黄芪注射液穴位注射对维持性血液透析患者低血压及蛋白质-能量营养不良的临床研究

    Clinical study of acupoint injection of astragalus injection on hypotension and protein-energy malnutrition in maintenance hemodialysis patients

      摘要
    • 摘要:
      目的  探讨黄芪注射液穴位注射对维持性血液透析（maintenance hemodialysis，MHD）患者低血压及蛋白质-能量营养不良（protein-energy malnutrition，PEM）的影响。
      方法  选择2021年3月1日至2022年5月31日武汉市汉口医院收治的68例MHD患者，利用随机数字表法分为对照组（34例，采用常规血液透析治疗）与研究组（34例，在对照组基础上采用黄芪注射液穴位注射治疗），收集患者的临床基本资料并比较两组患者低血压发生率、PEM发生率、血清白蛋白（albumin，Alb）、前白蛋白（prealbumin，PA）、血红蛋白（hemoglobin，Hb）、收缩压（systolic blood pressure，SBP）、舒张压（diastolic blood pressure，DBP）、炎症因子水平的变化及不良反应发生率。
      结果  与对照组低血压发生率（26.47%）、PEM发生率（20.59%）比较，研究组MHD患者低血压发生率（5.88%）及PEM发生率（2.94%）均显著降低，差异有统计学意义（P＜0.05）。治疗前，2组MHD患者SBP、DBP、Alb、白细胞介素（interleukin，IL）6、IL-17及C反应蛋白（C-reactive protein，CRP）水平比较，差异无统计学意义（P＞0.05）。治疗后，研究组MHD患者SBP为（105.84 ± 22.93）mmHg（1 mmHg=0.133 kPa）、DBP为（72.04 ± 9.72）mmHg、Alb为（43.89 ± 5.22）g/L、PA为（287.03 ± 53.38）mg/L、Hb为（94.95 ± 23.68）g/L；对照组SBP为（92.74 ± 18.73）mmHg、DBP为（65.94 ± 8.66）mmHg、Alb为（38.74 ± 5.05）g/L、PA为（248.67 ± 49.29）mg/L、Hb为（83.35 ± 17.67）g/L，两组差异有统计学意义（P＜0.05）。研究组MHD患者IL-6为（20.51 ± 4.05） ng/L、IL-17为（12.16 ± 3.09）ng/L、CRP为（5.85 ± 0.67）mg/L；对照组IL-6为（32.36 ± 5.96）ng/L、IL-17为（25.77 ± 4.86）ng/L、CRP为（6.96 ± 0.95）mg/L，两组差异有统计学意义（P＜0.05）。研究组与对照组在治疗期间的不良反应总发生率分别为2.94%、11.76%，差异无统计学意义（P＞0.05）。
      结论  穴位注射黄芪注射液能够明显降低MHD患者低血压发生率及PEM发生率，改善MHD患者的血压水平、营养状态及机体炎症，该治疗方法安全性强，值得在临床上进行推广。

       

      Abstract:
      Objective  To investigate the influences of acupoint injection of astragalus injection on hypotension and protein-energy malnutrition(PEM) in maintenance hemodialysis (MHD) patients.
      Methods From March 2021 to May 2022, 68 patients with MHD admitted to Wuhan Hankou Hospital were randomly divided into the control group(34 patients, treated with routine hemodialysis) and the study group(34 patients, treated with acupoint injection of astragalus injection on the basis of the control group), the basic clinical data of patients were collected, and the incidence of hypotension, the incidence of PEM, serum albumin(Alb), prealbumin(PA), hemoglobin(Hb), systolic blood pressure(SBP), diastolic blood pressure(DBP), changes in inflammatory factor levels, and the incidence of adverse reactions between the two groups were compared.
      Results  The incidence of hypotension of the control group(26.47%), the incidence of PEM of the control group(20.59%), the incidence of hypotension(5.88%) and PEM(2.94%) in MHD patients in the study group were significantly decreased(P<0.05). Before treatment, SBP, DBP, Alb, interleukin-6(IL-6), interleukin-17(IL-17) and C-reactive protein were detected in two groups of MHD patients. After treatment, the levels of SBP (105.84±22.93) mmHg (1 mmHg=0.133 kPa), DBP (72.04±9.72) mmHg, Alb (43.89±5.22) g/L, PA (287.03±53.38) mg/L and Hb (94.95±23.68) g/L in MHD patients in study group. The levels of SBP (92.74±18.73) mmHg, DBP (65.94±8.66) mmHg, Alb (38.74±5.05) g/L, PA (248.67±49.29) mg/L, Hb (83.35±17.67) g/L in control group(P<0.05). The levels of IL-6 (20.51±4.05) ng/L, IL-17 (12.16±3.09) ng/L and CRP (5.85±0.67) mg/L in MHD patients in study group. The levels of IL-6 (32.36±5.96) ng/L, IL-17 (25.77±4.86) ng/L, CRP (6.96±0.95) mg/L in control group(P<0.05). The total incidence of adverse reactions in the study group and the control group during the treatment period was 2.94% and 11.76%, respectively, with no obvious difference(P>0.05).
      Conclusion  Acupoint injection of astragalus injection can obviously reduce the incidences of hypotension and PEM in MHD patients, and improve the blood pressure level, nutritional status and body inflammation in MHD patients. This treatment method is safe and worthy of clinical promotion.

       

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