摘要
目的 观察补肾排毒通络法对尿毒症腹膜透析患者微炎症状态及T细胞亚群功能的影响.方法 选择沈阳市红十字会医院2015年6月至2018年1月收治的尿毒症腹膜透析患者60例,按治疗方法不同分为单纯西医治疗组和加用中药治疗组,每组30例.两组均给予持续不卧床腹膜透析和西医常规治疗,加用中药组在常规西医治疗基础上联合中药治疗,基本方：黄芪30 g、党参20 g、茯苓20 g、白术15 g、当归20 g、虫草菌丝15 g、厚朴20 g、地黄15 g、仙灵脾20 g、红花15 g、丹参20 g、大黄5 g、半夏10 g、银杏叶15 g、牛膝15 g、枸杞子25 g、姜黄15 g、女贞子25 g加减.治疗12周后,观察两组患者免疫功能及微炎症指标的变化.结果 加用中药治疗组治疗后CD4＋、CD8＋、CD4＋/CD8＋、IgG水平较入组时及同期单纯西医治疗组明显升高〔CD4＋：0.41±0.06比0.35±0.06、0.37±0.06,CD8＋：0.33±0.04比0.29±0.04、0.31±0.04,CD4＋/CD8＋：1.89±0.16比1.39±0.20、1.33±0.23,IgG（g/L）：1.22±0.36比0.97±0.32、1.08±0.39〕,而加用中药治疗组C-反应蛋白（CRP）、白细胞介素-6（IL-6）均较单纯西医治疗组显著降低〔CRP（mg/L）：10.01±7.12比13.92±6.94、14.93±7.43,IL-6（pg/L）：35.06±10.95比43.97±9.12、45.91±9.94,均P〈0.05〕.加用中药治疗组治疗后血红蛋白（Hb）、IgM、IgA虽较入组时及同期单纯西医治疗组升高,但差异无统计学意义（均P〉0.05）.两组入组时和治疗后IgM、IgA、血尿素氮（BUN）、血清肌酐（SCr）、钾、氯、钙、磷水平比较差异均无统计学意义（均P〉0.05）.结论 加用中药治疗可有效改善尿毒症腹膜透析患者的免疫功能及微炎症状态.
Objective To investigate the effects of kidney tonifying, detoxifying and dredging method on micro-inflammation status and T-cell subgroup function in patients with peritoneal dialysis. Methods Sixty patients with uremia undergoing peritoneal dialysis enrolled by Shenyang Red Cross Hospital from June 2015 to January 2018 were divided into a single western medicine treatment group and an addition Chinese medicine treatment group according to difference in therapeutic methods, 30 cases in each group. Both groups were treated with continuous ambulatory peritoneal dialysis and other routine western therapy, and the patients in addition Chinese medicine treatment group, additionally received traditional Chinese medicine （TCM） herbal decoction for oral administration, the basic prescription including stragalus 30 g, radix codonopsis 20 g, tuckahoe 20 g, white atractylodes rhizome 15 g, angelica sinensis 20 g, cordyceps hyphae 15 g, mangnolia officinalis 20 g, rehmannia 15 g, herba epimedii 20 g, safflower 15 g, salvia 20 g, rhubarb 5 g, pinellia ternate 10 g, folium ginkgo 15 g, radix achyranthis bidentatae 15 g, fructus lycii 25 g, curcuma 15 g, fructus ligustri lucidi 25 g, the above items could be added or subtracted according to patient＇s individual situation. After treatment for 12 weeks, the changes of indicators of immune function and micro-inflammation before and after treatment in both groups were observed. Results After treatment, the levels of CD4＋, CD8＋, CD4＋/CD8＋, immunoglobulin G （IgG） in the addition Chinese medicine treatment group were significantly higher than those before treatment and those in the single western medicine treatment group in the same period [CD4＋： 0.41 ± 0.06 vs. 0.35± 0.06, 0.37 ± 0.06, CD8＋： 0.33±0.04 vs. 0.29±0.04, 0.31 ±0.04, CD4＋/CD8＋： 1.89±0.16 vs. 1.39±0.20, 1.33±0.23, IgG （g/L）： 1.22±0.36 vs. 0.97±0.32, 1.08±0.39], while C-reactive protein （CRP） and interleukin-6 （IL-6） were decreased significantly [CRP （mg/L）： 10.01 ±7.12 vs. 13.92±6.94, 14.93±7.43, IL-6 （pg/L）： 35.06±10.95 vs. 43.97±9.12, 45.91 ±9.94, all P 〈 0.05]. The levels of hemoglobin （Hb）, IgM, and IgA in the addition Chinese medicine treatment group were higher than those before treatment and those in the single western medicine treatment group in the same period, but the differences were not statistically significant （all P 〉 0.05）. There were no statistically signifieant differences in IgM,IgA, blood urea nitrogen （BUN）, serum creatinine （SCr）, potassium, chloride, calcium, phosphate levels before and after 12 weeks of treatment in the two groups （all P 〉 0.05）. Conclusion Addition Chinese medicine treatment can effectively improve the immune function and micro-inflammation status in patients with peritoneal dialysis.
作者
牛铁明
韩毅
冯惠莲
岳惠卿
栾迅飞
于文晴
付畅
董庆泽
黄添翼
Niu Tieming;Han Yi;Feng Huilian;Yue Huiqing;Luan Xunfei;Yu Wenqing;Fu Chang;Dong Qingze;Huang Tianyi(Department of Nephrology,Shenyang Red Cross Hospital,Shenyang 110013,Liaoning,China;Department of Traditional Chinese Medicine,Shenyang Red Cross Hospital.Shenyang 110013.Liaoning China)
出处
《中国中西医结合急救杂志》
CAS
CSCD
北大核心
2018年第5期480-484,共5页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
沈阳市医药卫生科研课题（2014-291）
关键词
补肾排毒通络法
慢性肾衰竭
免疫功能
微炎症状态
Kidney tonifying
detoxifying and dredging method
Chronic renal failure
Immune function
Micro-inflammation status
