健脾益肾丸对维持性血液透析患者微炎症状态的影响
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摘要
【目的】探讨健脾益肾丸对维持性血液透析(maintenance hemodialysis, MHD)患者微炎症状态的影响。
     【方法】随机选择20例本院MHD患者作为治疗组,进行自身前后对照,治疗期间予维持性血液透析的基础上加用健脾益肾丸,分别在治疗前、治疗后检测患者血清C反应蛋白(CRP)、白介素6(IL-6)和血浆内毒素水平,并进行比较。同时取20名健康成人作为正常对照组。
     【结果】1、治疗前患者血清CRP及血浆内毒素水平明显高于对照组(p<0.01),治疗后血清CRP及血浆内毒素水平较治疗前明显下降(p<0.05)。2、治疗前患者血清IL-6水平分别与对照组、治疗后比较均无明显差异(p>0.05)。3、治疗后临床症状累计得分数值较治疗前下降(p<0.05)。4、治疗前及治疗后患者血清K+均在正常范围之内,两组间比较无明显差异(p>0.05)。
     【结论】健脾益肾丸能有效降低MHD患者血清CRP及血浆内毒素水平,提示健脾益肾丸可以在一定程度上改善MHD患者微炎症状态。健脾益肾丸可有助于降低患者的临床症状积分,且不会升高血清K+水平。
[Objectives] To investigate the effect of Kidney-benefiting and Spleen-fortifying Pill on microinflammatory state in patients with uremia undergoing maintenance hemodialysis.
     [Methods] Twenty patients with chronic renal failure during maintenance hemodialysis were randomly selected as the therapy group administrated with Kidney-benefiting and Spleen-fortifying Pill and twenty normal individuals were selected as the normal control group. The serum levels of C-reactive protein(CRP), interlukin-6 (IL-6) and the plasma level of endotoxin of each patient before and after treatment were measured respectively and compared with that of other patients and that of the normal control group.
     [Results] 1. Compared with the normal control group, the serum level of CRP and the plasma level of endotoxin were significantly higher in the therapy group (p<0.01). The serum level of CRP and the plasma level of endotoxin was markedly lowered after treatment (p<0.05).2. Compared with the normal control group or the therapy group after treatment, the serum level of IL-6 showed no significant difference in the therapy group before treatment (p>0.05).3. Cumulative scores of clinical symptoms after treatment decreased than that before treatment(p<0.05).4. The serum levels of K+ in therapy group before and after treatment were both in the normal range and there was no significant difference between the two groups (p>0.05).
     [Conclusions] Kidney-benefiting and Spleen-fortifying Pill can reduce the serum level of CRP and the plasma level of endotoxin, which proves that Kidney-benefiting and Spleen-fortifying Pill can improve the microinflammatory state in patients with uremia undergoing maintenance hemodialysis in the certain extent. In addition, Kidney-benefiting and Spleen-fortifying Pill is beneficial in reducing the clinical symptom score without increasing the serum level of K+.
引文
[1]Stenvinkel P. Inflammatory and atheroselerotic interactions in the depleted uremic patient. Blood Purif,2001,19(5):53-61.
    [2]Jeznach Steinhagen A, Sotwifiski R, Szczygie B. Malnutrition in flammation atherosclerosis in hemodialysis patients[J]. Rocz Panstw Zakl Hig,2007, 58(1):83-88.
    [3]林坚,易无庸,李顺民,等.健脾益肾丸降低维持性血透患者脂调素水平的临床研究.医学临床研究,2004,21(12):1402-1404.
    [4]Joumosi D. Hemofiltration during cardiopulmonary bypass. Kidey Int.1998, 53, (66):174-181.
    [5]倪玲,朱汉威.慢性肾衰竭的微炎症状态.上海交通大学学报(医学版),2006,26(1):100-104.
    [6]张涤华,余学清,郑智华,等.高纯度透析浓缩液对血液透析患者血清白细胞介素-6,肿瘤坏死因子-α,白蛋白水平的影响[J].中华肾脏病杂志,2005,21(2):76-80.
    [7]TsirpanlisG, Chatzipanagiotou S, Nikolaou, et al. Microinflammotion versus inflammation in chronic renal failure patiems. Kidney Int,2004,66(12): 2093-2098.
    [8]谢恺庆,杨海波,周红卫,等.尿毒症维持性血液透析患者微炎症状态与脂蛋白(a)的关系[J].中国动脉硬化杂志,2004,12(4):469-470.
    [9]Cooper AC, Mikhail A, Lethbfidge MW, et al. Increased expression of erythropoiesis inhibiting cytokines(IFN-7, TNF-Q, IL-10 and IL-13)by T cells in patients exhibiting a poor response to erythropoietin therapy [J]. Am Soc Nephrol,2003,14(5):1776-1784.
    [10]张琳,曾庆波,曾章超.白细胞介素-6(IL-6)与肾脏疾病.实用中西医结合临床,2000,5(2):80-81.
    [11]Bologa RM, Levine DM, Parker TS,et al. Interleukin-6 predicts hypoalbumi-nemia,hypocholesterolemia, and mortality in hemodialysis patients. Am J Kidney Dis,1998,32(1):107-114.
    [12]粱莹.内毒素致病机制的研究进展[J].现代医药卫生,2004,20(24):2667-2668.
    [13]Jurgen B. Medical Complications of the Lnog-Term Dialysis Patient.In Cameron S.Davison AM. Oxford Textbook of Clinical Nephrology. Ox ford:Ox ford Univ Press.1992.1436-1457.
    [14]Qureshi AR, Alvestrand A, Divinofilho JC, et al. Inflammation, malnutrition and cardiac disease as predictors of mortality in hemodialysis patients. [J] Am Soc Nephrol,2002,13(Suppl1):28-36.
    [15]丁德良,郑国俊.尿毒症非透析患者微炎症状态与动脉粥样硬化的关系.新医学,2006,37(7):466-468.
    [16]Stenvinkel P, Heimburger O, Paultre F, et al. Strong association between Malnutrition, inflammation and atherosderosis in chronic renal failure. Kidney Int,1999,55(5):1899-1911.
    [17]薛骏,丁峰,景秀琛,等.透析液微生物学质量提高对维持性血液透析患者营养和炎症状态的影响.中华肾脏病杂志,2003,19(6):381.
    [18]BaranyP, DivinoFiho JC, Bergstrom J. High C-reactive protein is a strong predictor of resistance to erythropoietein in hemodialysis patients. [J]Am KidneyDis,1997,29(4):565.
    [19]王刚,郑尘非.舒降之对维持血透患者微炎症状态的影响.中国中西医结合肾病杂志,2004,5(9):515-517.
    [20]王海蓉,李建军,蒋锡嘉,等.血管紧张素II对培养血管内皮细胞核因子-kB激活及厄贝沙坦干预研究.中华心血管病杂志,2004,32(1):64-67.
    [21]王晓慧,樊福成,王展.左卡尼汀对血液透析患者微炎症及营养状况的影响.临床肾脏病杂志,2008,8(8):357-358.
    [22]沈建明,勾荣,万芸,等.乌司他丁改善维持性血液透析患者微炎症及氧化应激状态.临床肾脏病杂志,2008,12(12):546-548.
    [23]孙馥云,李丽华,孙文英,等.百令胶囊联用复方α酮酸对腹膜透析患者微炎症的影响.中国药师,2008,11(9):1029-1031.
    [24]陈香美,张冬.应重视维持性血液透析患者微炎症状态的认识.中国血液净化,2005,4(2):59-61.
    [25]夏瑗瑜,车相友.羟苯磺酸钙对维持性血液透析患者微炎症状态的影响.中国血液净化,2006,5(12):829-831.
    [26]杨杰,张晓辉,何强等.还原型谷胱甘肽对维持性血液透析患者微炎症状态的影响.浙江医学.2008.30(11):1242-1243.
    [27]陈江华,何强,徐莹.维持性血液透析患者微炎症状态的认识与防治.中华肾脏病 杂志,2005,21(2):117-118.
    [28]Hoffmann U, Fischereder M, Marx M, et al. Induction of cytokines and adhesion molecules in stable hemodialysis patients:is there an effect of nmmbrane material[J]. Am Nephrol,2003,23(6):442-447.
    [29]Tsuchida K, Takemto Y, Sugimura K, et al. Direct hemoperfusion by using lixelle(R)colum for the treatment of systemic inflammatory response syndrome[J].Toxicol Clin To col,2002,40(4):507-512.
    [30]胡马洪,张庚,许秀娟.大黄和谷氨酰胺对重症患者血清细胞因子的影响[J].浙江中医药大学学报,2007,31(2):116-117.
    [31]罗志毅,黄新,包国荣.大黄中主要成分清除超氧阴离子自由基的电子自旋共振技术(ESR)研究[J].中华中医药学刊,2007,25(3):612-614.
    [32]沈建明,邓妍妍,叶婷婷,等.大黄对尿毒症非透析患者微炎症和氧化应激状态的影响.郧阳医学院学报,2008,10(5):423-425.
    [33]蒲超,杨亦彬.复方丹参片对维持性血液透析患者氧化应激和微炎症状态的干预作用.中国中西医结合杂志,2006,26(9):791-794.
    [34]鲍英华,陈荣华.姜黄素的研究进展.国外医学儿科学分册,2003,30(5):254-256.
    [35]李新建,刘晓城.姜黄素调节小鼠免疫功能的实验研究.中国组织化学与细胞学杂志,2005,14(2):132-135.
    [36]王鸿泰,李秀珍.姜黄、女贞子对慢性肾衰竭微炎症状态下肾功能的影响.临床肾脏病杂志,2007,7(1):11-12.
    [37]刘良,李晓娟,王培训,等.青藤碱对人外周血单个核细胞IL-10和IL-8两细胞因子基因表达的影响[J].中国免疫学杂志,2002,18(4):241-244.
    [38]李晓娟,王培训,刘良,等.青藤碱抗炎抗风湿作用机理研究[J].广州中医药大学学报,2004,21(21):34-36.
    [39]吴志茹,程彤,贾志芳,等.盐酸青藤碱对血液透析患者微炎症状态的影响.临床荟萃,2008,23(19):1420-1421.
    [40]马腾.血必净对维持性血液透析患者微炎症状态的影响.中国医学创新,2009,4(6):26-27.
    [41]冯兵,叶自林,杨旭,等.雷公藤多甙对糖尿病肾病患者微炎症反应的影响.临床肾脏病杂志,2009,2(9):82-84.
    [42]张雯,陶筱娟,程军,等.参麦注射液对维持性血液透析患者微炎症状态的影响.浙 江中西医结合杂志,2008,18(11):684-685.
    [43]汤军,黄琦,徐志瑛,等.麦冬多糖的免疫活性研究.中国中医基础医学杂志,1998,4(9):4.
    [44]宋立群,代丽娟.虫草肾茶方对慢性肾衰竭非透析患者微炎症状态的改善作用.中国中西医结合肾病杂志,2008,9(9):829-831.
    [45]叶彩霞,李建华.八珍汤对慢性肾衰竭患者促红素抵抗的影响.辽宁中医杂志,2008,35(2):161-162.
    [46]伍劲华.肾衰合剂对慢性肾衰整体功能代偿及微炎症状态的影响.新中医.2007,7(7):84-85.
    [47]李靖,瞿伟.倍生颗粒对血透患者微炎症状态的影响.山东中医杂志,2006,11(11):749-750.
    [48]郑筱萸.中药新药临床研究指导原则,中国医药科技出版社,2002,1:163.