保肾解毒汤灌肠辅助血液滤过治疗横纹肌溶解综合征致急性肾衰竭  

Treatment of Acute Renal Failure Caused by Rhabdomyolysis Syndrome by Baoshen Jiedu Decoction Enema Assisted with Hemofiltration

作　　者：耿玉安 师延刚 许智晶 齐路 崔震宇 刘瑞芳 GENG Yu'an;SHI Yangang;XU Zhijing;QI Lu;CUI Zhenyu;LIU Ruifang(The Third People's Hospital of Henan Province,Zhengzhou Henan China 450000)

机构地区：[1]河南省直第三人民医院,河南郑州450000

出　　处：《中医学报》2020年第7期1524-1528,共5页Acta Chinese Medicine

基　　金：河南省医学科技攻关计划项目(2018020580)。

摘　　要：目的:观察保肾解毒汤灌肠辅助血液滤过治疗横纹肌溶解综合征致急性肾衰竭患者的临床疗效,并观察其对患者β2-微球蛋白(β2-microglobulin,β2-MG)、肾损伤分子-1(kidney injury molecule-1,KIM-1)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)、IL-1水平的影响。方法:96例横纹肌溶解综合征致急性肾衰竭患者依据简单随机化法分为试验组(n=48)、对照组(n=48)。在常规治疗基础上,对照组给予血液滤过治疗,试验组在对照组治疗基础上给予保肾解毒汤灌肠治疗。两组患者均治疗2周。比较两组患者治疗前后病情严重程度,血清β2-MG、尿KIM-1、血清TNF-α、血清IL-6、血清IL-1水平,免疫功能:CD8^+、CD4^+、CD4^+/CD8^+水平以及两组患者治疗15 d、28 d存活率。结果:治疗后,两组患者急性生理学与慢性健康状况评分系统Ⅱ评分显著低于治疗前,且试验组低于对照组(P<0.05);两组患者血清β2-MG、尿KIM-1水平显著低于治疗前,且试验组低于对照组(P<0.05);两组患者血清TNF-α、IL-6、IL-1水平显著低于治疗前,且试验组低于对照组(P<0.05);两组患者血清CD8^+水平显著低于治疗前,且试验组低于对照组,血清CD4^+、CD4^+/CD8^+水平较治疗前增高,且试验组高于对照组(P<0.05);试验组治疗15 d、28 d存活率分别为89.58%、79.17%,高于对照组的72.92%、58.33%(P<0.05)。结论:保肾解毒汤灌肠辅助血液滤过治疗横纹肌溶解综合征致急性肾衰竭疗效显著,可显著降低患者β2-MG、KIM-1、TNF-α、IL-6、IL-1水平,改善患者肾功能,提升患者免疫功能,减轻病情程度,提高预后生存率。Objective:To observe the clinical effect of Baoshen Jiedu Decoction enema assisted with hemofiltration in the treatment of acute renal failure caused by rhabdomyolysis syndrome,and its effect on patients'levels ofβ2-microglobulin(β2-MG),kidney injury molecule-1(KIM-1),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and IL-1.Methods:96 patients with acute renal failure caused by rhabdomyolysis syndrome were divided into experimental group(n=48)and control group(n=48).On the basis of routine treatment,the control group was given hemofiltration treatment,and the experimental group was given Baoshen Jiedu Decoction enema treatment on the basis of the control group.Both groups were treated for 2 weeks.The severity of disease,serumβ2-MG,urinary KIM-1,serum TNF-α,serum IL-6,serum IL-1 level,immune function:CD8^+,CD4^+,CD4^+/CD8^+level and survival rate of 15 and 28 days after treatment were compared between the two groups.Results:After treatment,the scores of acute physiology and chronic health status scoring system II in the two groups were significantly lower than those before treatment,and the levels of serum β2-MG and urine KIM-1 in the experimental group were significantly lower than those before treatment,and the levels of serum β2-MG and urine KIM-1 in the experimental group were significantly lower than those in the control group(P<0.05);the levels of TNF-α,IL-6 and IL-1 in the two groups were significantly lower than those before treatment,and the levels in the experimental group were lower than those in the control group(P<0.05);the level of serum CD4^+,CD4^+/CD8^+in the experimental group was higher than that in the control group(P<0.05);the survival rates of the experimental group were 89.58% and 79.17%respectively after 15 and 28 days of treatment,which were higher than 72.92% and 58.33% of the control group(P<0.05).Conclusion:Baoshen Jiedu Decoction enema assisted with hemofiltration in the treatment of acute renal failure caused by rhabdomyolysis syndrome has a significant effect,which can sign

关 键 词：保肾解毒汤 横纹肌溶解综合征 急性肾衰竭 血液滤过 β2-微球蛋白 肾损伤分子-1 炎症因子 免疫功能 

分 类 号：R277.592.5[医药卫生—中医学]