【摘要】 目的观察保元通络方对血液透析患者心血管事件的影响。方法收集维持性血液透析的尿毒症患者43例(治疗组22例,对照组21例),在基础治疗的同时治疗组给予保元通络方,连续观察8周,每4周收集血浆白蛋白(ALB)、血红蛋白(Hb)、总胆固醇(TC)、甘油三酯(TG)、同型半胱氨酸(HCY)、超敏C反应蛋白(Hs-CRP)、四诊信息等指标,并进行中医危险因素及生存情况分析。结果水湿、湿热是血液透析患者发生心血管事件的危险因素。治疗组第4、8周时证候积分减少、TC升高、血HCY下降较治疗前均有统计学差异(P<0.05),对照组无明显变化。治疗组第8周时ALB水平上升较治疗前有统计学差异(P<0.05),而对照组较治疗前有所下降。治疗组第8周与第4周时相比Hb升高有统计学差异(P<0.05),而对照组较治疗前均明显下降。患者TG、Hs-CRP8周内均无明显变化。研究期间未发生心血管事件的生存率治疗组为45.45%,对照组为28.57%,差异有统计学意义(P<0.05)。结论保元通络方可改善血液透析患者的不适症状,提高血浆ALB、Hb,降低HCY水平及心血事件发生的风险。更多还原

【Abstract】 Objective To study the effect of Baoyuan Tongluo Formula (Formula for protecting the heart and removing obstruction of meridians) on cardiovascular events of hemodialysis patients.Methods In a single-centered,prospective,random-controlled study,the 43 uremia patients receiving maintenance hemodialysis were enrolled (22 in the treatment group and 21 in the control group) and Baoyuan Tongluo Formula was given to the treatment group additionally.The observation lasted for 8 weeks.The serum albumin,hemoglobin,total cholesterol,triglyceride,homocysteine,high sensitivity C-reactive protein (hs-CRP),and four diagnostic information were collected every 4 weeks for analysis.Results Water-damp and dame-heat were the risk factors of cardiovascular events in hemodialysis patients.In the treatment group,the symptom score of the 6th and 8th week decreased,total cholesterol increased,and homocysteine decreased with significant difference (P<0.05),while in the control group,there was no significant difference.In the 8th week,compared with before treatment,the serum albumin of the treatment group was increased significantly (P<0.05),but that of the control group was decreased.Comparing with the 4th week,the hemoglobin of the treatment group in the 8th week was statistically increased (P<0.05),but that of the control group was significantly decreased than before treatment.There were no significant changes in triglyceride and hs-CRP within 8 weeks.The survival rate of the treatment group without cardiovascular accident during the observation was 45.45%,while that of the control group was 28.57%,the difference was significant (P<0.05).Conclusion The comprehensive treatment with Baoyuan Tongluo Formula is effective in improving the symptoms,increasing the levels of albumin and hemoglobin,decreasing the level of homocysteine and reducing the risk of cardiovascular events.更多还原