健脾补肾活血泄浊方联合杂合式血液净化疗法对慢性肾衰竭患者肾功能及血清CD_4~+/CD_8~+水平的影响
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摘要
目的:研究健脾补肾活血泄浊方联合杂合式血液净化疗法对慢性肾衰竭(CRF)患者肾功能及血清CD_4~+/CD_8~+水平的影响。方法:选取CRF患者96例,随机数字表法分为研究组和对照组各48例。对照组采用杂合式血液净化疗法治疗,研究组于对照组基础上加用健脾补肾活血泄浊方治疗。观察比较两组治疗效果、治疗前后肾功能指标[血尿素氮(BUN)、血清肌酐(Scr)、内生肌酐清除率(Ccr)]、血清T淋巴细胞亚群[CD_4~+、CD_8~+、CD_4~+/CD_8~+]、血清炎症因子[白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)]水平及生活质量(SF-36评分)。结果:研究组治疗总有效率高于对照组(P<0.05);治疗后研究组Scr、BUN水平低于对照组,Ccr水平高于对照组(P<0.05);治疗后研究组CD_8~+水平低于对照组,CD_4~+、CD_4~+/CD_8~+水平高于对照组(P<0.05);治疗后研究组IL-6、CRP、TNF-α水平低于对照组(P<0.05);治疗后研究组情感职能、躯体疼痛、社会职能、整体健康各项评分高于对照组(P<0.05)。结论:健脾补肾活血泄浊方联合杂合式血液净化疗法治疗CRF,能显著提高治疗效果,有效改善患者肾功能,且能显著增强机体免疫功能,降低炎症因子水平,提高生活质量。
Objective:To study the effects of Jianpi Bushen Huoxue Xiezhuo decoction combined with hybrid blood purification therapy on renal function and serum CD_4~+/CD_8~+ levels in patients with chronic renal failure(CRF).Methods:96 patients with CRF were randomly divided into study group(n=48)and control group(n=48).The control group was treated with hybrid blood purification therapy.The study group was treated with Jianpi Bushen Huoxue Xiezhuo decoction on the basis of the control group.The therapeutic effects,renal function indicators before and after treatment[Blood urea nitrogen(BUN),Serum creatinine(Scr),Endogenous creatinine clearance(Ccr)],serum T lymphocyte subsets[CD_4~+,CD_8~+,CD_4~+/CD_8~+],serum inflammatory factors[Interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor alpha(TNF-α)]levels and quality of life(SF-36 score)were observed and compared between the two groups.Results:The total effective rate of the study group was higher than that of the control group(P<0.05);after treatment,the levels of Scr and BUN in the study group were lower than those in the control group,and the Ccr level was higher than that in the control group(P<0.05).The CD_8~+level of the study group was lower than that of the control group and CD_4~+,CD_4~+/CD_8~+levels were higher than those of the control group(P<0.05);the levels of IL-6,CRP,TNF-αin the study group were lower than those in the control group after treatment(P<0.05);after treatment,the scores of emotional function,physical pain,social function and overall health in the study group were higher than those of the control group(P<0.05).Conclusion:Jianpi Bushen Huoxue Xiezhuo decoction combined with hybrid blood purification therapy for CRF can significantly improve the therapeutic effect,effectively improve the renal function of patients,and can significantly enhance the body's immune function,reduce the level of inflammatory factors and improve the quality of life of patients.
Objective:To study the effects of Jianpi Bushen Huoxue Xiezhuo decoction combined with hybrid blood purification therapy on renal function and serum CD_4~+/CD_8~+ levels in patients with chronic renal failure(CRF).Methods:96 patients with CRF were randomly divided into study group(n=48)and control group(n=48).The control group was treated with hybrid blood purification therapy.The study group was treated with Jianpi Bushen Huoxue Xiezhuo decoction on the basis of the control group.The therapeutic effects,renal function indicators before and after treatment[Blood urea nitrogen(BUN),Serum creatinine(Scr),Endogenous creatinine clearance(Ccr)],serum T lymphocyte subsets[CD_4~+,CD_8~+,CD_4~+/CD_8~+],serum inflammatory factors[Interleukin-6(IL-6),C-reactive protein(CRP),tumor necrosis factor alpha(TNF-α)]levels and quality of life(SF-36 score)were observed and compared between the two groups.Results:The total effective rate of the study group was higher than that of the control group(P<0.05);after treatment,the levels of Scr and BUN in the study group were lower than those in the control group,and the Ccr level was higher than that in the control group(P<0.05).The CD_8~+level of the study group was lower than that of the control group and CD_4~+,CD_4~+/CD_8~+levels were higher than those of the control group(P<0.05);the levels of IL-6,CRP,TNF-αin the study group were lower than those in the control group after treatment(P<0.05);after treatment,the scores of emotional function,physical pain,social function and overall health in the study group were higher than those of the control group(P<0.05).Conclusion:Jianpi Bushen Huoxue Xiezhuo decoction combined with hybrid blood purification therapy for CRF can significantly improve the therapeutic effect,effectively improve the renal function of patients,and can significantly enhance the body's immune function,reduce the level of inflammatory factors and improve the quality of life of patients.
引文
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[5]陈云,鲁盈.益肾健脾活血泄浊汤加减治疗慢性肾功能衰竭30例临床观察[J].甘肃中医药大学学报,2016,33(1):48-51.
[6]刘晖,强胜,杜珍芳,等.健脾益肾化湿泄浊方治疗慢性肾功能衰竭的临床观察[J].中医药导报,2018,24(12):94-96.
[7]易继飞.健脾益肾泄浊方治疗慢性肾衰竭临床研究[J].实用中医药杂志,2016,32(10):969-970.
[8]周卫国,胡彦兴,卓彩琴.健脾补肾泄浊活血方配合别嘌醇治疗痛风肾疗效观察[J].山西中医,2017,33(2):24-26.
[9] Wei F,Chen Z,Yang H,et al.Effect of Sanqi Oral Liquid on the expressions of CD4,CD8and CD68cells in 5/6nephrectomized rats with chronic renal failure[J].Chin J Integr Med,2013,19(8):589.
[10]张均,赵景宏,刘力,等.健脾益肾泄浊方联合西医治疗慢性肾衰竭对患者免疫功能及微炎症状态的影响[J].现代中西医结合杂志,2017,26(35):3906-3908.
[2] Xiang F,Zhu J,Cao X,et al.Lymphocyte depletion and subset alteration correlate to renal function in chronic kidney disease patients[J].Renal Failure,2016,130(9):1-8.
[3]中国中西医结合学会肾脏疾病专业委员会.慢性肾衰竭中西医结合诊疗指南[J].中国中西医结合杂志,2015,35(9):1029-1033.
[4]国家食品药品监督管理总局.中药新药临床研究指导原则(试行)[M].北京:中国中医药出版社,2002:163-164.
[5]陈云,鲁盈.益肾健脾活血泄浊汤加减治疗慢性肾功能衰竭30例临床观察[J].甘肃中医药大学学报,2016,33(1):48-51.
[6]刘晖,强胜,杜珍芳,等.健脾益肾化湿泄浊方治疗慢性肾功能衰竭的临床观察[J].中医药导报,2018,24(12):94-96.
[7]易继飞.健脾益肾泄浊方治疗慢性肾衰竭临床研究[J].实用中医药杂志,2016,32(10):969-970.
[8]周卫国,胡彦兴,卓彩琴.健脾补肾泄浊活血方配合别嘌醇治疗痛风肾疗效观察[J].山西中医,2017,33(2):24-26.
[9] Wei F,Chen Z,Yang H,et al.Effect of Sanqi Oral Liquid on the expressions of CD4,CD8and CD68cells in 5/6nephrectomized rats with chronic renal failure[J].Chin J Integr Med,2013,19(8):589.
[10]张均,赵景宏,刘力,等.健脾益肾泄浊方联合西医治疗慢性肾衰竭对患者免疫功能及微炎症状态的影响[J].现代中西医结合杂志,2017,26(35):3906-3908.