降磷益肾散对维持性血液透析患者高磷血症及营养状况的影响  

Effect of jiangphosphorusyishen powder on hyperphosphatemia inmaintenance hemodialysis patients influence of nutritional status

作　　者：韩杰 王颖 HAN Jie;WANG Ying(Xinzhou Hospital of Traditional Chinese Medicine,Xinzhou 034000,China)

机构地区：[1]忻州市中医医院,山西忻州034000

出　　处：《临床医药实践》2024年第9期647-650,714,共5页Proceeding of Clinical Medicine

基　　金：山西省中医药管理局科研项目(项目编号:2023ZYYB081)。

摘　　要：目的:探讨中药制剂降磷益肾散对维持性血液透析患者(MHD)高磷血症及其营养状况的影响。方法:选择2022年1月5日-2023年7月5日符合临床纳入标准要求的血液透析患者80例,按照随机数字表法分为对照组和观察组,每组40例。观察组给予降磷益肾散联合低钙透析液维持性血液透析治疗,对照组给予碳酸钙联合低钙透析液常规治疗。比较两组患者治疗前后的电解质两项(血磷、血钙)、肾功能[血清肌酐(Scr)及血清尿素氮(BUN)]、甲状旁腺激素(iPTH)及营养指标(血红蛋白、血清白蛋白、血清前白蛋白)水平。记录两组治疗前后的中医症候评分,并评价两组的安全性和治疗效果。结果:治疗后,观察组总有效率为92.50%,高于对照组的80.00%,差异有统计学意义(P<0.05)。治疗后,对照组的中医症候各项评分均明显高于观察组,差异有统计学意义(P<0.05)。对照组患者电解质两项、肾功能及iPTH等明显高于观察组,差异均有统计学意义(P<0.05)。两组营养指标水平比较,差异无统计学意义(P>0.05)。治疗后,两组患者均未见不良反应。结论:降磷益肾散联合低钙透析液治疗维持性血液透析患者高磷血症的疗效优于传统的碳酸钙联合低钙透析液常规治疗,但两者营养状况疗效一般。降磷益肾散可改善患者体内钙磷水平,补钙抑磷,其机制可能与降低患者体内iPTH分泌以及改善肾脏微循环、降低肾脏纤维化相关。Objective:To study the effects of jiangphosphorusyishensan on hyperphosphatemia and nutritional status in maintenance hemodialysis patients(MHD).Methods:From January 5,2022 to July 5,2023,80 eligible MHD patients were admitted and divided into control group and treatment group according to random number table method,with 40 casesin each group.The control group was treated with calcium carbonate combined with low calcium dialysate,while the treatment group was treated with jiangphosphorusyishen powder combined with low calcium dialysate.The two items of electrolytes(blood phosphorus,blood calcium),renal function serum creatinine(Scr)and serum urea nitrogen(BUN)in renal function,parathyroid hormone(iPTH)and nutrition index(hemoglobin,serum albumin and serum prealbumin)in the two groups were observed and recorded before and after treatment,and the relevant scores of traditional Chinese medicine(TCM)syndromes in the observation group and the treatment group were recorded.The safety and therapeutic effect of the two groups were evaluated.Results:After the end of the experiment,the total effective rate of the control group was 80.00%,and that of the treatment group was 92.50%,which was significantly higher than that of the control group,and the difference was statistically significant(P??0.05).After treatment,the TCM syndrome scores and total scores of the control group were significantly higher than those of the treatment group(P<0.05).Electrolytes,renal function and iPTH in control group were significantly higher than those in treatment group,with statistical significance(P<0.05).There was no statistical significance between the treatment group and the observation group(P>0.05).Conclusion:In the treatment of hyperphosphatemia in maintenance hemodialysispatients,Chinese herbal preparation jiang phosphorus yishen powder combined with low calcium dialysate has obvious curative effect compared with the conventional treatment of calcium carbonate combined with low calcium dialysate,but the effect on nutritional status is

关 键 词：维持性血液透析 降磷益肾散 高磷血症 

分 类 号：R692.5[医药卫生—泌尿科学]