Kev soj ntsuam soj ntsuam ntawm Cistanche Deserticola Ntawm Kev Tiv Thaiv Residual Renal Function

Wang Lingfen, Zhao Wei, Wang Zhanqi, Tian Cuili, Li Hongyan, Bi Macro, Sun Lixin, Zhu Ning

(Department of Nephrology, Hebei Geriatric Hospital, Shijiazhuang 050011, Hebei)

[Cov lus tseem ceeb]Cistanche deserticola;Lub raum; Lub raum dialysis;Tsoos suav tshuaj kho mob

Kev tiv thaiv ntawm lub raum tsis ua haujlwm yog lub luag haujlwm tseem ceeb hauv kev kho mob raum kab mob. Txawm hais tias rau cov neeg mob uas muaj kab mob hauv lub raum tau txais kev kho mob lim ntshav hauv theem 5 [1], nws tuaj yeem txhim kho qhov ciaj sia ntawm cov neeg mob lim ntshav, txo qhov kev txwv ntau dhau ntawm kev noj zaub mov thiab kua dej, txhim kho kev tshem tawm ntawm nruab nrab molecules, tswj qib hemoglobin zoo. , phosphorus, potassium, thiab urea, thiab txhim kho cov khoom noj khoom haus thiab kev ua neej zoo. Phau Ntawv Qhia Txog Kev Kho Mob Hauv Tebchaws Meskas rau Kab Mob Raum Tsis Zoo thiab Dialysis (NKF-K / DOQI) pom zoo kom ntxiv rau kev ua haujlwm ntawm lub raum mus rau qhov kev ntsuam xyuas ntawm kev lim ntshav txaus, hais txog kev tswj qhov ntim, lub cev qhuav, ntshav siab, thiab txhim kho nws tus kheej. - Kev xav [2,3]. Cov tshuaj suav tshuaj suav hais tias muaj txiaj ntsig zoo hauv kev txhim kho kev lim ntshav txaus thiab tiv thaiv lub raum tsis zoo [4]. Ib qho tshuaj suav tshuaj suav tshuaj tau txais txiaj ntsig hauv kev kho mob raum nrog kev ua tau zoo thiab daim ntawv thov yooj yim. Txij lub Kaum Hli 2007 txog Lub Peb Hlis 2010, peb tau siv txoj hauv kev tswj tus kheej ntawm 90 tus neeg mob hemodialysis thiab piv cov kev lim ntshav niaj hnub nrog rau qhov ncauj Cistanche deserticola thiab kev lim ntshav yooj yim. Cov txiaj ntsig tau raws li hauv qab no.

Cistanche deserticola - tiv thaiv lub raum ua haujlwm

1 Cov ntaub ntawv thiab cov txheej txheem

1.1 Cov ntaub ntawv dav dav

90 cov neeg mob yog cov neeg mob sab nraud los ntawm Lub Tsev Haujlwm Saib Xyuas Lub Raum Tshuaj ntawm Hebei Provincial Geriatric Tsev Kho Mob (16 tus neeg mob), Lub Tsev Haujlwm Saib Xyuas Lub Raum Tshuaj Kho Mob ntawm Hebei Youai Tsev Kho Mob (14 tus neeg mob), Lub Tsev Haujlwm Saib Xyuas Lub Raum Tshuaj ntawm Lub Tsev Kho Mob Affiliated ntawm Hebei University (30 mob), thiab Department of Renal Medicine of the Third Affiliated Hospital of Peking University Medical Department (30 mob), 48 txiv neej thiab 42 poj niam; Hnub nyoog (55.0 ± 8.5) xyoo; Cov chav kawm ntawm tus kab mob yog (11.0 ± 5.6) xyoo; Cov kab mob tseem ceeb yog mob glomerulonephritis hauv 36 tus neeg mob, mob raum mob ntshav siab hauv 28 tus neeg mob, mob raum puas tsuaj hauv 10 tus neeg mob, kab mob polycystic raum hauv 5 tus neeg mob, gouty raum hauv 5 kis, thiab lwm yam 6 tus neeg mob.

1.2 Diagnostic hauv paus

1.2.1 Diagnostic cov txheej txheem Kev kuaj mob ntawm lub raum tsis ua haujlwm thiab uremia nyob rau theem kawg yuav tsum xa mus rau Cov Tshuaj Siv Hauv Tsev [5].

1.2.2 Cov txheej txheem suav nrog

Meet the diagnostic criteria; Maintenance hemodialysis>2 years; Regular hemodialysis, 3 times a week, 4 hours each time; The long-term access for hemodialysis is the arm arteriovenous fistula, with blood flow velocity>200 ml / min; Cov zis ntim ntau tshaj 400mL hauv 24 teev ntawm kev lim ntshav; Cov neeg mob uas tsis mob raws plab; Cov tsos mob sib txawv ntawm cov tshuaj suav tshuaj yog spleen thiab raum yang deficiency, qhov tsis txaus ntawm cov hauv paus hniav thiab cov hauv paus hniav ntau dhau; Tsis muaj kev kis mob hnyav, cov xwm txheej cardio-cerebrovascular tshwm sim thaum kho. 1.3 Kev kho mob

Txoj kev kawm tswj tus kheej tau siv rau kev soj ntsuam kev kho mob tas li rau 6 lub hlis. Lub sijhawm soj ntsuam yuav tsum tau khaws cia deb ntawm 4 mus rau 9 lub hlis kom tsis txhob muaj kev tawm hws ntawm qhov kev tshawb fawb. Thawj 3 lub hlis yog pawg tswj hwm dawb huv, thiab 3 lub hlis dhau los yog pab pawg kho mob Cistanche deserticola.

Cistanche txiv neej cov txiaj ntsig-prokojcts lub raum ua haujlwm

Nyem qhov no mus saib Cistanche hmoov khoom

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1.3.1 Pab pawg tswj tsis pub muaj

Kev siv cov tshuaj niaj hnub xws li hypoglycemic, hypotensive, lipid-regulating, calcium thiab phosphorus metabolism, thiab kho ntshav qab zib. Kev lim ntshav tsis tu ncua: 3 zaug hauv ib lub lis piam (dialysis txhua hnub), 4 teev txhua zaus. Cov ntshav khiav yog 200 ~ 250mL / min. Kev khiav dej num ntawm carbonate dialysate yog 500mL / min. German Braun Dialog hemodialyzer thiab Fessenius 4008B hemodialyzer yog siv. Lub dialyzer siv lub polysulfone hollow fiber ntau daim nyias nyias. Lub cheeb tsam ntawm lub tshuab lim dej yog 1.3m2 rau thawj peb zaug, thiab 1.5m2 lossis 1.7m2 rau lwm tus. Cov pa anticoagulation nrog zoo tib yam heparin lossis qis molecular hnyav heparin yog siv.

1.3.2 Cistanche deserticola kho pab pawg

Cistanche deserticola tau muab los ntawm kev kho mob hauv pawg tswj hwm dawb paug. Txoj kev:Cistanche deserticola 30g, ib koob ib hnub, decoct rau 100mL, haus ntau zaus raws li kev hloov tshuaj yej, ib hnub ib zaug.

Cistanche extract hmoov-tiv thaivcts lub raum ua haujlwm

1.4 Kev soj ntsuam ntsuas

Sau cov 24- teev cov zis ntim, qhov nruab nrab lub cev hnyav ntawm lub hli ua ntej lim ntshav, qhov nruab nrab ntawm cov hlab ntsha siab thiab ultrafiltration ntim thaum kawg ntawm lub hli ua ntej lim ntshav, cov ntshav urea nitrogen (BUN), ntshav phosphorus (P) , hemoglobin (Hgb), albumin (Alb), low-density lipoprotein cholesterol (LDL-C) thiab C-reactive protein (CRP) ua ntej dialysis hauv lub sijhawm lim ntshav thaum pib ntawm txhua lub hlis; Sau cov ntaub ntawv tshem tawm, qhov tshwm sim tsis zoo thiab kev hloov pauv hauv qhov quav.

1.5 Cov txheej txheem txheeb cais

SPSS11.5 kev txheeb cais software tau siv. Cov ntaub ntawv ntsuas tau qhia los ntawm txhais tau tias ± tus qauv sib txawv (x ± s) thiab t-test tau siv.

2 Kev tshwm sim

2.12 Saib Table 1 rau kev sib piv ntawm cov cim qhia ntawm 2 pawg.

It can be seen from Table 1 that the relevant indicators of the two groups were gradually improved, but the relevant indicators of the blank control group had no statistically significant difference compared with the previous month (P>0.05). Cov pab pawg kho mob Cistanche deserticola tau txhim kho zoo hauv lub hlis thib ob, thiab qhov sib txawv ntawm cov ntsuas hauv thawj lub hlis yog qhov tseem ceeb (P<0.05). The relevant indicators in the third month remained stable, and there was no statistically significant difference compared with the second month (P>0.05).Nws qhia tau hais tias Cistanche deserticolatuaj yeem txhawb nqa kev tshem tawm cov dej thiab cov kuab tshuaj, ua kom cov zis seem tshuav, tiv thaiv lub raum tsis ua haujlwm, tswj lub cev qhuav dej, ntim ultrafiltration, thiab ntshav siab, txhim kho cov khoom noj khoom haus thiab cov txheej txheem inflammatory, txhim kho kev lim ntshav txaus, thiab cov nyhuv curative yog ruaj khov thiab tsis tu ncua.

Cistanche hmoov-tiv thaiv lub raum ua haujlwm

2.2 Lwm yam

Thaum lub sij hawm soj ntsuam, tsis muaj kev tshem tawm, tsis muaj kev phiv tshuaj xws li mob plab, raws plab, ua npaws, lossis pob khaus, thiab tsis muaj cem quav tshiab. Muaj 76 tus neeg mob cem quav, thiab 64 tus neeg mob cem quav hauv pawg neeg kho mob Cistanche deserticola tau txhim kho zoo.

Table 1   2 Kev sib piv ntawm cov ntsuas muaj feem hauv cov pab pawg

Piv nrog rau lub hli dhau los hauv pab pawg no, ＊ P<0.05

3 Kev sib tham

Lub raum tsis ua haujlwmbelongs rau pawg ntawm clearance, edema, thiab tso zis nyob rau hauv tsoos suav tshuaj. Kev kho mob raum tsis ua haujlwm feem ntau ua raws li cov hauv paus ntsiab lus sau tseg hauv "Internal Classic": "qhib lub qhov rooj ntawm cov dab, ntxuav lub tsev, thiab tshem tawm cov dej thiab dej". Lub pathogenesis ntawm kev saib xyuas hemodialysis yog raws li kev qaug zog ntawm yin thiab yang nyob rau hauv lub poov xab thiab lub raum, thiab nyob rau hauv tsub zuj zuj ntawm dampness thiab turbidness thiab toxins yog tus qauv. Nws yog siv los kho tus po thiab lub raum, tshem tawm cov turbidness nyob rau hauv lub viscera, thiab tonify tus po thiab lub raum. Nyob rau hauv lub hauv paus ntawm hemodialysis, ib qho tshuaj, thiab cov tshuaj rau tonifying tus po thiab lub raum, tshem tawm cov viscera thiab txo turbidity, activating ntshav ncig, thiab tshem tawm cov ntshav stasis feem ntau yog siv los tiv thaiv cov seem ntawm lub raum ua haujlwm thiab tiv thaiv cov teeb meem [6]. Txawm hais tias tus neeg sawv cev tshuaj rhubarb muaj cov txiaj ntsig ntawm kev txo cov kab mob raws plab thiab turbidity los tiv thaiv lub raum seem, nws yooj yim ua rau cem quav thiab ua phem rau kev noj qab haus huv yog tias noj rau lub sijhawm ntev [7], thiab tsis haum rau kev haus dej mus ntev vim qhov kev txwv ntawm decoction thiab kev sib deev saj. Cistanche deserticola tsis tsuas yog moistens plab hnyuv thiab defecates tab sis kuj ntxiv cov ntshav essence, uas yog tsim nyog rau cov neeg mob dialysis. Cistanche deserticola yog qab zib thiab qab ntsev, sov nyob rau hauv qhov, moist thiab muaj kua nyob rau hauv cov xwm. Nws tuaj yeem nkag mus rau hauv lub raum thiab cov hnyuv loj meridians, tsis yog tsuas yog ntxiv rau lub raum yang tab sis kuj muaj txiaj ntsig zoo rau cov ntshav cov ntsiab lus thiab moistening dryness. Nws lub zog yog maj mam, thiab nws tuaj yeem siv tau ntev [8]. Kev soj ntsuam soj ntsuam tau pom tias cov zis seem ntawm cov neeg mob lim ntshav hauv cov pab pawg kho mob Cistanche deserticola tau nce ntxiv, cem quav tau txhim kho, ultrafiltration ntim, lub cev qhuav dej thiab txhais tau tias cov hlab ntsha siab tau qis dua ua ntej, thiab cov ntsuas metabolic ntawm urea nitrogen, phosphorus. , thiab cov lipoprotein tsawg-density tau txo qis, thaum cov zaub mov qhia ntawm albumin thiab cov ntshav liab qe dawb tau nce ntxiv, qhia tias Cistanche deserticola tuaj yeem tiv thaiv lub raum tsis zoo, txhim kho cov khoom noj khoom haus ntawm cov neeg mob, txo qhov mob, thiab txhim kho kev lim ntshav txaus. . Lub mechanism yuav tsum zoo sib xws rau cov nyhuv ntawmCistanche deserticola mantawm tonifying ntshav essence thiab warming lub yang thiab yooj yim dej.Cov kev tshawb fawb pharmacological niaj hnub tau pom tiasCistanche deserticola hmoov extract ntawm dejua tauua rau ileal contraction, txhim khu plab hnyuv peristalsis thiab shorten lub sij hawm defecation hauv nas; Nws tuaj yeem txhim kho cov cellular thiab humoral tiv thaiv kab mob ntawm nas, txhawb cov metabolism thiab lub cev muaj zog, tiv thaiv oxidation thiab kev laus, thiab txhawb kev ua haujlwm ntawm endocrine. Tsis tas li ntawd, nws tuaj yeem tiv thaiv daim siab, tiv thaiv myocardial ischemia, tiv thaiv atherosclerosis, txo cov ntshav siab, txhawb kev tso zis, thiab txo cov ntsiab lus ntawm urea nitrogen hauv cov ntshav. Nws tsis muaj kev phiv [9].

Cistanche tshuaj yej -tiv thaiv lub raum ua haujlwm

Los xaus,Cistanche deserticola muaj kev nyab xeeb thiab siv tau yam tsis muaj kev phiv tshuaj. Nws tuaj yeem tiv thaiv lub raum tsis zoo, txhawb cov kua dej thiab tshem tawm, pab txhim kho kev lim ntshav kom txaus, thiab txhim kho lub neej zoo ntawm cov neeg mob hemodialysis.

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