补阳还五汤治疗AKI患者血液透析综合征及铁代谢异常  

Buyang Huanwu decoction for treatment of hemodialysis syndrome and abnormal iron metabolism in AKI patients

作　　者：姚丽君 聂子牧 YAO Lijun;NIE Zimu(Department of Renal Disease Rheumatology and Immunology,Xuchang Municipal Hospital,Xuchang 461000,China)

机构地区：[1]许昌市立医院肾脏病风湿免疫科,许昌461000

出　　处：《华夏医学》2024年第1期155-159,共5页Acta Medicinae Sinica

基　　金：河南省医学科技攻关项目(LHGJ202001126)。

摘　　要：目的探讨补阳还五汤加减对急性肾损伤(AKI)患者血液透析综合征及铁代谢的治疗作用。方法选取112例AKI患者,按照随机数字表法分为常规组和中药组,每组56例。常规组采用蔗糖铁辅助维持性血液透析(MHD)治疗;中药组采用补阳还五汤加减辅助MHD治疗。比较两组治疗后的铁代谢、血脂、血流动力学等指标和不宁腿综合征(RLS)发生情况。结果治疗后,中药组血清铁(SI)、血清铁蛋白(SF)、血清转铁蛋白饱和度(TFS)均高于常规组,差异有统计学意义(P<0.05)。总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、血浆黏度、全血高切黏度、全血低切黏度均低于常规组(P<0.05)。随访1个月、3个月和6个月,中药组不拧腿综合征发生率均低于常规组(P<0.05)。结论补阳还五汤加减辅助MHD能有效缓解AKI患者血液透析性铁代谢异常,促进血流动力学恢复,降低RLS发生风险。Objective To observe the therapeutic effects of modified Buyang Huanwu decoction on hemodialysis syndrome and iron metabolism in patients with acute kidney injury(AKI).Methods 112 AKI patients were divided into two groups the conventional group and traditional Chinese medicine group using a random number table method,with 56 cases in each group.The conventional group were treated with sucrose iron assisted maintenance hemodialysis(MHD).The traditional Chinese medicine group were treated with modified Buyang Huanwu decoction as an adjunct to MHD.The changes in iron metabolism,blood lipids,hemodynamics,and the occurrence of restless leg syndrome(RLS)were compared between two groups of patients after treatment.Results After treatment,the serum iron(SI),serum ferritin(SF),and serum transferrin saturation(TFS)of the traditional Chinese medicine group were higher than those of the conventional group.Total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),plasma viscosity,whole blood high shear viscosity,and whole blood low shear viscosity were all lower than those of conventional methods.The incidence of non-twisted leg syndrome in the traditional Chinese medicine group was lower than that in the conventional group at the first,third,and sixth month of follow-up(P<0.05).Conclusion Modified Buyang Huanwu decoction can effectively alleviate hemodialysis induced iron metabolism abnormalities in AKI patients with MHD,promote hemodynamic recovery,and reduce the risk of RLS.

关 键 词：急性肾损伤 维持性血液透析 不宁腿综合征 补阳还五汤 铁代谢 

分 类 号：R692[医药卫生—泌尿科学]