加味六君子汤治疗腹膜透析容量超负荷的疗效观察  

Therapeutic efficacy of Jiawei Liujunzi decoction in treatment of volume overload with peritoneal dialysis

作　　者：俞树瀚 陈莎 张庆霞 潘虹 刘志杰 YU Shuhan;CHEN Sha;ZHANG Qingxia;PAN Hong;LIU Zhijie(Department of Nephrology,Dongyang Hospital of Traditional Chinese Medicine of Affiliated to Wenzhou Medical University,Dongyang 322100,Zhejiang,China)

机构地区：[1]温州医科大学附属东阳市中医院肾内科,浙江东阳322100

出　　处：《中国现代医生》2024年第28期76-79,共4页China Modern Doctor

基　　金：浙江省金华市公益性技术应用研究项目(2022-4-286)。

摘　　要：目的探讨加味六君子汤改善脾虚型持续不卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者容量超负荷及残肾保护的作用。方法选取2022年7月至2023年4月于温州医科大学附属东阳市中医院腹膜透析中心就诊的82例患者为研究对象。根据随机数字表法将患者分为对照组和治疗组,每组各41例。对照组给予西医基础治疗,治疗组在对照组的基础上加用加味六君子汤,用药疗程8周。比较两组患者的细胞外水分占身体总水分的百分比(ECW%)、残肾尿素清除指数(Kt/V)、脑钠肽(brain natriuretic peptide,BNP),评价用药安全性。结果治疗后,两组患者的ECW%、BNP均显著低于本组治疗前(P<0.05),对照组患者的尿量显著少于本组治疗前(P<0.05)。治疗后,两组患者的ECW%、BNP、Kt/V、尿量比较差异均无统计学差异(P>0.05)。治疗后,两组患者的丙氨酸转氨酶、天冬氨酸转氨酶、白蛋白、磷、钙、钾比较差异均无统计学意义(P>0.05),安全性良好。随访12个月,治疗组患者的生存率显著高于对照组(P<0.05)。结论加味六君子汤可在一定程度上改善脾虚型CAPD患者的容量超负荷情况,安全性良好,可提高患者的远期生存率。Objective To explore the effect of Jiawei Liujunzi decoction in improving volume overload and residual renal protection in continuous ambulatory peritoneal dialysis(CAPD)patients with spleen deficiency.Methods A total of 82 patients treated in the Peritoneal Dialysis Center of Dongyang Hospital of Traditional Chinese Medicine of Affiliated to Wenzhou Medical University from July 2022 to April 2023 were selected as study objects.According to random number table method,the patients were divided into control group and treatment group,41 cases in each group.The control group was given basic western medicine treatment,and the treatment group was given supplemented with Jiawei Liujunzi decoction on the basis of control group,and the treatment course was 8 weeks.The percentage of extracellular water to total body water(ECW%),urea clearance index of residual kidney(Kt/V)and brain natriuretic peptide(BNP)of two groups were compared,and safety of the drug was evaluated.Results After treatment,ECW%and BNP in two groups were significantly lower than before treatment(P<0.05).The urine volume of control group was significantly lower than that before treatment(P<0.05).After treatment,there were no significant differences in ECW%,BNP,Kt/V and urine volume between two groups(P>0.05).After treatment,there were no significant differences in alanine aminotransferase,aspartate aminotransferase,albumin,phosphorus,calcium and potassium between two groups(P>0.05),indicating good safety.After 12 months of follow-up,the survival rate of treatment group was significantly higher than that of control group(P<0.05).Conclusion Jiawei Liujunzi decoction can improve the volume overload of CAPD patients with spleen deficiency to a certain extent,with good safety,and can improve the long-term survival rate of patients.

关 键 词：加味六君子汤 容量负荷 残肾功能 持续不卧床腹膜透析 

分 类 号：R459.5[医药卫生—治疗学] R255.9[医药卫生—临床医学]