Effect Of Total Glucosides Of Paeony On Microinflammatory State And Quality Of Life In Maintenance Hemodialysis Patients

Objective1.To investigate the microinflammatory state of maintenance hemodialysis(MHD)patients;2.To investigate the effect of total glucosides of paeony(TGP)on microinflammatory state in maintenance hemodialysis(MHD)patients and its partial mechanism.3.To evaluate the changes of quality of life of maintenance hemodialysis(MHD)patients before and after treatment with total glucosides of paeony(TGP).Methods1.60 maintenance hemodialysis patients in the dialysis center of our hospital and 30 patients with normal physical examination in the outpatient department were included,and 60 MHD patients were divided into MHD treatment group and MHD control group by random number table method.The normal physical examination group was the normal control group.2.MHD control group was treated with regular hemodialysis,antihypertensive,erythropoietic,iron supplement and other drugs.MHD treatment group was additionally treated with total glucosides of paeony(TGP)capsules,1.2g each time,twice a day,for 4 months on the basis of MHD control group.3.The fasting venous blood of all the three groups of patients before treatment,the MHD control group and MHD treatment group after treatment was taken to observe the levels of nutritional index albumin(Alb),hemoglobin(Hb),inflammatory index hypersensitive C-reactive protein(Hs-CRP),interleukin-6(IL-6),tumor necrosis factor-?(TNF-?)and neutrophil gelatinaseassociated lipoprotein(NGAL),Toll-like receptor 4((TLR4)and myeloid differentiation factor 88(MYD88)before and after treatment.4.The nutritional index,microinflammatory index,Toll-like receptor 4((TLR4))and myeloid differentiation factor 88(MYD88)levels of MHD group and normal control group were compared before treatment respectively.And the changes of the abovementioned related indexes were compared in MHD treatment group and MHD control group after treatment.5.At the same time,the Kidney disease Quality of Life Scale was used to evaluate the quality of life scores of MHD control group and MHD treatment group before and after treatment respectively to compare the change level of quality of life between the two groups.Results1.Before treatment,the levels of Alb and Hb in peripheral venous blood of all MHD patients decreased compared with the normal control group,the levels of Hs-CRP,IL-6,TNF-? and NGAL increased significantly compared with the normal control group,the levels of TLR4 and MYD88 increased significantly compared with the normal control group,and the differences were statistically significant(p < 0.05);2.After treatment,the levels of Alb and Hb in peripheral venous blood of MHD treatment group were significantly higher than before treatment,the levels of Hs-CRP,IL-6,TNF-? and NGAL were significantly lower than before treatment,and the levels of TLR4 and MYD88 were significantly lower than before treatment(p < 0.05).3.After treatment,the levels of Alb,Hb,Hs-CRP,IL-6,TNF-?,NGAL,TLR4,MYD88 in peripheral venous blood of MHD control group did not change significantly compared with those before treatment,and the difference was not statistically significant(p > 0.05).4.Before treatment,there was no significant difference in quality of life scores between MHD treatment group and control group(p > 0.05).After treatment,the quality of life score of MHD control group did not change significantly compared with before,and the difference was not statistically significant(P > 0.05).However the quality of life score of MHD treatment group improved,and the difference was statistically significant compared with that before treatment(P < 0.05).Conclusion1.Microinflammatory state does exist in maintenance hemodialysis patients;2.TGP capsule can improve the levels of ALB and HB in MHD patients to correct nutritional status of patients.And it can decrease the levels of Hs-CRP,IL-6,TNF-? and NGAL to improve the microinflammatory state of the MHD patients,which may be related to inhibiting TLR4 /My D88 signal pathway.3.After treatment with TGP,the quality of life of MHD patients was improved which may be related to the improvement of patients' microinflammatory state.