目的 探讨肾衰宁颗粒联合注射用还原型谷胱甘肽治疗维持性血液透析慢性肾功能衰竭的临床疗效。方法 选取2023年1～10月在连云港市第四人民医院就诊的80例维持性血液透析慢性肾功能衰竭患者，根据随机数字表法将所有患者分为对照组和治疗组，每组各40例。对照组患者静脉滴注注射用还原型谷胱甘肽，1.5 g/m²加入100 mL生理盐水后输注，1次/d。治疗组在对照组基础上温水冲服肾衰宁颗粒，1袋/次，3次/d。两组的疗程为45 d。比较两组的临床效果、病情程度、肾功能指标、氧化应激指标、红细胞参数。结果 治疗组的总有效率为92.50%，对照组的总有效率为75.00%，组间差异显著（P＜0.05）。治疗后，两组的急性生理与慢性健康（APACHEⅡ）评分比治疗前小（P＜0.05），且治疗组的APACHEⅡ评分比对照组更小（P＜0.05）。治疗后，两组的肾小球滤过率（GFR）比治疗前大，肌酐（Scr）、尿蛋白定量（UTP）、β₂-微球蛋白（β₂-MG）比治疗前小（P＜0.05）；治疗组的GFR比对照组大，Scr、UTP、β₂-MG比对照组小（P＜0.05）。治疗后，两组的血清淀粉样蛋白A（SAA）、糖基化终产物（AGEs）、终末期氧化蛋白产物（AOPP）水平比治疗前低（P＜0.05）；治疗组的血清SAA、AGEs、AOPP水平比对照组低（P＜0.05）。治疗后，两组的红细胞压积（HCT）、血红蛋白（Hb）比治疗前高（P＜0.05）；治疗组的HCT、Hb比对照组高（P＜0.05）。结论 肾衰宁颗粒联合注射用还原型谷胱甘肽有助于提高维持性血液透析慢性肾功能衰竭的治疗效果，进一步控制病情，改善肾功能和红细胞功能，降低氧化应激反应。

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

连云港市第四人民医院科研项目（20230303）