Volume 38 Issue 3
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LYU Yong, ZHANG Lei, SONG Bei-bei, WANG Yi-ping. Clinical Study of the Supplemented Shenling Baizhu Powder on Patients of Spleen Deficiency and Turbidity Obstruction treated with Continuous Ambulatory Peritoneal Dialysis Combined with Suffering from Protein-energy Wasting[J]. Journal of Nanjing University of traditional Chinese Medicine, 2022, 38(3): 193-198. DOI: 10.14148/j.issn.1672-0482.2022.0193
Citation: LYU Yong, ZHANG Lei, SONG Bei-bei, WANG Yi-ping. Clinical Study of the Supplemented Shenling Baizhu Powder on Patients of Spleen Deficiency and Turbidity Obstruction treated with Continuous Ambulatory Peritoneal Dialysis Combined with Suffering from Protein-energy Wasting[J]. Journal of Nanjing University of traditional Chinese Medicine, 2022, 38(3): 193-198. DOI: 10.14148/j.issn.1672-0482.2022.0193
shu

Clinical Study of the Supplemented Shenling Baizhu Powder on Patients of Spleen Deficiency and Turbidity Obstruction treated with Continuous Ambulatory Peritoneal Dialysis Combined with Suffering from Protein-energy Wasting

  • The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230031, China

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  • Received Date: October 31, 2021
  • Available Online: March 23, 2022
    Graphical Abstract
    • Abstract
  •   OBJECTIVE  To observe the clinical efficacy of the supplemented Shenling Baizhu Powder on the microinflammatory state in patients of spleen deficiency and turbidity obstruction treated with continuous ambulatory peritoneal dialysis (CAPD) combined with suffering from protein-energy wasting (PEW).
      METHODS  A total of 91 patients of spleen deficiency and turbidity obstruction treated with CAPD combined with suffering from PEW were randomly divided into 45 cases in the treatment group and 46 cases in the control group, with shedding three cases in each group. The control group's treatments include CAPD, orally taken compound alpha ketoacid, and other conventional therapies. However, the treatment group was administrated with the supplemented Shenling Baizhu powder by orally taken on the basis of the treatments in the control group. The course of treatment was 12 weeks in both groups. Before and after treatment, we observed the changes in the traditional Chinese medicine (TCM) syndrome score, malnutrition-inflammation score (MIS) and overall urea clearance index scores (Kt/V) of the two groups of patients. In addition, we measured the patients' peripheral blood nutrition-related indexes [hemoglobin (HGB), albumin (ALB), transferrin (TRF), prealbumin (PA)], as well as the levels of microinflammatory indexes [interleukin-6 (IL-6), hypersensitive c-reactive protein (hs-CRP), tumor necrosis factor alpha (TNF-α) and interleukin-10 (IL-10)].
      RESULTS  After treatment, the TCM syndrome score in the treatment group was reduced significantly (P < 0.01), whose result was better than that in the control group (P < 0.01). In addition, the total clinical efficacy of TCM in the treatment group was remarkably better than that in the control group (P < 0.05). The MIS in the treatment group was reduced significantly but with significantly increased Kt/V (P < 0.01), whose results were also better than those in the control group (P < 0.05, P < 0.01). At the same time, ALB, PA, TRF and HGB levels were significantly increased in the treatment group (P < 0.01), while only ALB and PA levels were significantly increased in the control group (P < 0.01). Thus, the results in the treatment group were better than those in the control group (P < 0.05, P < 0.01). On top of that, serum hs-CRP, IL-6 and TNF-α levels were significantly reduced in both groups (P < 0.01), and IL-10 levels were increased in two groups (P < 0.05, P < 0.01). In conclusion, the results in the treatment group were superior to those in the control group (P < 0.05, P < 0.01).
      CONCLUSION  The supplemented Shenling Baizhu powder can notably alleviate the TCM syndromes in patients of spleen deficiency and turbidity obstruction treated with CAPD combined with suffering from PEW. In addition, it can relieve their PEW, alleviate the microinflammatory state, and strengthen the adequacy of peritoneal dialysis.
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  • [1]
    CARRERO JJ, THOMAS F, NAGY K, et al. Global prevalence of protein-energy wasting in kidney disease: A meta-analysis of contemporary observational studies from the international society of renal nutrition and metabolism[J]. J Ren Nutr, 2018, 28(6): 380-392. DOI: 10.1053/j.jrn.2018.08.006
    [2]
    KRISHNAMOORTHY V, SUNDER S, MAHAPATRA HS, et al. Evaluation of protein-energy wasting and inflammation on patients undergoing continuous ambulatory peritoneal dialysis and its correlations[J]. Nephrourol Mon, 2015, 7(6): 1-8.
    [3]
    KITTISKULNAM P, CHUENGSAMAN P, KANJANABUCH T, et al. Protein-energy wasting and mortality risk prediction among peritoneal dialysis patients[J]. J Ren Nutr, 2021, 31(6): 679-686. DOI: 10.1053/j.jrn.2020.11.007
    [4]
    王寒冰, 姚源璋. 微炎症状态下PD患者PEW的发生机制及药物干预[J]. 中国中西医结合肾病杂志, 2017, 18(12): 1126-1128. DOI: 10.3969/j.issn.1009-587X.2017.12.035

    WANG HB, YAO YZ. Mechanism of PEW in PD patients under microinflammatory state and drug intervention[J]. Chin J Integr Tradit West Nephrol, 2017, 18(12): 1126-1128. DOI: 10.3969/j.issn.1009-587X.2017.12.035
    [5]
    郑登勇, 魏仲南, 吴强. 补肾祛毒丸治疗维持性腹膜透析患者营养不良的临床观察[J]. 中国中西医结合肾病杂志, 2015, 16(11): 998-999. https://www.cnki.com.cn/Article/CJFDTOTAL-JXSB201511024.htm

    ZHENG DY, WEI ZN, WU Q. Clinical observation of Bushen Qudu Pill on malnutrition in patients with maintenance peritoneal dialysis[J]. Chin J Integr Tradit West Nephrol, 2015, 16(11): 998-999. https://www.cnki.com.cn/Article/CJFDTOTAL-JXSB201511024.htm
    [6]
    王友川. 六君子汤联合金匮肾气丸治疗肾脏病腹膜透析相关营养不良的疗效[J]. 中国老年学杂志, 2015, 35(9): 2538-2539. DOI: 10.3969/j.issn.1005-9202.2015.09.112

    WANG YC. The effect of Liujunzi Decoction combined with Jinkui Shenqi Pill on peritoneal dialysis-related malnutrition with renal disease[J]. Chin J Gerontol, 2015, 35(9): 2538-2539. DOI: 10.3969/j.issn.1005-9202.2015.09.112
    [7]
    赵奎. CAPD患者的中医证候调查及其预后影响因素的相关性分析[D]. 合肥: 安徽中医药大学, 2018.

    ZHAO K. Analysis of TCM syndrome in peritoneal dialysis patients and correlation analysis between TCM syndromes and influencing factors of prognosis[D]. Hefei: Anhui University of Chinese Medicine, 2018.
    [8]
    张建, 吕勇. 参苓白术散加味对持续性不卧床腹膜透析患者营养不良的影响[J]. 中医药临床杂志, 2018, 30(12): 2278-2282. https://www.cnki.com.cn/Article/CJFDTOTAL-AHLC201812032.htm

    ZHANG J, LYU Y. Effect of shenling baizhu powder on malnutritional status in continuous ambulatory peritoneal dialysis patients[J]. Clin J Tradit Chin Med, 2018, 30(12): 2278-2282. https://www.cnki.com.cn/Article/CJFDTOTAL-AHLC201812032.htm
    [9]
    ANDRASSY KM. Comments on 'KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease'[J]. Kidney Int, 2013, 84(3): 622-623.
    [10]
    FOUQUE D, KALANTAR-ZADEH K, KOPPLE J, et al. A proposed nomenclature and diagnostic criteria for protein-energy wasting in acute and chronic kidney disease[J]. Kidney Int, 2008, 73(4): 391-398. DOI: 10.1038/sj.ki.5002585
    [11]
    中药新药临床研究指导原则: 试行[M]. 北京: 中国医药科技出版社, 2002: 163-168.

    Guiding Principles for Clinical Research of New Chinese Medicine: Trial Implementation[M]. Beijing: China medical science press, 2002: 163-168.
    [12]
    肖月, 石建伟, 刘蕊, 等. MIS评分在诊断腹膜透析患者PEW中的应用[J]. 同济大学学报(医学版), 2017, 38(6): 92-96. https://www.cnki.com.cn/Article/CJFDTOTAL-TJIY201706019.htm

    XIAO Y, SHI JW, LIU R, et al. Application of malnutrition-inflammation score in evaluation of protein energy wasting in patients with peritoneal dialysis[J]. J Tongji Univ Med Sci, 2017, 38(6): 92-96. https://www.cnki.com.cn/Article/CJFDTOTAL-TJIY201706019.htm
    [13]
    倪兆慧, 金海姣. 中国腹膜透析发展70年[J]. 中国血液净化, 2019, 18(10): 661-663. DOI: 10.3969/j.issn.1671-4091.2019.10.001

    NI ZH, JIN HJ. The developmental history of peritoneal dialysis in China in the 70 years[J]. Chin J Blood Purif, 2019, 18(10): 661-663. DOI: 10.3969/j.issn.1671-4091.2019.10.001
    [14]
    陈香美, 周建辉. 中国腹膜透析技术发展现状与未来[J]. 中国实用内科杂志, 2013, 33(6): 413-415. https://www.cnki.com.cn/Article/CJFDTOTAL-SYNK201306002.htm

    CHEN XM, ZHOU JH. Current status and future of peritoneal dialysis technology in China[J]. Chin J Pract Intern Med, 2013, 33(6): 413-415. https://www.cnki.com.cn/Article/CJFDTOTAL-SYNK201306002.htm
    [15]
    杨波, 李洁, 任桐, 等. 102例维持性腹膜透析营养不良患者中医证型分布特点[J]. 中国中西医结合肾病杂志, 2014, 15(7): 587-590. DOI: 10.3969/j.issn.1009-587X.2014.07.009

    YANG B, LI J, REN T, et al. TCM syndrome characteristics of 102 malnutritional patients with CAPD[J]. Chin J Integr Tradit West Nephrol, 2014, 15(7): 587-590. DOI: 10.3969/j.issn.1009-587X.2014.07.009
    [16]
    黄帝内经[M]. 北京: 中华书局, 2012: 750.

    Huangdi's Canon of Medicine[M]. Beijing: Zhonghua book company, 2012: 750.
    [17]
    吴昆. 医方考[M]. 北京: 中国中医药出版社, 2007: 149.

    WU K. Medical Formulae Investigations[M]. Beijing: China press of traditional Chinese medicine, 2007: 149.
    [18]
    郭晓星. 参苓白术散治疗功能性消化不良的应用与疗效探析[J]. 中国现代药物应用, 2019, 13(1): 150-151. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWYY201901092.htm

    GUO XX. The Application and effect of Shenling Baizhu Powder on functional dyspepsia[J]. Chin J Mod Drug Appl, 2019, 13(1): 150-151. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWYY201901092.htm
    [19]
    黄雪霞, 吴金玉, 唐宇, 等. 参苓白术散对尿毒症小剂量腹膜透析临床疗效的影响[J]. 中国中西医结合肾病杂志, 2017, 18(4): 336-338. DOI: 10.3969/j.issn.1009-587X.2017.04.015

    HUANG XX, WU JY, TANG Y, et al. The effect of Shenling Baizhu powder on clinical efficacy of small dose peritoneal dialysis in uremia[J]. Chin J Integr Tradit West Nephrol, 2017, 18(4): 336-338. DOI: 10.3969/j.issn.1009-587X.2017.04.015
    [20]
    王乐琪, 张云帆, 李莎莎, 等. 丹参治疗微循环障碍作用机制的"成分-靶点-通路"多层次互作网络模型研究[J]. 中草药, 2020, 51(2): 439-450. https://www.cnki.com.cn/Article/CJFDTOTAL-ZCYO202002023.htm

    WANG LQ, ZHANG YF, LI SS, et al. Study on component-target-pathway multiple interactive network to reveal mechanism of Salvia miltiorrhiza in treatment of microcirculation disturbance[J]. Chin Tradit Herb Drugs, 2020, 51(2): 439-450. https://www.cnki.com.cn/Article/CJFDTOTAL-ZCYO202002023.htm
    [21]
    何伟明, 高坤, 周栋, 等. 丹参注射液对腹膜纤维化大鼠腹膜通透性的影响[J]. 中国中西医结合肾病杂志, 2009, 10(12): 1050-1053, 1140. DOI: 10.3969/j.issn.1009-587X.2009.12.005

    HE WM, GAO K, ZHOU D, et al. Effect of salviae miltiorrhizae injection on membrane permeability in rats with peritoneum fibrosis[J]. Chin J Integr Tradit West Nephrol, 2009, 10(12): 1050-1053, 1140. DOI: 10.3969/j.issn.1009-587X.2009.12.005
    [22]
    黎渐英, 林建雄, 梁碧宁, 等. 腹膜透析患者的生活质量与营养不良和慢性炎症的相关性研究[J]. 中国血液净化, 2010, 9(8): 423-425. DOI: 10.3969/j.issn.1671-4091.2010.08.005

    LI JY, LIN JX, LIANG BN, et al. A correlation study on life quality with malnutrition and chronic inflammation in patients on continuous ambulatory peritoneal dialysis[J]. Chin J Blood Purif, 2010, 9(8): 423-425. DOI: 10.3969/j.issn.1671-4091.2010.08.005
    [23]
    LEINIG CE, MORAES T, RIBEIRO S, et al. Predictive value of malnutrition markers for mortality in peritoneal dialysis patients[J]. J Ren Nutr, 2011, 21(2): 176-183. DOI: 10.1053/j.jrn.2010.06.026
    [24]
    肖寿海. 持续性不卧床腹膜透析患者并发低蛋白血症临床分析[J]. 河北医学, 2011, 17(2): 211-213. DOI: 10.3969/j.issn.1006-6233.2011.02.029

    XIAO SH. Clinical analysis of hypoproteinemia in patients with continuous ambulatory peritoneal dialysis[J]. Hebei Med, 2011, 17(2): 211-213. DOI: 10.3969/j.issn.1006-6233.2011.02.029
    [25]
    周艳, 方炜, 严豪, 等. 炎症、营养不良、瓣膜钙化指标联合预测腹膜透析患者全因死亡和心血管死亡的价值[J]. 上海交通大学学报(医学版), 2016, 36(9): 1322-1328. DOI: 10.3969/j.issn.1674-8115.2016.09.013

    ZHOU Y, FANG W, YAN H, et al. Value of combining inflammation, malnutrition, and calcification for predicting all-cause and cardiovascular mortality in peritoneal dialysis patients[J]. J Shanghai Jiao Tong Univ Med Sci, 2016, 36(9): 1322-1328. DOI: 10.3969/j.issn.1674-8115.2016.09.013
    [26]
    宋国巍, 王磊. 现有透析疗法对慢性肾衰竭尿毒症患者微炎症状态的影响[J]. 中国实验诊断学, 2015, 19(7): 1199-1200. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSZD201507063.htm

    SONG GW, WANG L. Effect of existing dialysis therapy on microinflammatory state in uremia patients with chronic renal failure[J]. Chin J Lab Diagn, 2015, 19(7): 1199-1200. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSZD201507063.htm
    [27]
    WANG AYM, WOO J, LAM CWK, et al. Is a single time point C-reactive protein predictive of outcome in peritoneal dialysis patients?[J]. J Am Soc Nephrol, 2003, 14(7): 1871-1879. DOI: 10.1097/01.ASN.0000070071.57901.B3
    [28]
    ESPINOZA M, AGUILERA A, AUXILIADORA BAJO M, et al. Tumor necrosis factor alpha as a uremic toxin: Correlation with neuropathy, left ventricular hypertrophy, Anemia, and hypertriglyceridemia in peritoneal dialysis patients[J]. Adv Perit Dial, 1999, 15: 82-86.
    [29]
    谌卫, 郭志勇, 吴灏, 等. 复方α-酮酸配伍低蛋白饮食对长期腹膜透析患者微炎症的影响及其与营养状态关系的随机对照研究[J]. 中西医结合学报, 2008, 6(5): 473-477. https://www.cnki.com.cn/Article/CJFDTOTAL-XBZX200805011.htm

    CHEN W, GUO ZY, WU H, et al. Effects of low-protein diet plus α-keto acid on micro-inflammation and the relationship between micro-inflammation and nutritional status in patients performing continuous ambulatory peritoneal dialysis: A randomized controlled trial[J]. J Chin Integr Med, 2008, 6(5): 473-477. https://www.cnki.com.cn/Article/CJFDTOTAL-XBZX200805011.htm
    [30]
    张俊卿, 李建宽, 王妍, 等. 潞党参甾体类成分及其抗炎活性[J]. 中成药, 2021, 43(1): 92-97. DOI: 10.3969/j.issn.1001-1528.2021.01.018

    ZHANG JQ, LI JK, WANG Y, et al. Steroids constituents from Codonopsis pilosula and their anti-inflammatory activities[J]. Chin Tradit Pat Med, 2021, 43(1): 92-97. DOI: 10.3969/j.issn.1001-1528.2021.01.018
    [31]
    徐伟, 方思佳, 关然, 等. 白术多糖对小鼠淋巴细胞的免疫调节作用[J]. 中国免疫学杂志, 2020, 36(13): 1573-1577. DOI: 10.3969/j.issn.1000-484X.2020.13.007

    XU W, FANG SJ, GUAN R, et al. Immunomodulatory effect of atractylodis macrocephalae Koidz. polysaccharides on mouse lymphocytes[J]. Chin J Immunol, 2020, 36(13): 1573-1577. DOI: 10.3969/j.issn.1000-484X.2020.13.007
    [32]
    徐旭, 窦德强. 茯苓对免疫低下小鼠免疫增强的物质基础研究[J]. 时珍国医国药, 2016, 27(3): 592-593. https://www.cnki.com.cn/Article/CJFDTOTAL-SZGY201603029.htm

    XU X, DOU DQ. The effective materials of Poria on immunoenhancement in hypoimmune mice[J]. Lishizhen Med Mater Med Res, 2016, 27(3): 592-593. https://www.cnki.com.cn/Article/CJFDTOTAL-SZGY201603029.htm
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