参芪清毒胶囊对血液透析患者残余肾功能保护作用的临床观察
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摘要
目的观察参芪清毒胶囊对血液透析患者残余肾功能(residual renal function, RRF)的保护作用。方法选取2016年1月～2017年6月在我院行血液透析的慢性肾功能衰竭患者160例,随机分为两组,每组80例。两组患者均给予常规维持性血液透析,对照组采取常规降压、纠正贫血等基础药物治疗,治疗组在对照组基础上加服中成药参芪清毒胶囊。测定两组患者治疗前以及治疗1个月、2个月、3个月和6个月后血肌酐(serum creatinine, Scr)、尿素氮(blood urea nitrogen, BUN)、胱抑素C(Cystatin C,Cys-C)、日均尿量、RRF等指标。结果治疗前两组患者Scr、BUN、Cys-C比较差异无统计学意义(P>0.05);治疗1个月后,治疗组Scr、BUN、Cys-C有明显下降(P<0.05),对照组下降不明显(P>0.05);治疗2个月、3个月和6个月后两组Scr、BUN、Cys-C均有明显下降(P<0.05),且治疗组低于对照组,两组比较差异有统计学意义(P<0.05)。治疗前两组患者日均尿量、RRF比较差异无统计学意义(P>0.05);治疗1个月后两组日均尿量下降不明显(P>0.05),RRF较治疗前均有明显下降(P<0.05);治疗2个月、3个月、6个月后两组日均尿量、RRF较治疗前均有明显下降(P<0.05),且对照组下降更为明显,两组比较差异有统计学意义(P<0.05)。结论参芪清毒胶囊联合常规血液透析治疗可以保护慢性肾功能衰竭患者RRF,增加尿量,缓解病情,具有一定临床推广意义。
Objective To investigate the protective effect of Shenqi Qingdu Capsule on residual renal function in hemodialysis patients. Methods A total of 160 patients with chronic renal failure who underwent hemodialysis in our hospital from January 2016 to June 2017 were equally and randomly divided into control group and treatment group. The control group was given routine maintenance hemodialysis, routine antihypertensive drug, and anemia correction drug, while the treatment group was given Shenqi Qingdu Capsule in addition to the treatment for the control group. The levels of serum creatinine(SCr), blood urea nitrogen(BUN), and cystatin C(Cys-C), daily urine volume, and residual renal function(RRF) were measured in both groups before treatment and after 1, 2, 3, and 6 months of treatment. Results Before treatment, there were no significant differences in levels of SCr, BUN, and Cys-C between the two groups(P >0.05). After one month of treatment, the treatment group showed significant decreases in levels of SCr, BUN, and Cys-C(P<0.05), while the control group showed no significant decreases in the above indices(P>0.05). After 2, 3, and 6 months of treatment, both groups showed significant decreases in levels of SCr, BUN, and Cys-C(P<0.05), and the treatment group had significantly lower levels of SCr, BUN, and Cys-C compared with the control group(P<0.05). Before treatment, there were no significant differences in daily urine volume and RRF between the two groups(P>0.05).After one month of treatment, both groups showed no significant decrease in daily urine volume(P>0.05), while they showed asignificant decrease in RRF(P<0.05). After 2, 3, and 6 months of treatment, both groups showed significant decreases in daily urine volume and RRF(P <0.05), and the control group had significantly greater decreases in the two indices compared with the control group(P <0.05). Conclusion For patients with chronic renal failure, Shenqi Qingdu Capsule combined with routine hemodialysis can protect RRF, increase urine volume, and alleviate the condition, so it has a certain clinical significance.
Objective To investigate the protective effect of Shenqi Qingdu Capsule on residual renal function in hemodialysis patients. Methods A total of 160 patients with chronic renal failure who underwent hemodialysis in our hospital from January 2016 to June 2017 were equally and randomly divided into control group and treatment group. The control group was given routine maintenance hemodialysis, routine antihypertensive drug, and anemia correction drug, while the treatment group was given Shenqi Qingdu Capsule in addition to the treatment for the control group. The levels of serum creatinine(SCr), blood urea nitrogen(BUN), and cystatin C(Cys-C), daily urine volume, and residual renal function(RRF) were measured in both groups before treatment and after 1, 2, 3, and 6 months of treatment. Results Before treatment, there were no significant differences in levels of SCr, BUN, and Cys-C between the two groups(P >0.05). After one month of treatment, the treatment group showed significant decreases in levels of SCr, BUN, and Cys-C(P<0.05), while the control group showed no significant decreases in the above indices(P>0.05). After 2, 3, and 6 months of treatment, both groups showed significant decreases in levels of SCr, BUN, and Cys-C(P<0.05), and the treatment group had significantly lower levels of SCr, BUN, and Cys-C compared with the control group(P<0.05). Before treatment, there were no significant differences in daily urine volume and RRF between the two groups(P>0.05).After one month of treatment, both groups showed no significant decrease in daily urine volume(P>0.05), while they showed asignificant decrease in RRF(P<0.05). After 2, 3, and 6 months of treatment, both groups showed significant decreases in daily urine volume and RRF(P <0.05), and the control group had significantly greater decreases in the two indices compared with the control group(P <0.05). Conclusion For patients with chronic renal failure, Shenqi Qingdu Capsule combined with routine hemodialysis can protect RRF, increase urine volume, and alleviate the condition, so it has a certain clinical significance.
引文
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[3] BANSAL N, MCCULLOCH C E, RAHMAN M, et al. Blood pressure and risk of all-cause mortality in advanced chronic kidney disease and hemodialysis:the chronic renal insufficiency cohort study[J]. Hypertension, 2015, 65(1):93-100.
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[5]彭红伟.肾康注射液对血液透析患者残余肾功能的保护作用[J].国际泌尿系统杂志,2015,35(4):547-549.
[6]赵茜芸,刘桂凌.老年维持性血液透析患者透析充分性与炎症反应、残余肾功能及营养的关系[J].中国老年学杂志,2018,38(8):1891-1893.
[7] LUO L H, ZHANG Y F, WANG X M, et al. Preparation, characterization,and in vitro and in vivo evaluation of cellulose/soy protein isolate composite sponges[J]. Journal of Biomaterials Applications, 2010, 24(6):503-526.
[8]李银辉,刘水仙,王晶,等.残余肾功能对维持性血液透析患者的影响[J].中国实验诊断学,2016,20(3):456-458.
[9] KUTNER N G, ZHANG R, HUANG Y, et al. Falls among hemodialysis patients:potential opportunities for prevention[J]. Clinical Kidney Journal, 2014, 7(3):257-263.
[10]梁文聪.黄芪注射液对维持性血液透析患者残余肾功能的影响[D].广州:广州中医药大学,2013.
[11]尚巍,王鹏飞.益肾活血降浊中药结肠透析与护理对慢性肾衰竭患者肾功能的影响[J].长春中医药大学学报,2016,32(6):1200-1202.
[12]王身菊,朱美凤,邓祥军,等.保元排毒丸对维持性血液透析患者残余肾功能的影响[J].中成药,2016,38(1):46-49.
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[15]雷雪姣.桂蓉汤辅助西药治疗慢性肾衰竭的临床研究[J].湖南中医药大学学报,2018,38(8):930-933.
[16]王琦,曲晓璐.《诸病源候论》辨治糖尿病肾脏疾病分析[J].湖南中医药大学学报,2018,38(1):47-49.
[17]刘洋,赵广良,张硕.黄芩素对2型糖尿病大鼠糖脂代谢和肾功能的影响及其作用机制[J].西部中医药,2016,29(10):23-26.
[18]王卫军,石娟.尿毒清颗粒辅助治疗慢性肾功能衰竭患者的临床疗效[J].广西医科大学学报,2017,34(9):1389-1391.
[19]臧晓峰,谢湘林,吴轶川,等.西洋参叶20s-原人参二醇组皂苷对糖尿病肾病大鼠肾功能及肾脏结构的保护作用[J].吉林大学学报(医学版),2007,33(5):845-848.
[20]程世平,查艳,袁静.水蛭对老年慢性肾衰竭患者血液流变性及肾功能的影响[J].中国老年学杂志,2013,33(16):4072-4073.
[2] GUAN Y M, LOU J Z. Residual Renal Function in Hemodialysis Patients[J]. Medical Recapitulate, 2013, 20(3):398-401.
[3] BANSAL N, MCCULLOCH C E, RAHMAN M, et al. Blood pressure and risk of all-cause mortality in advanced chronic kidney disease and hemodialysis:the chronic renal insufficiency cohort study[J]. Hypertension, 2015, 65(1):93-100.
[4] VILAR E, WELLSTED D, CHANDNA S M, et al. Residual renal function improves outcome in incremental haemodialysis despite reduced dialysis dose[J]. Nephrol Dial Transplant, 2009, 24(8):2502-2510.
[5]彭红伟.肾康注射液对血液透析患者残余肾功能的保护作用[J].国际泌尿系统杂志,2015,35(4):547-549.
[6]赵茜芸,刘桂凌.老年维持性血液透析患者透析充分性与炎症反应、残余肾功能及营养的关系[J].中国老年学杂志,2018,38(8):1891-1893.
[7] LUO L H, ZHANG Y F, WANG X M, et al. Preparation, characterization,and in vitro and in vivo evaluation of cellulose/soy protein isolate composite sponges[J]. Journal of Biomaterials Applications, 2010, 24(6):503-526.
[8]李银辉,刘水仙,王晶,等.残余肾功能对维持性血液透析患者的影响[J].中国实验诊断学,2016,20(3):456-458.
[9] KUTNER N G, ZHANG R, HUANG Y, et al. Falls among hemodialysis patients:potential opportunities for prevention[J]. Clinical Kidney Journal, 2014, 7(3):257-263.
[10]梁文聪.黄芪注射液对维持性血液透析患者残余肾功能的影响[D].广州:广州中医药大学,2013.
[11]尚巍,王鹏飞.益肾活血降浊中药结肠透析与护理对慢性肾衰竭患者肾功能的影响[J].长春中医药大学学报,2016,32(6):1200-1202.
[12]王身菊,朱美凤,邓祥军,等.保元排毒丸对维持性血液透析患者残余肾功能的影响[J].中成药,2016,38(1):46-49.
[13]海燕.肾脏病学(第二版)[M].北京:人民卫生出版社,1998:1393.
[14]中华医学会肾脏病学会第三次全国学术会议纪要[J].中华内科杂志,1993,31(10):605-608.
[15]雷雪姣.桂蓉汤辅助西药治疗慢性肾衰竭的临床研究[J].湖南中医药大学学报,2018,38(8):930-933.
[16]王琦,曲晓璐.《诸病源候论》辨治糖尿病肾脏疾病分析[J].湖南中医药大学学报,2018,38(1):47-49.
[17]刘洋,赵广良,张硕.黄芩素对2型糖尿病大鼠糖脂代谢和肾功能的影响及其作用机制[J].西部中医药,2016,29(10):23-26.
[18]王卫军,石娟.尿毒清颗粒辅助治疗慢性肾功能衰竭患者的临床疗效[J].广西医科大学学报,2017,34(9):1389-1391.
[19]臧晓峰,谢湘林,吴轶川,等.西洋参叶20s-原人参二醇组皂苷对糖尿病肾病大鼠肾功能及肾脏结构的保护作用[J].吉林大学学报(医学版),2007,33(5):845-848.
[20]程世平,查艳,袁静.水蛭对老年慢性肾衰竭患者血液流变性及肾功能的影响[J].中国老年学杂志,2013,33(16):4072-4073.