Study On Volume Overload Of Hemodialysis Patients With Diabetes And Clinical Efficacy Of Yi-Shen-Li-Shui Recipe

ObjectiveThe volume overload of diabetes mellitus(DM)hemodialysis patients was analyzed by bioelectrical impedance analysis(BIA),and based on the levels of serum Trimethylamine-N-Oxide(TMAO)and serum aquaporin-2(AQP2),the therapeutic effect of Yi-Shen-Li-Shui recipe on volume overload in DM hemodialysis patients was evaluated,which provides some clinical research basis and theoretical basis for the regulation of water metabolism by traditional Chinese medicine.MethodsMaintenance hemodialysis(MHD)patients in our hospital from May 1,2020 to December 31,2020 were randomly divided into two groups:diabetes mellitus group(n=40)and non-diabetes mellitus group(n=40).The volume status of the two groups was measured and analyzed by BIA.Using random number table method,20 patients in the diabetes mellitus group were selected into the traditional Chinese medicine treatment group,and the other 20 patients were selected as the control group.The traditional Chinese medicine treatment group was treated with oral Yi-Shen-Li-Shui recipe for 8 weeks,and the control group was given basic treatment.TMAO,AQP2,ultrafiltration volume(UV),urea clearance index(Kt/V),BIA and other related indexes were detected before and after treatment.During this period,two patients in the traditional Chinese medicine treatment group dropped out of the study because they were transferred to other hospitals for dialysis.All data were analyzed by SPSS 25.0 statistical software.Results1.Compared with Non-Diabetes Mellitus(NDM)hemodialysis patients,the extracellular water ratio(EC W/TB W)and hydration rate(TBW/FFM)of DM hemodialysis patients were significantly increased,and the phase angle(PA)of each segment of 50kHz was significantly lower than that of NDM hemodialysis patients.2.Among DM hemodialysis patients,there was no significant difference in ECW/TBW and TBW/FFM between the control group and the traditional Chinese medicine treatment group before and after treatment(P>0.05);After treatment,AQP2 decreased significantly in the traditional Chinese medicine treatment group(P<0.05),UV and Kt/V increasing significantly(P<0.05),but there was no significant difference in TMAO.After treatment,there were no significant difference in TMAO,AQP2,UV and Kt/V in the control group.The total effective rate of TCM clinical symptoms in the traditional Chinese medicine treatment group was 77.78%,which was significantly higher than 25.0%in the control group.There were no obvious adverse reactions after treatment.ConclusionThere is volume overload in patients with DM hemodialysis.After treatment with Yi-Shen-Li-Shui recipe,AQP2 was significantly reduced,and ultrafiltration volume and urea clearance index were significantly increased.TCM clinical symptoms of spleen and kidney deficiency and dampness and blood stasis were significantly improved,suggesting that Yi-Shen-Li-Shui recipe may have a good effect on improving volume overload in patients with DM hemodialysis.