益肾利水方对糖尿病肾脏疾病血透患者水通道蛋白和人体成分参数的影响  

Effects of Yishen Lishui Formula on Aquaporin and Human Body Composition Parameters in Hemodialysis Patients with Diabetic Kidney Disease

作　　者：徐缘钊 祁爱蓉[1] 凌舒艺 邹颜红 周买英 路遥[1] XU Yuan-Zhao;QI Ai-Rong;LING Shu-Yi;ZOU Yan-Hong;ZHOU Mai-Ying;LU Yao(Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518033 Guangdong,China)

机构地区：[1]深圳市中医院,广东深圳518033

出　　处：《广州中医药大学学报》2022年第1期42-47,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研立项项目(编号:20201307)。

摘　　要：【目的】探索益肾利水方对糖尿病肾脏疾病血透患者的容量状态是否与水通道蛋白2(AQP2)有关,并剖析其对人体成分参数的影响。【方法】选取广州中医药大学第四临床医学院(深圳市中医院)血透患者97例,按其原发病肾脏病将患者分为糖尿病组(55例)和非糖尿病组(42例),其中糖尿病组有18例患者完成8周的益肾利水方治疗。使用人体成分分析仪,检查患者人体成分参数,并记录患者基础信息及其临床症状、体征等。比较糖尿病组与非糖尿病组患者人体成分参数的差异,并观察糖尿病组中服用益肾利水方的患者治疗前后人体成分参数、血清指标、超滤量、KT/V值和AQP2水平的变化情况及治疗后各项中医症状的改善疗效。【结果】糖尿病组与非糖尿病组比较,患者各阶段相位角和细胞外水分/身体总水分比率(ECW/TBW)均有显著性差异(P<0.05)。服用8周益肾利水方后,糖尿病组的各人体成分参数均未见明显差异(P>0.05),其白蛋白、血红蛋白、肌酐、尿素、尿酸、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平亦均未见显著性差异(P>0.05),而超滤量、KT/V值、AQP2水平均有明显差异(P<0.05);且患者的倦怠乏力、气短懒言、食少纳呆、腰酸膝软、脘腹胀满、肢体困重、口中黏腻、肢体麻木等症状体征的总有效率均大于50.0%。【结论】糖尿病肾脏疾病血透患者存在容量负荷过多状态,且其预后状态较差。益肾利水方可降低糖尿病肾脏疾病血透患者容量负荷,并可提高透析充分性,增加其透析超滤率。Objective To explore whether the effect of Yishen Lishui Formula on hemodialysis capacity in hemodialysis patients with diabetic kidney disease(DKD)is related to aquaporin 2(AQP2),and to analyze its effect on body composition parameters. Methods A total of 97 hemodialysis patients hospitalized in the Fourth Clinical Medical School of Guangzhou University of Chinese Medicine were divided into diabetic group(n = 55)and non-diabetic group(n = 42). Of the diabetic group, 18 cases completed the 8-week treatment with Yishen Lishui Formula. The body composition analyzer was used to detect the composition parameters, and the basic information and clinical symptoms and signs of the patients were recorded. The difference in body composition parameters of the diabetic group and non-diabetic group was compared. Meanwhile,we observed the changes of body composition parameters,serum indicators,ultrafiltration volume,KT/V value and AQP2 in the 18 cases of the diabetic group before and after treatment, and evaluated the effecacy for improving the traditional Chinese medicine syndrome after treatment. Results There were significant differences in the phase angle at various stages and the ratio of extracellular water(ECW)to total body water(TBW)between diabetic group and non-diabetic group(P<0.05). After 8-week administration of Yishen Lishui Formula,there were no significant differences in body composition parameters of the 18 patients of diabetic group(P>0.05),neither significant differences were found in albumin, hemoglobin, creatinine, urea, uric acid, total cholesterol, triglyceride, high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)of the 18 patients of diabetic group(P>0.05). However,there were significant differences in ultrafiltration volume,KT/V value and aquaporin2(P<0.05). In addition,the effective rate for improving the symptoms and signs of fatigue,shortness of breath and unwilling to talk,poor appetite,soreness of waist and knees,abdominal distension,heaviness of the body,stick

关 键 词：益肾利水方 糖尿病肾脏疾病 血透 透析超滤率 水通路蛋白2(AQP2) 人体成分参数 

分 类 号：R259.872[医药卫生—中西医结合]