Effects Of Oxymatrine On Malnutrition And Anemia In Maintenance Hemodialysis Patients

ObjectiveTo observe the effects of Oxymatrine Capsules on malnutrition and anemia in maintenance hemodialysis(MHD) patients,and to investigate the best medication time and possibal mechanisms.Methods40 cases,who carried on maintenance hemodialysis respectively in the morning(20 cases) and in the afternoon(20 cases) in the Blood Purification Center of the First Hospital in Wuhan City,were selected randomly and divided into two groups:Wu Shi group(morning) and You Shi group(afternoon).Other 20 MHD patients were randomly selected as a blank control group.All groups carried out reguler and conventional dialysis treatments.Wu Shi group and You Shi group added oral oxymatrine capsules respectively at Wu Shi(11-13 o' clock) and You Shi(17-19 o' clock),whlie the control group did not. All groups had been observed for 3 months.Changes of symptoms, adverse drug reactions and dosage of EPO in patients were observed during medication.The symptom scores were compared before and after treatment.Nutritional biochemical indicators,anemic indicators and inflammatory indicators were tested.Dry weight, triceps skinfold(TSF) and mid-arm circumference(MAC) were measured and recorded. Results1.A total of 58 cases accessed to the final statistical analysis, of which 19 caces in You Shi group,19 caces in Wu Shi group and 20 caces in control group,while 2 cases exited.2.Three groups of patients were comparable in age,gender,dialysis age,total dialysis time per week,primary disease,etc.There was no significant statistical difference among them(P＞0.05).3.Comparison of symptom scores:After treatment,symptom scores of You Shi group and Wu Shi group decreased significantly(P＜0.01), while there was no significant difference in the blank control group; Scores of You Shi group and Wu Shi group were significantly lower than that of the blank group(P＜0.01,P＜0.05).There was no significant difference between You Shi group and Wu Shi group(P＞0.05).4.Comparison of nutritional biochemical indicators:After treatment,ALB,PA,TO,TF in You Shi group were significantly increased compared with itself pre-treatment and blank group postreatment (P＜0.05,P＜0.01);There was no significant change in SCr and BUN in You Shi group(P＞0.05).Levels of ALB,PA and TC in Wu Shi group increased significantly compared with itself pretreatment and the blank group post-treatment(P＜0.01);There was no significant change in SCr,BUN and TF in Wu Shi group(P＞0.05). The blank group had no remarkable changes in all nutritional biochemical indicators before and after treatment(P＞0.05).5.Comparison of anemic indicators and dosage of EPO:Levels of Hb, Hct and SF in Oxymatrine treated groups post-reatment were at various degrees higher than itself pre-treatment,and dosage of EPO decreased in these two groups.The blank group had no significant change in these indicators.The level of Hb in You Shi group was significantly higher than that of Wu Shi group.Levels of Hb and Hct in You Shi group were hihger than those of the blank group,while the level of Hb in Wu Shi group were hihger than that of the blank group.Dosage of EPO in these two grous was less than that in the blank group.6.Comparison of hs-CRP:After treatment,levels of hs-CRP in You Shi and Wu Shi group decreased significantly and were lower than that in the blank group pre-treatment(P＜0.01,P＜0.05).The level of hs-CRP in You Shi was lower than that in Wu Shi group;There was no notable change in the blank group before and after treatment (P＞0.05);7.Comparison of anthropometric indicators:There was no significant difference before and after treatment in dry weight,TSF and MAC among these three groups(P＞0.05).Conclusions1.Oxymatrine Capsules help to improve the states of malnutri-tion and anemia,decrease the dosage of EPO and alleviate clinic symptoms in MHD patients.The mechanism maybe attribute to the improvement of microinflammatory state.2.Oxymatrine Capsules dosed at You Shi show superior effect.The effect of intervening at different time remains to be explored further.3.Oxymatrine Capsules have few disadvantages and adverse reactions.