泻浊化瘀汤联合血液透析治疗尿毒症临床效果及对TLR4、炎症细胞因子水平的影响

目的探讨泻浊化瘀汤联合血液透析治疗尿毒症患者的临床效果。方法选取2013年10月-2018年1月收治的107例尿毒症患者,采用随机数字表法分为试验组54例和对照组53例,两组患者均常规采用血液透析治疗,对照组透析治疗的过程中给予基础治疗,观察组给予基础治疗+泻浊化瘀汤,对比两组患者干预前后血液透析后的血肌酐(Scr)、尿素氮(BUN)、血钙、血磷、甲状旁腺激素(PTH)、血清C反应蛋白(CRP)、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、Toll样受体4(TLR4)的水平。结果干预前,观察组和对照组的Scr、BUN、血钙、血磷、PTH、TNF-α水平差异无统计学意义(P>0.05);干预后,观察组的血磷、PTH、TNF-α水平均低于对照组(P<0.05),两组的Scr、BUN、血钙差异无统计学意义(P>0.05);干预前,观察组和对照组的血清IL-2、IL-6、TLR4和CRP水平差异无统计学意义(P>0.05);干预后,观察组的血清IL-2、IL-6、TLR4和CRP均低于对照组(P<0.05)。结论泻浊化瘀汤联合血液透析治疗尿毒症患者有利于降低血磷、降低患者的炎症反应程度及TLR4的水平,对于改善血透患者的治疗质量具有一定的作用。

Effect of Xiezhuo Huayu Decoction on Serum TLR4 and Inflammatory Cytokines in Patients with Uremia Hemodialysis

Objective To investigate the clinical effect of Xiezhuo Huayu Decoction combined with hemodialysis in the treatment of uremic patients. Methods Totally 107 cases of uremia treated in our hospital(2013.10 to 2018.01) were divided into the experimental group(54 cases) and the control group(53 cases). The two groups were routinely hemodialysis. The control group was given basic treatment during the dialysis treatment and the observation group was given basic therapy+Xiezhuo Huayu Decoction. We compared two groups’ levels of serum creatinine(Scr), urea nitrogen(BUN), blood calcium, blood phosphorus, parathyroid hormone(PTH), serum C reactive protein(CRP), interleukin-2(IL-2), interleukin-6(IL-6), tumor necrosis factor-alpha(TNF-α) and Toll like receptor 4(TLR4) were observed before and after hemodialysis. Results Before intervention, there was no significant difference in the levels of Scr, BUN, serum calcium, phosphorus, PTH or TNF-α between the observation group and the control group(P>0.05). After intervention, the serum phosphorous, PTH and TNF-α were observed in the observation group. The average blood levels were lower than those in the control group(P<0.05). There was no significant difference in serum Scr, BUN or serum calcium between the two groups(P>0.05). Before intervention, serum levels of IL-2 and IL-6 in the observation group and control group were not significantly different. There was no significant difference in TLR4 or CRP levels(P>0.05). After intervention, serum IL-2, IL-6, TLR4 and CRP were lower in the observation group than those in the control group(P<0.05). Conclusion The combination of Xiezhuo Huayu Decoction and hemodialysis in the treatment of uremia patients is beneficial to the blood phosphorus and reducing the inflammatory response and the level of TLR4, which has a certain effect on improving the treatment quality of hemodialysis patients.