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目的探讨自拟益气固肾化瘀方对维持性血液透析伴营养不良—炎性反应综合征患者血清炎性反应及血管内皮功能的影响。方法将终末期肾病行长期维持性血液透析伴有营养不良—炎性反应综合征患者120例,随机分为观察组与对照组各60例。2组患者均给予每周3次,每次3~4小时的维持性血液透析治疗。观察组患者给予自拟益气固肾方,对照组同期给予同等剂量的温水服用,治疗时间为3个月。治疗前后比较2组血清C反应蛋白(CRP)水平、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平及血管内皮功能单核细胞趋化蛋白-1(MCP-1)、基质金属蛋白酶-9(MMP-9)及一氧化氮(NO)、内皮素(ET)水平的影响。结果治疗后2组患者血清TNF-α、IL-6及CRP水平均低于治疗前,血清MCP-1、MMP-9及ET水平均低于治疗前,NO水平高于治疗前,且观察组变化幅度大于对照组,差异均有统计学意义(P<0.05)。结论自拟益气固肾化瘀方能明显减轻维持性血液透析伴营养不良—炎性反应综合征患者,可减少体内微炎性反应水平,调节血管内皮细胞功能。
Objective To investigate the effect of self-made qi qi and kidney-soothing prescription on serum inflammatory reaction and endothelial function in maintenance hemodialysis patients with malnutrition-inflammatory response syndrome. Methods A total of 120 patients with end-stage renal disease undergoing long-term maintenance hemodialysis accompanied with malnutrition-inflammatory response syndrome were randomly divided into observation group and control group with 60 cases each. Patients in both groups were given maintenance hemodialysis three times a week for 3 to 4 hours. Patients in the observation group were given self-made qi qi and kidney prescription, while the control group was given the same dose of warm water in the same period, the treatment time was 3 months. The level of serum C-reactive protein (CRP), the levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and the expression of vascular endothelial monocyte chemoattractant protein-1 ), Matrix metalloproteinase-9 (MMP-9), nitric oxide (NO) and endothelin (ET) Results The levels of serum TNF-α, IL-6 and CRP in the two groups after treatment were lower than those before treatment, and the levels of serum MCP-1, MMP-9 and ET were lower than before treatment and the level of NO was higher than before treatment The variation range was greater than that of the control group, the differences were statistically significant (P <0.05). Conclusion Self-made qi and reinforcing kidney and removing blood stasis can significantly reduce maintenance hemodialysis with malnutrition - patients with inflammatory response syndrome can reduce the level of micro-inflammatory response in vivo and regulate the function of vascular endothelial cells.