基于多频生物电阻抗法评估健脾泻浊方干预腹膜透析患者容量负荷的临床研究  

Clinical study on the intervention of Jianpi Xiezhuo Recipe on volume load in peritoneal dialysis patients based on multi-frequency bioelectrical impedance analysis

作　　者：王华[1] 竺奇凡 翁宁[1] 郭艳香[1] 曾佳丽[1] 倪军[1] 童孟立[1] WANG Hua;ZHU Qifan;WENG Ning;GUO Yanxiang;ZENG Jiali;NI Jun;TONG Mengli(Department of Nephrology,Hangzhou Hospital of Traditional Chinese Medicine,Hangzhou 310007,China;The Third Clinical Medical College,Zhejiang Chinese Medical University,Hangzhou 310053,China)

机构地区：[1]杭州市中医院肾病科,浙江杭州310007 [2]浙江中医药大学第三临床医学院,浙江杭州310053

出　　处：《中国现代医生》2022年第11期151-155,共5页China Modern Doctor

基　　金：浙江省中医药科学研究基金项目(2018ZB090)。

摘　　要：目的应用多频生物电阻抗法(MBIA)评估健脾泻浊方改善脾虚湿困型腹膜透析(PD)患者容量负荷的疗效,探讨多频生物电阻抗法(MBIA)对PD患者容量超负荷的预警评估作用。方法选取2018年7月至2020年10月在杭州市中医院行标准CAPD治疗满3个月以上脾虚湿困型患者58例,随机分成两组,其中对照组30例,予西医基础治疗,治疗组28例,予基础西医治疗+健脾泻浊方中药颗粒剂,给药观察12周,使用MBIA技术测量患者容量超负荷相关指标浮肿指数(ECW/TBW)值,并检测生化指标,影像学参数等,比较两组治疗后疗效,评估MBIA技术预警作用。结果治疗组治疗后浮肿指数(ECW/TBW)较治疗前下降,对照组较前升高,差异均有统计学意义(P<0.05),治疗组治疗后左心室舒张末期内径(LVIDd)均值下降,对照组较前升高,差异均无统计学意义(P>0.05),心脏射血分数(EF)、血磷、谷丙转氨酶、血清白蛋白治疗组与对照组治疗前后比较,差异无统计学意义(P>0.05);两组治疗后较治疗前浮肿指数(ECW/TBW)差值比较,差异有统计学意义(P<0.05),LVIDd、EF、血磷、谷丙转氨酶、白蛋白差值比较,差异无统计学意义(P>0.05)。结论健脾泻浊方能降低脾虚湿困型PD患者浮肿指数,改善容量负荷,生物电阻抗法能早期发现PD患者容量变化。Objective To evaluate the efficacy of Jianpi Xiezhuo Recipe in improving volume load in peritoneal dialysis(PD)patients with splenasthenic hygrosis by multi-frequency bioimpedance assay(MBIA),and to explore the early warning and evaluation effect of multi-frequency bioimpedance assay(MBIA)on volume overload in PD patients.Methods From July 2018 to October 2020,a total of 58 patients with splenasthenic hygrosis who had been treated with standard CAPD for more than 3 months in Hangzhou Hospital of Traditional Chinese Medicine were randomly divided into two groups.The control group(n=30)was treated with basic western medicine.The treatment group(n=28)was treated with basic western medicine+Chinese medicine granules of Jianpi Xiezhuo Recipe.The patients were observed for 12 weeks.Edema index(ECW/TBW)values,an indicator of volume overload,were measured using the MBIA technique.Biochemical indicators and imaging parameters were also measured.The efficacy after treatment was compared between the two groups.And the early warning effect of MBIA technique was evaluated.Results The edema index(ECW/TBW)in the treatment group after treatment was decreased compared with that before treatment,while the edema index in the control group after treatment was increased compared with that before treatment,and the differences had statistical significance(P<0.05).After treatment,the mean end-diastolic diameter(LVIDd)in the treatment group decreased,while that in control group was increased,and the differences had no statistical significance(P>0.05).There was no significant difference in cardiac fraction(EF),serum phosphorus,alanine aminotransferase and serum albumin before and after treatment in the control group(P>0.05).After treatment,the difference in edema index(ECW/TBW)between the two groups had statistical significance(P<0.05), but there was no significant difference in LVIDd, EF,serum phosphorus,alanine aminotransferase and albumin(P>0.05). Conclusion Jianpi Xiezhuo Recipe can reduce the edema index and improve the volume load i

关 键 词：生物电阻抗 健脾泻浊方 脾虚湿困 容量负荷 腹膜透析 

分 类 号：R495.5[医药卫生—康复医学] R255.9[医药卫生—临床医学]