The Influence Of Invigorating The Spleen And Tonifying The Kidney TCM Therapy To Protein-malnutrition And Leptin In Hemodialysis Patient

Background: Protein-malnutrition is an important complication in End Stage Renal Disease(ESRD).Studies have shown,probably 23%-76% of the hemodialysis patients have Malnutrition in varying degrees.Malnutrition,which have direct relationship with high death rate in hemodialysis patient,cause lower immune function,bad tolerance to dialys,infection,anaemia,heart-brain vessel disease and diabetes.etc.The patients in developing countries can't afford the high expense about Albumin.How to prevent and cure protein-malnutrition in hemodialysis patient become an important topic in renal dialys.The discovery of Leptin and its relationship with malnutrition attract more attentions these years.A large amount of research verifies,Leptin acts on the leptin receptor of the hypothalamu under the physiological state,cause the effect of suppressing appetite,increasing energy consumption,then cause the organism to become thin,malnutrition.The higher the Leptin level is,the less ALB,PA and Tfare.Leptin play an important part in causing Malnutrition in hemodialysis patient,and become a new index to appraisal Malnutrition.In present,the researcher in and abroad want to find the ways to change the level of Leptin in hemodialysis patient.Purpose: This study is done to observe the influence of the TCM method by invigorating the spleen and tonifying the kidney to protein-malnutrition and Leptin in hemodialysis patient,then find more measures and methods to cure protein-malnutrition in hemodialysis patient with herbs.Object: The patients came from the third internal medicine of the first hospital affiliated to Guangzhou University of Chinese Medicine.Method: 40 cases are divided into 2 groups at random,group NO. 1(22 cases)is offered the high-quality protein diet,fully hemodialysis and jianzhongtang(the mixture of herbs in TCM);group NO.2(18 cases) is offered the high-quality protein diet,fully hemodialysis but no herbs. After 90days,we checked the level of Leptin in these patients' serum by ELISA and the differences of indexes of protein-malnutrition.Result: The level of Leptin and ALB,pre-Alb,TRF are presented passively (P＜0.01 ),The level of Leptin in group NO.1 decreases obviously. The level of Leptin and indexes of protein-malnutrition in group NO.1 is different obviously with in group NO.2 (P＜0.05).Appetite and symptom are improving obviously before and after treatments. We find that the level of Leptin and some indexes of protein-malnutrition have little change before and after treatment in the serious cases.Conclusion: The level of Leptin have great relationship with the malnutrition grade in hemodialysis patient. The level of Leptin and ALB,pre-Alb,TRF are presented passively,and the level of Leptin and malnutrition grade are presented positively.The level of Leptin doesn't decrease after the routine treatments,but does after the method invigorating the spleen and tonifying the kidney of TCM,which can improve indexes of protein-malnutrition and appetite esp. The TCM method of invigorating the spleen and tonifying the kidney may become a kind of assisitant treatment in malnutrition,but the mechanism of its action are worth further research.