健脾益肾泄浊汤对终末期肾脏病腹膜透析患者残余肾功能及免疫功能的影响  

Effects of Jianpi Yishen Xiezhuo Decoction on residual renal function and immune function in patients with end-stage renal disease undergoing peritoneal dialysis

作　　者：赵娜[1] 毛晓琴 罗娅靓 杨周赟[1] Zhao Na;Mao Xiaoqin;Luo Yaliang;Yang Zhouyun(Sichuan College of Traditional Chinese Medicine,Mianyang 621000,China;Department of Nephrology,Shehong Traditional Chinese Medicine Hospital,Shehong 629200,China;Intensive-Care Unit,Santai County Traditional Chinese Medicine Hospital,Santai 621100,China)

机构地区：[1]四川中医药高等专科学校,绵阳621000 [2]射洪市中医院肾病科,射洪629200 [3]三台县中医院重症监护室,三台621100

出　　处：《国际中医中药杂志》2024年第12期1571-1576,共6页International Journal of Traditional Chinese Medicine

基　　金：四川省中医药科研课题(2020LC358)。

摘　　要：目的探讨健脾益肾泄浊汤对终末期肾脏病腹膜透析患者残余肾功能及免疫功能的影响。方法随机对照试验研究。选择2021年3月-2023年3月射洪市中医院102例终末期肾脏病腹膜透析患者作为观察对象,采用随机数字表法分为2组,每组51例。对照组在腹膜透析基础上给予西医常规疗法治疗,观察组在腹膜透析基础上服用健脾益肾泄浊汤。2组均连续治疗3个月。分别于治疗前后进行中医证候评分;采用全自动生化分析仪检测血清SCr、BUN水平;采用流式细胞仪检测CD3^(+)、CD4^(+)、CD8^(+)水平,计算CD4^(+)/CD8^(+)比值;采用ELISA法检测IL-2、CXC趋化因子配体9(CXCL9)、超敏C反应蛋白(hs-CRP)水平;收集患者24 h尿液以全自动尿常规分析仪进行24 h尿蛋白定量(24 hUP)检测;记录治疗期间的不良反应,评价临床疗效。结果观察组总有效率为92.16%(47/51)、对照组为76.47%(39/51),2组比较差异有统计学意义(χ^(2)=4.74,P=0.029)。治疗后,观察组乏力倦怠[(1.78±0.47)分比(2.17±0.51)分,t=4.02]、腰膝酸软[(1.90±0.52)分比(2.29±0.59)分,t=3.54]、纳呆食少[(2.03±0.55)分比(2.65±0.70)分,t=4.97]、舌苔厚腻[(2.26±0.68)分比(2.98±0.75)分,t=5.08]积分及总分[(7.97±2.22)分比(10.09±2.55)分,t=4.48]低于对照组(P<0.01);血清SCr[(296.12±30.27)mmol/L比(326.81±32.43)mmol/L,t=4.94]、BUN[(12.19±3.02)mmol/L比(16.88±3.64)mmol/L,t=7.08]水平及24 hUP[(1.22±0.35)g比(1.75±0.42)g,t=6.92]低于对照组(P<0.01);CD3^(+)[(54.76±5.21)%比(50.03±4.90)%,t=4.72]、CD4^(+)[(56.33±5.09)%比(52.18±5.33)%,t=4.02]水平及CD4^(+)/CD8^(+)[(1.98±0.39)比(1.67±0.34),t=4.28]比值高于对照组(P<0.01),CD8^(+)[(28.43±2.58)%比(31.29±2.47)%,t=5.72]水平低于对照组(P<0.01);血清IL-2[(46.49±6.07)μg/L比(53.43±7.08)μg/L,t=5.31]、CXCL9[(16.32±3.45)μg/L比(19.98±3.53)μg/L,t=5.30]、hs-CRP[(11.22±3.85)mg/L比(15.75±3.92)mg/L,t=5.89]水平低于对照组(P<0.01)。治疗期间,观察组不良反应发�Objective To investigate the effects of Jianpi Yishen Xiezhuo Decoction on residual renal function and immune function in patients with end-stage renal disease undergoing peritoneal dialysis.Methods Randomized controlled trial study was performed.A total of 102 end-stage renal patients with peritoneal dialysis in the Shehong Traditional Chinese Medicine Hospital from March 2021 to March 2023 were selected as the observation objects,and were divided into 2 groups by random number table method,with 51 cases in each group.The control group was given conventional Western medicine therapy on the basis of peritoneal dialysis,and the observation group was given Jianpi Yishen Xiezhuo Decoction on the basis of peritoneal dialysis.Both groups were treated continuously for 3 months.TCM syndrome score was performed before and after treatment,and serum SCr and BUN levels were detected by automatic biochemical analyzer.The levels of CD3^(+),CD4^(+)and CD8^(+)were detected by flow cytometry;the ratio of CD4^(+)/CD8^(+)was calculated;the levels of IL-2,CXC chemokine ligand 9(CXCL9)and hypersensitive C-reactive protein(hs-CRP)were detected by ELISA.24 h urine was collected and 24 h urine protein quantification(24 hUP)was performed by automatic urine routine analyzer.The adverse reactions during treatment were recorded and the clinical efficacy was evaluated.Results The total effective rate was 92.16%(47/51)in the observation group and 76.47%(39/51)in the control group,with statistical significance(χ^(2)=4.74,P=0.029).After treatment,fatigue(1.78±0.47 vs.2.17±0.51,t=4.02),waist and knee weakness(1.90±0.52 vs.2.29±0.59,t=3.54),lethargy and less food(2.03±0.55 vs.2.65±0.70,t=4.97),thick-coated tongue(2.26±0.68 vs.2.98±0.75,t=5.08)and total scores(7.97±2.22 vs.10.09±2.55,t=4.48)were lower than those in the control group(P<0.01);serum SCr[(296.12±30.27)mmol/L vs.(326.81±32.43)mmol/L,t=4.94],BUN[(12.19±3.02)mmol/L vs.(16.88±3.64)mmol/L,t=7.08],24 hUP[(1.22±0.35)g vs.(1.75±0.42)g,t=6.92]were lower than those in the cont

关 键 词：肾病 腹膜透析 健脾益肾泄浊汤 肾功能 免疫功能 炎症因子 

分 类 号：R277.5[医药卫生—中医学]