目的 探討腎衰寧顆粒聯(lián)合注射用還原型谷胱甘肽治療維持性血液透析慢性腎功能衰竭的臨床療效。方法 選取2023年1～10月在連云港市第四人民醫(yī)院就診的80例維持性血液透析慢性腎功能衰竭患者，根據(jù)隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，每組各40例。對(duì)照組患者靜脈滴注注射用還原型谷胱甘肽，1.5 g/m²加入100 mL生理鹽水后輸注，1次/d。治療組在對(duì)照組基礎(chǔ)上溫水沖服腎衰寧顆粒，1袋/次，3次/d。兩組的療程為45 d。比較兩組的臨床效果、病情程度、腎功能指標(biāo)、氧化應(yīng)激指標(biāo)、紅細(xì)胞參數(shù)。結(jié)果 治療組的總有效率為92.50%，對(duì)照組的總有效率為75.00%，組間差異顯著（P＜0.05）。治療后，兩組的急性生理與慢性健康（APACHEⅡ）評(píng)分比治療前?。?i>P＜0.05），且治療組的APACHEⅡ評(píng)分比對(duì)照組更小（P＜0.05）。治療后，兩組的腎小球?yàn)V過率（GFR）比治療前大，肌酐（Scr）、尿蛋白定量（UTP）、β₂-微球蛋白（β₂-MG）比治療前?。?i>P＜0.05）；治療組的GFR比對(duì)照組大，Scr、UTP、β₂-MG比對(duì)照組?。?i>P＜0.05）。治療后，兩組的血清淀粉樣蛋白A（SAA）、糖基化終產(chǎn)物（AGEs）、終末期氧化蛋白產(chǎn)物（AOPP）水平比治療前低（P＜0.05）；治療組的血清SAA、AGEs、AOPP水平比對(duì)照組低（P＜0.05）。治療后，兩組的紅細(xì)胞壓積（HCT）、血紅蛋白（Hb）比治療前高（P＜0.05）；治療組的HCT、Hb比對(duì)照組高（P＜0.05）。結(jié)論 腎衰寧顆粒聯(lián)合注射用還原型谷胱甘肽有助于提高維持性血液透析慢性腎功能衰竭的治療效果，進(jìn)一步控制病情，改善腎功能和紅細(xì)胞功能，降低氧化應(yīng)激反應(yīng)。

Objective To investigate the clinical effect of Shenshuaining Granules combined with Reduced Glutathione for injection in treatment of chronic renal failure during maintenance hemodialysis. Methods Patients (80 cases) with chronic renal failure during maintenance hemodialysis in the Fourth People's Hospital of Lianyungang from January to October 2023 were divided into control and treatment groups according to the random number table method, with 40 cases in each group. Patients in the control group were iv administered with Reduced Glutathione for injection, 1.5 g/m²added into normal saline 100 mL, once daily. Patients in the treatment group were po administered with Shenshuanning Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 45 d. The clinical efficacies, disease degree, renal function indexes, oxidative stress indexes, and red blood cell parameters in two groups were compared. Results The total effective rate was 92.50% in the treatment group and 75.00% in the control group, and the difference was significant between the treatment group and the control group (P < 0.05). After treatment, APACHEⅡ score of two groups was lower than that before treatment (P < 0.05), and APACHEⅡ score of the treatment group was lower than that of the control group (P < 0.05). After treatment, GFR was higher than that before treatment, but Scr, UTP, and β₂-MG were lower than that before treatment (P < 0.05). GFR in the treatment group was higher than that in the control group, but Scr, UTP, and β₂-MG were lower than that in the control group (P < 0.05). The serum levels of SAA, AGEs, and AOPP of two groups were lower than those before treatment (P < 0.05), and the serum levels of SAA, AGEs, and AOPP in the treatment group were lower than those in the control group (P < 0.05). After treatment, HCT and Hb in two groups were higher than before treatment (P < 0.05), and HCT and Hb in the treatment group were higer than those in the control group (P < 0.05). Conclusion Shenshuaining Granules combined with Reduced Glutathione for injection can improve the therapeutic effect of chronic renal failure during maintenance hemodialysis, further control the disease, improve renal function and red blood cell function, and reduce oxidative stress response.

R983

連云港市第四人民醫(yī)院科研項(xiàng)目（20230303）