【摘要】 目的：探讨砂仁山药鲫鱼汤对脾肾阳虚型尿毒症患者“营养-炎症-免疫轴”的影响及临床意义。方法：将我院于2021年7月—2024年7月收治的91例脾肾阳虚型尿毒症合并营养不良患者按随机数字表法分为对照组（45例）与观察组（46例）。对照组给予常规血液透析联合加味真武汤治疗，观察组在血液透析基础上采取药膳砂仁山药鲫鱼汤治疗。治疗3个月后随访。评估治疗前后两组临床疗效、中医证候积分和生活质量评分、微炎症与营养等相关指标变化，统计不良反应发生情况。结果：观察组总有效率高于对照组（97.83%vs 84.44%）。相比对照组，观察组治疗后倦怠乏力、畏寒肢冷、气短懒言、食少纳呆、腰膝酸软评分均明显更低；观察组治疗后血红蛋白、白蛋白、转铁蛋白、尿素氮水平均明显更高，观察组治疗后总胆固醇水平无明显差异；观察组治疗后营养相关指标[上臂围、肱三头肌皮褶厚度、上臂肌围]水平均更高；观察组治疗后CD4~+、CD4~+/CD8~+均更高、CD8~+更低；观察组治疗后白细胞介素-6、高敏C反应蛋白、肿瘤坏死因子-α水平均更低；观察组治疗后生活质量评分更高。治疗后营养不良发生率明显低于对照组（8.70%vs 51.11%）。结论：在血液透析基础上联合应用砂仁山药鲫鱼汤，有助于改善脾肾阳虚型尿毒症患者的营养状况、微炎症状态和免疫功能，提升生活质量。更多还原

【Abstract】 Objective To investigate the effects and clinical relevance of Amomum yam and crucian carp soup, a traditional medicinal dietary formula, on the nutrition-inflammation-immune(NII) axis in patients with uremia characterized by spleen-kidney yang deficiency. Methods A total of 91 patients diagnosed with spleen-kidney yang deficiency and uremia with malnutrition were enrolled between July 2021 and July 2024. Using a random number table method, they were assigned to a control group(n=45) or an observation group(n=46). The control group received conventional hemodialysis combined with Jiawei Zhenwu Decoction, while the observation group was treated with Amomum-Yam-Carp Soup in addition to hemodialysis. Follow-up was conducted after three months. Clinical efficacy, Traditional Chinese Medicine syndrome scores, quality of life, inflammatory markers, and nutritional indices were assessed before and after treatment. The incidence of adverse reactions was recorded. Results The overall response rate in the observation group was significantly higher than in the control group(97.83% vs 84.44%). Compared with the control group, the observation group showed significantly lower scores for fatigue, cold extremities, shortness of breath, poor appetite, and lumbar/knee weakness after treatment. Levels of hemoglobin(Hb), albumin(ALb), transferrin(TRF), and blood urea nitrogen(BUN) were significantly increased in the observation group, while total cholesterol(TC) levels showed no significant change. Nutritional indicators, including mid-arm circumference(MAC), triceps skinfold thickness(TSF), and mid-arm muscle circumference(MAMC), were significantly improved. Immunological markers also indicated an increase in CD4~+ and CD4~+/CD8~+ ratios and a decrease in CD8~+ levels. Additionally, inflammatory markers such as interleukin-6(IL-6), high-sensitivity C-reactive protein(hs-CRP), and tumor necrosis factor-alpha(TNF-α) were significantly lower post-treatment. Quality of life scores were significantly higher in the observation group. The incidence of malnutrition after treatment was significantly lower in the observation group compared to the control group(8.70% vs 51.11%). Conclusion The administration of Amomum yam and crucian carp soup alongside hemodialysis significantly improved nutritional status, reduced systemic inflammation, and enhanced immune function in patients with spleen-kidney yang deficiency uremia, ultimately contributing to better quality of life.更多还原