补肾健脾降浊汤联合促红细胞生成素治疗维持性血液透析患者肾性贫血的疗效观察  

Effects observation of Bushen Jianpi Jiangzhuo decoction combined with EPO on renal anemia in patients with hemodialysis

作　　者：占永标[1] 杨爱华 丁昀 林志帅 ZHAN Yongbiao;YANG Aihua;DING Yun;LIN Zhishuai(Department of Nephrology,Zhejiang Xiaoshan Hospital,Hangzhou 311202,Zhejiang,China)

机构地区：[1]浙江萧山医院肾内科,浙江杭州311202

出　　处：《中国现代医生》2023年第9期61-64,共4页China Modern Doctor

基　　金：浙江省中医药科技计划项目(2020ZB210)。

摘　　要：目的 探讨补肾健脾降浊汤联合促红细胞生成素(erythropoietin,EPO)治疗维持性血液透析(maintenance hemodialysis,MHD)患者合并肾性贫血的临床疗效。方法 选择2020年9月至2022年6月浙江萧山医院肾内科60例MHD患者,采用随机数字表法分为治疗组和对照组,每组各30例。对照组皮下注射EPO注射液及口服铁剂、叶酸等一般治疗,治疗组在对照组的基础上联合补肾健脾降浊汤治疗,两组均连续治疗8周,比较两组患者的红细胞(red blood cell,RBC)、血红蛋白(hemoglobin,Hb)、白蛋白(albumin,ALB)、血清铁蛋白(serum ferritin,SF)、转铁蛋白饱和度(transferrin saturation,TSAT)、C反应蛋白(C-reaction protein,CRP)及血清钾(serum potassium,K)、肌酐(creatinine,Cr)、尿素氮(blood urea nitrogen,BUN)、尿酸(uric acid,UA)的水平。结果 治疗后,治疗组的RBC、Hb水平较治疗前升高,且高于对照组(P<0.05);治疗组的血清ALB较治疗前显著升高(P<0.01),对照组治疗前后比较差异无统计学意义(P>0.05);治疗后治疗组的CRP较治疗前显著降低(P<0.05),对照组治疗前后比较差异无统计学意义(P>0.05);治疗组的SF、TSAT治疗前后比较,差异无统计学意义(P>0.05),而对照组治疗后SF显著降低(P<0.05),TSAT治疗前后无统计学意义(P>0.05)。两组患者的Cr、BUN、UA及血K水平组间及治疗前后比较,差异无统计学意义(P>0.05)。结论 补肾健脾降浊汤联合EPO注射液能较好地纠正MHD患者的肾性贫血,改善营养状况,减轻微炎症反应,缓解因EPO注射液治疗引起的贮存铁消耗。Objective To explore the clinical effect of Bushen Jianpi Jiangzhuo decoction combined with erythropoietin(EPO)injection on maintenance hemodialysis(MHD)complicated with renal anemia.Methods From September 2020 to June 2022,60 patients with MHD in Department of Nephrology,Zhejiang Xiaoshan Hospital were randomly divided into treatment group and control group,with 30 patients in each group,the control group was treated with subcutaneous injection of EPO,oral iron,folic acid,and other general treatments,the study group was treated with Bushen Jianpi Jiangzhuo decoction on the basis of the control group,the two groups were treated continuously for 8 weeks,and the red blood cell(RBC),Hemoglobin(Hb),albumin(ALB),serum ferritin(SF),transferrin saturation(TSAT),C-reaction protein(CRP),and serum potassium(K),creatinine(Cr),blood urea nitrogen(BUN),and uric acid(UA)levels were compared.Results After treatment,the levels of RBC and Hb in the treatment group were higher than before treatment,and higher than those in the control group(P<0.05);The serum ALB in the treatment group was significantly higher than before treatment(P<0.01),there was no significant difference in the control group before and after treatment(P>0.05);After treatment,CRP in the treatment group was significant lower than that before treatment(P<0.01),there was no statistically significant difference in the control group before and after treatment(P>0.05),and there was no statistically significant difference between SF and TSAT in the treatment group before and after treatment(P>0.05).There was no statistically significant difference between the two groups in the levels of Cr,BUN,UA,and blood K before and after treatment.Conclusion Bushen Jianpi Jiangzhuo decoction combined with EPO injection can effectively correct renal anemia in MHD patients,improve nutritional status,alleviate micro inflammatory reactions,and alleviate the consumption of stored iron caused by EPO injection treatment.

关 键 词：肾性贫血 维持性血液透析 促红细胞生成素注射液 补肾健脾降浊汤 中西医结合 

分 类 号：R256.5[医药卫生—中医内科学]