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投稿时间：2022-04-25 网络发布日期：2023-02-20
投稿时间：2022-04-25 网络发布日期：2023-02-20
中文摘要: 目的 探讨甘草干姜汤加减联合灸法对维持性腹膜透析终末期肾病患者的临床疗效。方法 选择2019年6月至2021年6月于河北医科大学第一医院就诊的维持性腹膜透析终末期肾病患者62例，采用随机数字表方法将患者分为对照组与治疗组，各31例。对照组患者给予西医常规治疗，治疗组在对照组基础上给予甘草干姜汤加减联合益气回元灸法治疗。治疗4周后观察两组患者中医证候评分、透析充分性［血清肌酐(Scr)、尿素氮(BUN)、尿酸、肾小球滤过率（eGFR）水平；残余肾功能(RRF)、残肾尿素清除指数(KT/V)、透析KT/V参数水平］及心肌损伤因子［血清氨基末端B型利钠肽(NT-proBNP)、肌酸激酶同工酶(CK-MB)、肌钙蛋白Ⅰ(cTnⅠ)水平］，随访6个月记录心血管不良反应事件。结果 治疗后治疗组中医证候评分低于对照组（P＜0.05）。治疗后治疗组Scr、BUN、尿酸水平显著低于对照组，eGFR、RRF、透析KT/V、残肾KT/V显著高于对照组（P＜0.05）。治疗后治疗组血清NT-proBNP、CK-MB、cTnⅠ水平显著低于对照组（P＜0.05）。随访发现，治疗组心血管不良事件发生率显著低于对照组（29.03% vs54.84%，P<0.05）。结论 甘草干姜汤加减联合灸法可增强患者透析充分性，保护患者残余肾功能，改善患者临床症状，降低心血管事件发生风险，临床疗效显著。
Abstract:ObjectiveTo investigate the clinical effect of Gancao Ganjiang Decoction (GGD) combined with moxibustion on the patients with end-stage renal disease (ESRD) received maintenance peritoneal dialysis (PD). MethodsSixty-two ESRD patients received maintenance PD in the First Hospital of Hebei Medical University from June 2019 to June 2021 were selected and were randomly divided into control group and treatment group (n=31, each). The routine western medicine was given in control group, while the modified GGD combined with Yiqi Huiyuan moxibustion was added in treatment group based on the routine western medicine. After 4 weeks of treatment, the TCM syndrome scores, the dialysis adequacy ［serum creatinine (Scr), blood urea nitrogen (BUN), uric acid, estimated glomerular filtration rate (eGFR),residual renal function (RRF), residual renal urea clearance index (KT/V) and PD KT/V parameters］ and the cardiac injury biomarkers ［serum amino-terminal brain natriuretic peptide (NT-proBNP), creatine kinase-myocardial band (CK-MB), cardiac troponin Ⅰ (cTnⅠ) levels］ were observed and compared between two groups. Cardiovascular adverse events were observed during 6 months follow-up period. ResultsAfter treatment, TCM syndromes scores in treatment group were statistically lower than those in control group (P<0.05). Compared with those in control group, the levels of serum Scr, BUN and uric acid significantly decreased, and the levels of eGFR, RRF, PD KT/V and residual renal KT/V significantly increased in treatment group(P＜0.05）. The serum levels of NT-proBNP, CK-MB and cTnⅠ were lower in treatment group than those in control group (P<0.05). The incidence of cardiovascular adverse events in treatment group was significantly lower than that in control group during follow-up period (29.03% vs54.84%, P<0.05). ConclusionFor ESRD patients receiving maintenance PD, modified GGD combined with moxibustion can enhance the dialysis adequacy, protect the residual renal function, improve the clinical symptoms and reduce the risk of cardiovascular events effectively.
keywords: Gancao Ganjiang Decoction Yiqi Huiyuan moxibustion Maintenance peritoneal dialysis Dialysis adequacy Cardiovascular events End-stage renal disease
文章编号： 中图分类号： 文献标志码：B
基金项目:河北省中医药类科研计划项目（2021125）
引用文本：
李丹露，胡秀红，高玉伟，杨洪娟.甘草干姜汤加减联合灸法对维持性腹膜透析终末期肾病患者透析充分性及心血管事件的影响[J].中国临床研究,2023,36(2):271-275.
李丹露，胡秀红，高玉伟，杨洪娟.甘草干姜汤加减联合灸法对维持性腹膜透析终末期肾病患者透析充分性及心血管事件的影响[J].中国临床研究,2023,36(2):271-275.