润肺益肾饮联用左卡尼汀对尿毒症维持性血液透析患者营养不良、微炎症状态和生活质量的影响

目的观察润肺益肾饮联用左卡尼汀对尿毒症维持性血液透析患者营养不良、微炎症状态和生活质量的影响。方法选取2018年9月—2019年3月武汉市中医医院血液透析中心现有规律血液透析患者60例,按照随机数字表法分为观察组和对照组各30例。对照组给予常规透析及对症降压、纠正贫血及低盐低脂优质高蛋白饮食治疗,透析结束时予左卡尼汀1.0 g静推,3次/周,治疗组在对照组的基础上给予润肺益肾饮口服治疗,2组疗程均为12周。观察比较2组患者治疗前后血浆前白蛋白(PA)、白蛋白(ALB)、血红蛋白(Hb)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平及营养状态MOSGA评分、生活质量SF-36评分的差异。结果治疗后2组PA、ALB及Hb水平均较治疗前明显升高(P均<0.05),hs-CRP、IL-6、TNF-α水平均较治疗前明显下降(P均<0.05);且治疗组PA、ALB及Hb水平均明显高于对照组(P均<0.05),hs-CRP、IL-6、TNF-α水平均明显低于对照组(P均<0.05);2组治疗后MQSGA评分均较治疗前明显降低(P均<0.05),SF-36评分中生理功能、生理职能、总体健康、活力、情感职能评分均较治疗前明显升高,且观察组上述各评分改善情况明显优于对照组(P均<0.05)。结论润肺益肾饮联用左卡尼汀能更有效地改善尿毒症维持性血液透性患者营养不良,减轻微炎症状态,提高患者生活质量。

Effect of Runfei Yishen Decoction combined with levocarnitine on malnutrition,micro-inflammatory status and quality of life in patients with uremia treated with maintenance hemodialysis

Objective It is to observe the effect of Runfei Yishen Decoction combined with levocarnitine on malnutrition,micro-inflammatory state and quality of life in patients with uremia treated with maintenance hemodialysis.Methods 60 patients treated with regular hemodialysis in the Hemodialysis Center of Wuhan Hospital of Traditional Chinese Medicine from September 2018 to March 2019 were selected and divided into observation group and control group according to the random number table,30 cases in each group.The control group was treated with conventional dialysis and symptomatic therapy such as antihypertension,anti-anemia,and low-salt,low-fat and high-protein diet;at the end of dialysis,1.0 g of levocarnitine was given intravenously,3 times a week.The treatment group was treated with Runfei Yishen Decoction based on the control group,and the course of treatment in both groups was 12 weeks.The differences in the levels of plasma prealbumin(PA),albumin(ALB)and hemoglobin(Hb),high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factorα(TNF-α),nutritional status MOSGA score,SF-36 score of life quality were compared before and after treatment between the two groups.Results The levels of PA,ALB and Hb after treatment were significantly higher and the levels of hs-CRP,IL-6,and TNF-αafter treatment were significantly lower than those before treatment in the two groups(all P<0.05).The levels of PA,ALB and Hb in the treatment group were significantly higher while the levels of hs-CRP,IL-6,and TNF-αwere significantly lower than those in the control group after treatment(all P<0.05).The MQSGA scores of the two groups after treatment were all lower than those before treatment(all P<0.05),the scores of the five dimensions of physiological function,physiological function,general health,vitality,and emotional function in the SF-36 score were significantly higher than those before treatment in the two groups(P<0.05),and the improvement of each score of the treatment group was significantly better than that of the control group(P<0.05).Conclusion The combination of Runfei Yishen Decoction with Levocarnitine can more effectively improve the malnutrition,reduce the micro-inflammatory state,and improve the quality of life of patients with uremia treated with maintenance hemodialysis.