健脾益肾活血方外用穴位敷贴对维持性腹膜透析患者残余肾功能保护作用的临床观察  

Jianpiyishenhuoxue Formula for Clinical Observation of Acupoint Sticking to Maintain the Protective Effect of Residual Renal Function of CAPD Patients

作　　者：张璐芸[1] 陈万佳[1] 李交[1] 张先闻[1] 邓跃毅[1] 罗健华[1] ZHANG Luyun;CHEN Wanjia;LI Jiao(Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai,200032)

机构地区：[1]上海中医药大学附属龙华医院,上海200032

出　　处：《中国中西医结合肾病杂志》2018年第11期965-968,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：上海市卫生及计划生育委员会项目(No.20144Y0172);上海市杏林新星培养计划项目(No.ZY3-RCPY-2-2003);上海中医药大学"高峰高原学科"高水平创新团队

摘　　要：目的:观察健脾益肾活血方外用穴位敷贴对维持性腹膜透析患者残肾功能的保护作用。方法:选择在我院腹透中心行维持性腹膜透析患者共80例,按照随机数字表法随机分为试验组和对照组,每组各40例。其中试验组采用健脾益肾活血方外用穴位敷贴联合基础治疗(包括维持性腹膜透析,降压降糖治疗,补铁、促红素治疗,纠正钙磷代谢紊乱及甲旁亢等治疗);对照组采用口服健脾益肾活血方联合基础治疗(同前)。统计两组患者治疗前后残肾功能、尿量、中医证候积分、计算尿素清除指数(Kt/V),腹膜透析肌酐清除率(creatinine clearance rate,Ccr),血白蛋白、前白蛋白、血红蛋白、钙磷乘积、甲状旁腺激素、体重指标、三酰甘油、胆固醇等指标进行比较。结果:两组治疗前后残肾功能、尿量均有所下降,但差异无统计学意义(P> 0. 05),且两组RRF的差值差异亦无统计学意义(P> 0. 05);试验组中医证候有效率为37. 5%,对照组为30%,两组无明显组间差异(P> 0. 05)。治疗后,试验组患者在营养指标(血浆白蛋白、前白蛋白、血红蛋白、体重指数、三酰甘油、胆固醇)方面均无明显变化(P> 0. 05)。对照组相较于基线,在血红蛋白、前白蛋白上有所下降(P <0. 05),体重指数有所升高(P <0. 05),其余各指标在治疗前后差异无统计学意义(P> 0. 05)。两组营养指标方面在治疗后组间差异均无统计学意义(P> 0. 05)。试验组与对照组在透析充分性指标(Kt/V、腹膜透析CCr)方面,组内、组间差异均无统计学意义(P> 0. 05)。结论:健脾益肾活血外用中药穴位敷贴对腹透患者残肾功能有一定的保护作用,与口服中药汤剂比较疗效相当,且对改善患者营养状态方面有一定优势。Objective: To observe the protective effect of acupoint application of Jianpi Yishen Huoxue recipe on residual renal function in maintenance peritoneal dialysis patients. Methods: A total of 80 patients undergoing maintenance peritoneal dialysis in our hospital were selected and randomly divided into experimental group and control group with 40 cases in each group. Among them,the experimental group was treated with acupoint external application of Jianpi Yishen Huoxue recipe combined with basic therapy( including maintenance peritoneal dialysis,hypotension and hypoglycemia,iron supplementation and propofol therapy,correction of calcium and phosphorus metabolism disorder and hyperthyroidism and other treatment),the control group was treated with oral tonifying spleen,tonifying kidney and activating blood circulation prescription combined with basic treatment( same as former). RRFs,urine volume,TCM symptom score,KT/V,serum albumin,prealbumin,hemoglobin,calcium and phosphorus product,PTH,body weight,triglyceride and cholesterol were compared before and after treatment. Results: After treatment,there was no significant change in nutritional indexes( plasma albumin,prealbumin,hemoglobin,body mass index,triglyceride,cholesterol) in the experimental group( P > 0. 05). Compared with the baseline,the control group showed a decrease in hemoglobin and prealbumin( P > 0. 05),a slight increase in body mass index( P > 0. 05),and no significant difference between the other indexes before and after treatment( P > 0. 05). There was no significant difference in nutritional indexes between the two groups after treatment( P > 0. 05). There was no significant difference in dialysis adequacy index( Kt/V) and peritoneal dialysis( CCR) between the experimental group and the control group( P > 0. 05). Conclusion: Acupoint application of traditional external Chinese medicine of Jianpi Yishen Huoxue recipe has a certain protective effect on residual kidney function of patients with abdominal dialysis,which is comparable to that of oral Chi

关 键 词：穴位敷贴 腹膜透析 残肾功能 

分 类 号：R692.5[医药卫生—泌尿科学]