| Objective: Blood dialysis is the treatment of end-stage renal diseasemainly one of alternative therapies, malnutrition is end-stage renal disease(ESRD) keep the blood dialysis patients common major complications. Thestudy showed that malnutrition on maintenance hemodialysis(maintenancehemodialysis, MHD) in patients with rate was23%~76%, ofwhich about6%~8%severe malnutrition (1-2), severe malnutrition increasesthe maintenance hemodialysis patients to be hospitalized and mortality,serious impact on the quality of life of the patients. Malnutrition patients notonly reduce the immune function, anemia aggravating, often happen infection,disease of heart head blood-vessel, serious complications, maintenancehemodialysis, how to improve the quality of life of the patients and long-termsurvival rate, will in the future is renal physician's challenge. Therefore, toeffectively prevent and corrective maintenance hemodialysis patientsmalnutrition, is to improve the quality of life of the patients maintenancehemodialysis, reduce the mortality of important measures. Maintenancehemodialysis patients with malnutrition caused by insufficient intake ofprotein uremia, metabolic and endocrine disorder, digestive system symptoms,blood lean meat increased levels, persistent metabolic acidosis, inflammatoryreaction factors, from the current related study can be informed, with Chinesemedicine therapy to improve maintenance hemodialysis patients malnutritionsymptoms have certain curative effect, and relatively cheap, have importantresearch value and broad application prospect, so from a new breakthrough inthe field of medicine for has the great significance and prospect.The spleen and stomach drop benefiting kidney, turbidity party accordingto the traditional Chinese medicine is the mentor and the pathogenesis characteristics was founded, preliminary clinical observation have apparentcurative effect. This topic through detailed and complete aims to clinicalobservation of to make clear its curative effect, its possible that themechanism of action. For clinical treatment maintenance hemodialysispatients malnutrition, create a new train of thought.Method: Observe maintenance hemodialysis patients60cases wererandomly divided into two groups: control group given the high quality andhigh protein diet full HD, but not herbal treatment. The treatment groupbenefiting kidney, and oral invigorating spleen stomach drop turbidity party(basic party:12g, codonopsis pilosula astragalus20g, white atractylodes15g,poria cocos12g, dried tangerine or orange peel to12g, law12g, smilaxglabra roxb sprouting15g, sand benevolence12g, pogostemon patchouli12g, rhubarb9g, danshen15g, etc.). Add: deficiency and yam, lentils; Yindeficiency and cultivated land, newly cultivated land GuiBan; Yang, c.deserticola and eucommia, dodder; Yin and Yang added two empty dogwood,cinnamon, dry ginger; Yin deficiency of both qi and medlar, yellow fine,containing. A daily agent, each agent two Fried, each Fried200ml, blending,and sooner or later, temperature uniform, three months for a period oftreatment, observe two treatment. Two groups of patients were given lawhemodialysis, three times per week, the high quality protein diet and othersymptomatic treatment and support. Make two groups of patients in thegender, age, original disease, course and degree of malnutrition after statisticsprocessing has no significant difference (P>0.05), comparable. Two groupsof patients before and after treatment observation hypersensitivity c-reactiveprotein (hs-CRP), serum albumin (Alb), before the serum albumin (PA),endogenous human erythropoietin (EPO), the hemoglobin (Hgb), red bloodcell deposited (HCt), residual renal function (RRF), urea nitrogen (BUN),creatinine (Scr), poor nutrition rating, Chinese medicine the symptom scorechanges, and make curative effect evaluation. Results:1drug24weeks later the treatment group and control group patients TCMsymptoms than before the drug are integral significantly reduced, but thetreatment group of TCM symptoms integral reduce very significant (p <0.01),the treatment group and control group between was significant difference (p <0.01). Drug use24weeks later two groups of patients, nausea and vomitingclassification (0degrees+mild) is the number of medicine are the before havedeclined, but the treatment groups of patients, nausea and vomitingclassification (0degrees+mild) is the number of group compared with thesignificant difference. These data can explain the treatment group to improvedigestion system function disorder obvious effects. After the treatment grouppatients nutrition state subjective ratings have very improved obviously (p <0.01), and the control group integral no significant changes before and aftertreatment (p>0.05). The chart can be seen in treatment group of nutritionalstatus after improved obviously, curative effect is significantly better than thecontrol group.2the two groups of patients before drug Alb, PA level no significantdifference (P>0.05).24weeks after treatment group Alb, PA is no changebefore treatment (P>0.05), but the treatment group Alb, PA is beforetreatment significantly increased (P <0.05), the curative effect of treatmentgroup was better than control. Shows that the treatment group to improvemaintenance hemodialysis patients nutrition status in treatment group.Treatment group and control group before drug hs-CRP level no significantdifference between (P>0.05).24weeks after treatment in treatment groupand a drug hs-CRP before rising (P <0.01), but the treatment group andcontrol group between significant difference (P <0.01), the treatment groupwas significantly higher than the control group. Shows that the treatmentgroup to improve maintenance hemodialysis patients micro inflammationstatus effect than those in the control group. Two groups of patients beforedrug Hgb, HCt between level no significant difference (P>0.05).24weeksafter treatment in treatment group, HCt and a drug Hgb before rising (P <0.01), but the treatment group and control group between significant difference (P <0.01), the treatment group was significantly higher than thecontrol group. Shows that the treatment group than in control group action toimprove anemia. The chart shows the control group therapy24weeks laterBUN, Scr is before treatment has dropped, but before treatment comparedwith no significant difference (p>0.05); The treatment group were treated24weeks later BUN, Scr is before treatment decreased obviously (p <0.01), andthe control group was significant difference (p <0.01); The treatment groupand control group therapy24weeks later RRF all declined, but patients RRFtreatment group is down significantly, two groups of patients with significantdifference (p <0.05). Explain the treatment group in delaying maintenancehemodialysis patients residual kidney function better than control group.Before treatment between treatment group and control group serum level ofEPO no significant difference (P>0.05).24weeks after treatment, the controlgroup serum EPO before drug level is not improved significantly (P>0.05),the treatment group patients serum EPO before treatment level is improvedsignificantly. And the control group serum EPO to level with significantdifference (P <0.01). Shows that the treatment group in the blood canobviously increase content of EPO.Conclusion:1the spleen and stomach drop benefiting kidney, can obviously improve theturbidity maintenance hemodialysis patients malnutrition clinical symptomsand signs integral, make the patient's quality of life improved obviously.2the spleen and stomach drop benefiting kidney, turbidity party can improveAlb, PA level, improve maintenance hemodialysis patients nutrition state; Canreduce the hs-CRP level, can effectively control maintenance hemodialysispatients micro inflammation of the state; Can promote endogenous humanerythropoietin secretion, improve the level of serum EPO; Reduce the Bun,Scr, reduce uremia toxins on maintenance hemodialysis patients malnutritioninhibitory effect. Speculation is that the treatment group than in control grouprole of the possible mechanism. 3spleen and stomach drop the kidney, can improve the turbidity Hgb, Hct,serum EPO and PA level. Reduce the Bun, Scr, improve patients with anemia,and renal function level, and slow down long-term hemodialysis patients onthe progress of the remnants of the kidney function.4the spleen and stomach drop benefiting kidney, turbidity party is have thevirtual centralizer, detoxification drop turbidity and remove blood stasisefficacy of traditional Chinese medicine formula and become, reflect Chinesemedicine centralizer and remove with evil, with the integrity of the specimenprinciple, and the application of erythropoietin, levorotatory carney, statinsal.growth hormone drugs such as compared, have definite effect, fewside-effects, price is low wait for an advantage, with extensive clinicalapplication value. |
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