RESUMO
Objective:To discuss influence of addition and subtraction therapy of Zhenwutang to residual renal function （RRF）， nutritional status， dialysis adequacy and quality of life of patients with maintenance hemodialysis （MHD）. Method:One hundred and thirty-six patients were randomly divided into control group （68 cases） and observation group （68 cases） by random number table. Patients in two group got MHD， 3 times/week， 4 h/time， levocarnitine injection （1 g dissolved in 5-10 mL water for injection） after the dialysis， 2-3 min/time， recombinant human erythropoietin injection with subcutaneous injection for 4 weeks， 3 000 U， 3 times/day， valsartan capsules for 3 months， 80 mg/time， 1 time/day. The control group took Manshenning mixture， 35 mL / time， 3 times / day.Patients in observation group added addition and subtraction therapy of Zhenwutang for 3 months， 1 dose/day. Before and after treatment， urea nitrogen （BUN）， creatinine （CR） and 24 hours' urine volume were recorded. And RRF， rate of decrease of RRF and rate of decrease in urine volume were also calculated. Levels of hemoglobin （HB）， albumin （ALB）， prealbumin （PA） and transferrin （TRF） were detected. After treatment， standardized protein metabolism rate （nPCR）， urea clearance index （Kt / V） and glomerular filtration rate （EGFR） were discussed. And improved subjective comprehensive nutrition assessment （SGA）， dialysis related quality of life （kdta） and health survey summary （SF-36） were graded. Six months' follow-up， primary end point event （24 h urine volume ≤ 400 mL） and no residual renal function （24 h urine volume ≤ 400 mL） were recorded. Result:Levels of RRF， Kt/V， nPCR， eGFR， Hb， Alb， PA， TRF and total scores of KDTA and SF-36 in observation group were higher than those in control group （P<0.01）. And score of SGA， rate of decrease of RRF and rate of decrease in urine volume were less than those in control group （P<0.01）.Incidence rate of primary end point event was 27.94%（19/68） lower than 47.06%（32/68） in control group （χ2=5.302， P<0.05）， incidence rate of no residual renal functionwas 17.65%（11/68） lower than 36.76%（25/68） in control group （χ2=6.274， P<0.05）. And BUN and Cr were lower than those in control group （P<0.01）， 24 h urine volume was more than that in control group （P<0.01）. Conclusion:Addition and subtraction therapy of Zhenwutang can maintenance of RRF， improvement of nutritional status， improvement of dialysis adequacy and quality of life of patients .