补肾健骨方对维持性血液透析患者肾性骨病与血清Klotho蛋白水平的影响  

Effects of BushenJiangu Decoction on renal osteopathy and serum Klotho protein level among maintenance hemodialysis patients

作　　者：于思明[1] 郭丹丹[1] 代丽娟[1] 裴春鹏[1] 董柏涵 Yu Siming;Guo Dandan;Dai Lijuan;Pei Chunpeng;Dong Bohan(Heilongjiang University of Traditional Chinese Medicine,Harbin 150040,China;不详)

机构地区：[1]黑龙江中医药大学,哈尔滨150040 [2]黑龙江中医药大学附属第一医院

出　　处：《中国临床保健杂志》2021年第4期454-458,共5页Chinese Journal of Clinical Healthcare

基　　金：黑龙江省自然科学基金联合引导项目(LH2019H112);黑龙江省中医药科研项目(ZHY2020-121)。

摘　　要：目的探讨补肾健骨方治疗维持性血液透析患者肾性骨病的临床疗效,以及对血钙、血磷、甲状旁腺激素与血清Klotho蛋白、骨硬化蛋白(Sclerostin)水平的影响。方法选取维持性血液透析患者60例,按随机数字表法分为治疗组与对照组各30例。两组均给予充分透析、降低血磷、维持血钙、控制甲状旁腺激素水平等对症治疗,治疗组在此基础上口服补肾健骨方,疗程4周。观察两组患者的治疗前后的临床疗效、骨痛评分,血清钙、磷、甲状旁腺激素水平,以及血清Klotho蛋白与Sclerostin水平。结果治疗组共有25例完成观察,对照组共有28例完成观察。治疗组总有效率72%,优于对照组50%(P<0.05);治疗后两组疼痛评分均低于同组治疗前(P<0.01),治疗组低于对照组(P<0.01);两组治疗后血钙水平均高于同组治疗(P<0.01),组间差异无统计学意义(P>0.05)。两组治疗后血磷水平均低于同组治疗前(P<0.01),治疗组低于对照组(P<0.01)。两组甲状旁腺激素水平均低于同组治疗前(P<0.01),组间比较差异无统计学意义(P>0.05);治疗组治疗后Klotho蛋白水平高于同组治疗前(P<0.01)且高于对照组(P<0.01),对照组Klotho蛋白水平与同组治疗前比较差异无统计学意义(P>0.05)。两组Sclerostin水平均低于同组治疗前(P<0.05,P<0.01),组间比较差异无统计学意义(P>0.05)。结论维持性血液透析肾性骨病患者在一般治疗基础上口服补肾健骨方,有利于缓解骨痛症状与血磷控制,降低血清Klotho蛋白水平。Objective To observe the clinical efficacy of BushenJiangu Decoction in the treatment of renal osteopathy among maintenance hemodialysis patients,and its effect on serum calcium,phosphorus,parathyroid hormone,serum Klotho protein and osteosclerotin levels.Methods Sixty patients with maintenance hemodialysis were selected and randomly divided into treatment group and control group,30 cases in each group.Both groups were given symptomatic treatment such as full dialysis,reducing blood phosphorus,maintaining blood calcium and controlling parathyroid hormone level.On the basis of this,the treatment group was given BushenJiangu Decoction for 4 weeks.The clinical efficacy,bone pain score,serum calcium,phosphorus,parathyroid hormone levels,serum Klotho protein and osteosclerosis protein levels were observed before and after treatment.Results There were 25 cases in the treatment group and 28 cases in the control group.The total effective rate of the treatment group was 72%,which was better than 50%of the control group(P<0.05);after treatment,the pain scores of the two groups were lower than before treatment(P<0.01),and the treatment group was lower than the control group(P<0.01);the blood calcium level of the two groups after treatment was higher than that of the same group(P<0.01),and there was no significant difference between the two groups(P>0.05).After treatment,the blood phosphorus level in the two groups was lower than that before treatment in the same group(P<0.01),and that in the treatment group was lower than that in the control group(P<0.01).Parathyroid hormone levels of the two groups were lower than those before treatment in the same group(P<0.01),and there was no significant difference between the two groups(P>0.05);Klotho protein level of the treatment group after treatment was higher than that before treatment in the same group(P<0.01)and higher than that of the control group(P<0.01),and there was no significant difference between the two groups(P>0.05).The level of sclerostin protein in the two groups wa

关 键 词：肾透析 补肾 中草药 慢性肾疾病-矿物质和骨代谢异常 中西医结合疗法 

分 类 号：R58[医药卫生—内分泌]