目的:腹膜纤维化所致的超滤失败是长期腹透治疗的主要并发症,也是腹透患者退出腹透治疗的主要原因。近几年来,中医药治疗腹透相关性腹膜纤维化已经成为研究热点。为此,回顾腹透相关性腹膜纤维化与中医药防治的实验研究结果,综述中医药防治腹透相关性腹膜纤维化有效干预方法及可能的作用机制。 资料来源:应用计算机检索中国期刊全文数据库、万方数据库结合手工检索1993—01/2006—06期间的相关文章,检索词“腹膜透析、腹膜纤维化、中医药、防治”,限定文章语言种类为中文。 资料选择:对资料进行初审,选取中医药防治腹透相关性腹膜纤维化实验包括治疗组和对照组的文献,然后筛除非随机实验研究,查找剩余的文献全文,以是否为随机对照实验研究作为纳入标准。 资料提炼:共收集到14篇关于腹透相关性腹膜纤维化与中医药防治关系的随机和未随机实验,纳入12个随机对照实验研究,排除2篇。12个实验对象中10个符合腹透相关性腹膜纤维化实验研究,2个为相关药物药理研究。治疗中药选用了单昧中药、中药提取物和中药复方等对大鼠腹膜间皮细胞、腹膜结构等的影响,对各种不同的抗腹透相关性腹膜纤维化中药,进行了对照研究及相关性分析。 资料综合:①腹膜透析腹膜纤维化中医药疗法的探索主要有单昧中药、中药提取物和中药复方等对大鼠腹膜间皮细胞、腹膜结构的影响。黄芪可以增加心排血量,使腹腔血流灌注增加从而提高跨毛细血管超滤,增加腹膜有效透析面积,且可抑制由转化生长因子β1引起的纤维连接蛋白产生。丹参能有效地提高腹膜溶质清除率和超滤量,丹参、黄芪对腹膜超微结构有良性影响。中药提取物主要为川芎嗪,有抑制腹膜间皮细胞CD40表达的作用,能显著改善腹膜透析中?
OBJECTIVE: The ultra-filtration failure resulted from peritoneal fibrosis, is a main complication after long terms of peritoneal dialysis, and compels patients to withdraw from peritoneal dialysis. It has been a popular studying topic to control peritoneal fibrosis using traditional Chinese medicine. Thus relevant reports has been reviewed to summarize an effective method and the possible mechanism of traditional Chinese medicine in prevention and treatment of peritoneal fibrosis. DATA SOURCES: Correlative articles between January 1993 and June 2006 were searched by computer and manually in Chinese periodical full text database and Wanfang database with the key words of “peritoneal dialysis, peritoneal fibrosis, traditional Chinese medicine, prevention and cure”, and the language was limited to Chinese. STUDY SELECTION: The experimental articles focused on traditional Chinese medicine in prevention and cure of peritoneal fibrosis were checked in the first trial, and literatures on the experiment of traditional Chinese medicine in prevention and cure of peritoneal fibrosis including treatment group and control group were selected, whereas obvious non-randomized studies were excluded, and rest articles were looked for the full text according to the inclusion criteria of whether they were randomized control experiment. DATA EXTRACTION: A total of 14 non-randomized experiments focused on traditional Chinese medicine in the prevention and cure of peritoneal fibrosis were collected, and 12 of randomized control experiments were included, whereas 2 articles were excluded. 10 researches out of these 12 articles were experimental studies of peritoneal fibrosis, the other 2 were pharmacological researches of relevant drugs. Single Chinese drugs, Chinese drugs extractive and compound Chinese drugs, which had effects on rat peritoneal mesothelial cells and peritonaeum structure were adopted in the treatment, and comoarative experiment and relative analysis were done on different Chinese drugs against peritone