黄芪注射液对尿毒症维持性血液透析患者残余肾功能影响

摘要

目的：探讨黄芪注射液对尿毒症血液透析患者残余肾功能（RRF）的影响。方法选取2014年9月—2015年9月在我院进行血液透析的70例尿毒症患者为研究对象，随机分为观察组和对照组，2组患者均积极处理原发病，给予优质蛋白、低盐饮食，控制血压、血糖，纠正贫血等常规治疗，观察组在上述基础上加用黄芪注射液30 mL，于透析结束前60 min 缓慢泵入，2组 2 个月为1疗程，共3个疗程。观察 2组治疗前后血清肌酐（SCr）、尿素氮（BUN）水平和血红蛋白（Hb）、白蛋白（Alb）、前白蛋白（PA）水平，计算治疗前后日均尿量。结果治疗后，2组 SCr、BUN 下降程度大于对照组，RRF 下降程度小于对照组，有统计学意义（P ＜0.05）；治疗后，2组 Hb 均升高，观察组升高优于对照组（P ＜0.05），治疗后观察组 Alb、PA 均有所升高，对照组 Alb 变化不明显，PA 降低，观察组优于对照组，有统计学意义（P ＜0.05）；治疗后，2组日尿量均下降，观察组下降程度低于对照组，有统计学意义（P ＜0.05）。结论黄芪注射液可有效延缓 MHD 患者尿量及 RRF 的下降，同时也为中医药保护 MHD 患者 RRF 提供有效临床证据。%Objective To discuss the effect of Huangqi injection on RRF(residual renal function)of MHD(ma-intenance hemodialysis)patients suffered from Uremia. Methods The 70 uremia patients admitted into our hospital from September 2014 to September 2015 for hemodialysis were enrolled and randomly divided into observation group and control group. Besides routine treatments for all patients,including treating primary disease positively,providing high-quality protein,low-salt diet and blood pressure and sugar control measures,improving the state of anemia,the observation group was given 30mL of Huangqi injection 60mins before the end of hemodialysis. There were three cour-ses of treatment with each one being two months. Levels of SCr,BUN,Hb,Alb and PA,together with the urine amounts in two groups before and after treatment were observed for comparison. Results After treatment,levels of SCr and BUN dropped in both groups and the drop in observation group were more obvious than that in control group. The RRF level in observation group dropped less obvious than that in control group. The difference was with statistical signifi-cance( P < 0. 05 ). Both groups have elevated Hb level,with that in observation group being more obvious (P < 0. 05). After treatment,Alb and PA levels in observation elevated while in control group,though the level of PA dropped,no obvious change of Alb level was observed. Observation group performed better than control group,the difference was statistically significant(P < 0. 05). Urine amount in both groups dropped,while observation group is less remarkable than control group,the difference was statistically significant(P < 0. 05). Conclusion Application of Huangqi injection can effectively delay the decrease of urine amount and RRF level in MHD patients. Itˊs clinically proofing that TCM plays an important role in protecting MHD patients.