Abstract:

Objective　To explore the effects of Rehmannia leaf glycoside capsules combined with L-carnitine on inflammatory factors, residual renal function (RRF), and oxidative stress in hemodialysis patients. Methods　A total of 124 patients with chronic renal failure who received hemodialysis treatment in the People's Hospital of Xiangxiang from January 2020 to December 2022 were prospectively selected in this study and were divided into a control group and a combination group by the random number table method, with 62 cases in each group. The control group included 35 males and 27 females, aged (49.29±5.43) years; the combination group included 37 males and 25 females, aged (49.58±5.46) years. The control group received L-carnitine treatment, and the combination group received Rehmannia leaf glycoside capsules + L-carnitine treatment, continuous treatment for 2 months. The inflammatory factors [hypersensitive C-reactive protein (hs-CRP), interleukin-2 (IL-2), and tumor necrosis factor-α (TNF-α)], renal function indexes [serum creatinine, urea nitrogen, and RRF], and oxidative stress indexes [malondialdehyde (MDA), reactive oxygen species (ROS), and advanced oxidation protein products (AOPP)] before treatment and 2 months after treatment and adverse reactions were compared between the two groups. t test and χ² test were used. Results　After 2 months of treatment, the levels of inflammatory factors in both groups were decreased compared with those before treatment (all P<0.05), and the levels of hs-CRP [(4.03±1.13) mg/L], IL-2 [(8.26±1.34) ng/L], and TNF-α [(31.46±4.53) ng/L] in the combination group were lower than those in the control group [(7.05±1.59) mg/L, (11.05±2.02) ng/L, and (44.29±5.24) ng/L], with statistically significant differences (t=12.191, 9.063, and 14.585; all P<0.05). After 2 months of treatment, the levels of renal function indexes in both groups were decreased compared with those before treatment (all P<0.05), the levels of serum creatinine [(464.33±21.16) μmol/L] and urea nitrogen [(15.58±2.46) mmol/L] in the combination group were lower than those in the control group [(514.26±28.25) μmol/L and (19.27±3.15) mmol/L], and the level of RRF [(4.29±1.13) ml/min] was higher than that in the control group [(2.54±0.76) ml/min], with statistically significant differences (t=17.162, 7.270, and 10.119; all P<0.05). After 2 months of treatment, the levels of oxidative stress indexes in both groups were decreased compared with those before treatment (all P<0.05), and the levels of MDA [(5.02±1.13) nmol/L], ROS [(192.35±17.59) μmol/L], and AOPP [(89.45±9.58) μmol/L] in the combination group were lower than those in the control group [(8.15±2.10) nmol/L, (264.16±21.47) μmol/L, and (112.04±12.67) μmol/L], with statistically significant differences (t=10.335, 20.372, and 11.198; all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the combination group and the control group [8.06% (5/62) vs. 11.29% (7/62)] (χ²=0.369, P=0.544). Conclusion　Rehmannia leaf glycoside capsules combined with L-carnitine has definite efficacy in the treatment of hemodialysis patients, which can reduce the production of inflammatory factors, relieve the oxidative stress, and protect the RRF, and has good safety and clinical application value.

Key words:

Hemodialysis, Rehmannia leaf glycoside capsules, L-carnitine, Inflammatory factors, Residual renal function, Oxidative stress

摘要：

目的　探讨地黄叶总苷胶囊联合左卡尼汀对血液透析患者炎症因子、残余肾功能及氧化应激的影响。方法　本文为前瞻性研究。选取2020年1月至2022年12月在湘乡市人民医院接受血液透析治疗的124例慢性肾衰竭患者作为研究对象，按照随机数字表法分为两组，各62例。对照组男35例、女27例，年龄（49.29±5.43）岁，接受左卡尼汀治疗；联合组男37例、女25例，年龄（49.58±5.46）岁，接受地黄叶总苷胶囊联合左卡尼汀治疗，连续治疗2个月。对比两组患者治疗前、治疗2个月后炎症因子指标［超敏C反应蛋白（hs-CRP）、白细胞介素-2（IL-2）、肿瘤坏死因子-α（TNF-α）］、肾功能指标［血肌酐、尿素氮、残余肾功能］、氧化应激指标［丙二醛（MDA）、活性氧（ROS）、人晚期氧化蛋白产物（AOPP）］及不良反应。采用t检验、χ²检验。结果　治疗2个月后，两组患者炎症因子各项指标水平均低于治疗前（均P<0.05），且联合组hs-CRP［（4.03±1.13）mg/L］、IL-2［（8.26±1.34）ng/L］、TNF-α水平［（31.46±4.53）ng/L］均低于对照组［（7.05±1.59）mg/L、（11.05±2.02）ng/L、（44.29±5.24）ng/L］，差异均有统计学意义（t=12.191、9.063、14.585，均P<0.05）。治疗2个月后，两组患者肾功能各项指标水平均低于治疗前（均P<0.05），且联合组血肌酐［（464.33±21.16）μmol/L］、尿素氮水平［（15.58±2.46）mmol/L］均低于对照组［（514.26±28.25）μmol/L、（19.27±3.15）mmol/L］，残余肾功能［（4.29±1.13）ml/min］高于对照组［（2.54±0.76）ml/min］，差异均有统计学意义（t=17.162、7.270、10.119，均P<0.05）。治疗2个月后，两组患者氧化应激各项指标水平均低于治疗前（均P<0.05），且联合组MDA［（5.02±1.13）nmol/L］、ROS［（192.35±17.59）μmol/L］、AOPP水平［（89.45±9.58）μmol/L］均低于对照组［（8.15±2.10）nmol/L、（264.16±21.47）μmol/L、（112.04±12.67）μmol/L］，差异均有统计学意义（t=10.335、20.372、11.198，均P<0.05）。联合组不良反应发生率与对照组比较［8.06%（5/62）比11.29%（7/62）］，差异无统计学意义（χ²=0.369，P=0.544）。结论　地黄叶总苷胶囊联合左卡尼汀治疗血液透析患者疗效确切，可减少炎症因子产生，缓解氧化应激，保护残余肾功能，且安全性好，有临床应用价值。

关键词:

血液透析, 地黄叶总苷胶囊, 左卡尼汀, 炎症因子, 残余肾功能, 氧化应激