood glucose levels[blood urea nitrogen(BUN),24h urine protein,serum creatinine(Scr),fasting blood glucose(FBG),and 2h postprandial blood glucose(2h-PPG)],and amelioration of TCM syndrome were observed and compared between the two groups.Results The effective rate in observation group was significantly higher than that in control group(P<0.05).The levels of IL-1β,IL-6,IL-17,IL-22,TNF-α,TGFβ1,SAA,MDA and AOPPs in observation group were significantly decreased,and the levels of SOD were significantly increased,as compared with those in the control group(P<0.05).After treatment,BUN,24h urine protein,Scr,FBG,and 2h-PPG in observation group were significantly improved,as compared with those in control group(P<0.05).In the observation group,the scores of TCM syndromes,including fatigue,limb numbness,lack of appetite,emotional numbness,lassitude,shortness of breath and want of speech,dizziness,headache,low back pain,skin malocclusion,spontaneous sweating,and dry stool were significantly lower than those in control group(P<0.05).Conclusion Sanxianbushen decoction combined with western medicine has obvious therapeutic effects on diabetic renal failure after dialysis,which

关 键 词：糖尿病肾衰竭 维持性血液透析 三仙补肾方 西医治疗 价值评估 

分 类 号：R587.24[医药卫生—内分泌]