益肾健脾助运方对糖尿病肾病维持性血液透析并发蛋白质能量消耗患者营养状态及微炎症状态的影响  

Effect of Yishen Jianpi Zhuyun Recipe in nutritional status and micro-inflammatory status of patients with diabetic nephropathy on maintenance hemodialysis complicated with protein energy expenditure

作　　者：冯强 蔡学兵[2] 刘松涛 Feng Qiang;Cai Xuebing;Liu Songtao(Hemodialysis Department,Anyang People’s Hospital,Anyang 455133,China;不详)

机构地区：[1]安阳市人民医院血液透析室,455133 [2]安阳市人民医院中医科,455133 [3]林州市食管癌医院中医科

出　　处：《国际移植与血液净化杂志》2022年第4期22-25,共4页International Journal of Transplantation and Hemopurification

摘　　要：目的探讨益肾健脾助运方对糖尿病肾病维持性血液透析并发蛋白质能量消耗(protein energy expenditure,PEW)患者营养状态及微炎症状态的影响。方法选取安阳市人民医院血液透析室2018年9月至2020年9月期间收治的95例糖尿病肾病维持性血液透析并发PEW患者作为研究对象,依据治疗方案不同将其分为观察组和对照组。对照组患者接受优质蛋白饮食+降糖+调节钙磷代谢等基础治疗和血液透析治疗,观察组患者在对照组治疗的基础上加用益肾健脾助运方治疗。比较两组患者体表测量学指标[肱三头肌皮褶厚度(triceps skinfold thickness,TSF)、中臂围(mid-arm circumference,MAC)、中臂肌围(mid-arm muscle circumference,MAMC)及体质量]、炎症感染指标[白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平]及营养状态指标[血清白蛋白(albumin,ALB)、前白蛋白(prealbumin,PA)、血红蛋白(hemoglobin,Hb)]。结果治疗后,两组患者TSF、MAC、MAMC差异无统计学意义(P>0.05),观察组患者PA、血清ALB、Hb及体质量均明显高于对照组(P<0.05),IL-6及TNF-α均低于对照组(P<0.05)。结论益肾健脾助运方联合西医治疗能显著改善糖尿病肾病维持性血液透析并发PEW患者营养状态及微炎症状态,改善PEW,效果优于单独西医治疗,值得推荐。Objective To analyze the effect of Yishen Jianpi Zhuyun prescription in nutritional status and micro-inflammatory status in patients undergoing maintenance hemodialysis for diabetic nephropathy and protein energy expenditure(PEW).Methods From September 2018 to September 2020,95 patients with diabetic nephropathy complicated by PEW on maintenance hemodialysis were selected as the research subjects,and were divided into 2 groups according to different treatment plans.The control group received basic treatment and hemodialysis treatment.Basic treatment includes high-quality protein diet+hypoglycemic+regulation of calcium and phosphorus metabolism,etc.Patients in the observation group were treated with Yishen Jianpi Zhuyun prescription on the basis of the treatment of the control group.Body surface measurement indicators including triceps skinfold thickness(TSF),mid-arm circumference(MAC),mid-arm muscle circumference(MAMC)and body mass,inflammation and infection indicators including interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)levels and nutritional status indicators including serum albumin(ALB),prealbumin(PA),hemoglobin(Hb)wene compared between the two groups.Results There was no significant differences in TSF,MAC,and MAMC between the two groups(P>0.05).The observation group had significantly higher PA,ALB,Hb and body mass than control group(P<0.05).The IL-6 and TNF-αof the observation group were lower than those in the control group(P<0.05).Conclusion Yishen Jianpi Zhuyun prescription could significantly improve the nutritional status and micro-inflammatory status of patients with diabetic nephropathy and PEW on maintenance hemodialysis,and improve PEW.

关 键 词：益肾健脾助运方 糖尿病肾病 蛋白质能量消耗 微炎症状态 

分 类 号：R259[医药卫生—中西医结合] R277.5[医药卫生—中医内科学]