补肾健脾降浊汤联合重组人促红素注射液治疗血液透析患者肾性贫血的效果及对促红素反应性的影响  

Effect of Bushen Jianpi Jiangzhuo Decoction combined with Recombinant Human Erythropoietin Injection on renal anemia in hemodialysis patients and its influence on erythropoietin reactivity

作　　者：丁昀 占永标[1] 郝伟华[1] 葛永亮 DING Yun;ZHAN Yongbiao;HAO Weihua;GE Yongliang(Department of Rheumatic Immunological Nephropathy,Zhejiang Xiaoshan Hospital,Zhejiang Province,Hangzhou311202,China)

机构地区：[1]浙江萧山医院风湿免疫肾病科,浙江杭州311202

出　　处：《中国当代医药》2023年第20期79-82,86,共5页China Modern Medicine

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重组人促红素注射液治疗血液透析患者肾性贫血的效果及对促红素反应性的影响。方法选取2021年5月至2022年9月浙江萧山医院血液净化中心收治的50例维持性血液透析合并肾性贫血患者作为研究对象,按照随机数字表法分为对照组和观察组,每组各25例。对照组接受皮下注射重组人促红素注射液治疗8周,观察组在对照组基础上加用补肾健脾降浊汤进行治疗。比较两组患者治疗前,治疗4、6、8周后的红细胞计数(RBC)、血红蛋白(HGB)及红细胞比容(HCT),以及治疗前、治疗8周后的血清铁蛋白(SF)、转铁蛋白饱和度(TSAT)、促红细胞生成素(EPO)。结果治疗前,两组患者EPO、SF比较,差异无统计学意义(P>0.05);治疗8周后,观察组EPO高于本组治疗前及对照组,SF低于本组治疗前,差异有统计学意义(P<0.05)。两组患者治疗前后TSAT组间、组内比较,差异无统计学意义(P>0.05)。整体分析发现,RBC、HCT和HGB组间比较、时间点比较及交互作用比较,差异均有统计学意义(P<0.05);两组患者治疗4、6、8周RBC、HCT和HGB均高于本组治疗前,观察组治疗6、8周RBC、HCT和HGB均高于本组治疗4周,观察组治疗8周RBC、HCT和HGB均高于本组治疗6周,差异有统计学意义(P<0.05);观察组治疗8周RBC、HCT和HGB均高于对照组,差异有统计学意义(P<0.05)。结论对于维持性血液透析肾性贫血的患者,补肾健脾降浊汤联合重组人促红素注射液治疗能提高体内EPO水平,减轻重组人促红素抵抗,维持贮存铁利用,从而更好地纠正贫血。Objective To explore the effect of Bushen Jianpi Jiangzhuo Decoction combined with Recombinant Human Erythropoietin Injection on renal anemia in hemodialysis patients and its influence on erythropoietin reactivity.Methods A total of 50 maintenance hemodialysis and renal anemia patients admitted to Zhejiang Xiaoshan Hospital Blood Purification Center from May 2021 to September 2022 were selected as research objects.They were divided into control group(n=25)and observation group(n=25)according to the random number table method,the control group received a subcutaneous injection of Recombinant Human Erythropoietin Injection for 8 weeks,while the observation group was treated additionally with Bushen Jianpi Jiangzhuo Decoction on the basis of the treatment of control group.Then respectively compared the red blood cell count(RBC),hemoglobin(HGB)and hematocrit(HCT)of the two groups before treatment,after 4,6,8 weeks'treatment,as well as serum ferritin(SF),transferrin saturation(TSAT)and erythropoietin(EPO)of pre-treatment and after 8 weeks of treatment.Results Before treatment,there were no significant differences in EPO and SF between the two groups(P>0.05).After 8 weeks of treatment,the EPO in the observation group was higher than that in the pre-treatment and control group,and the SF was lower than that before treatment,with statistically significant differences(P<0.05).There were no statistically significant differences between and within groups in the comparison of TSAT between the two groups before and after treatment(P>0.05).Overall analysis found that there were statistical significances in RBC,HCT and HGB in comparison between groups,comparison at timepoints and interaction(P<0.05).RBC,HCT and HGB in the two groups after 4,6 and 8 weeks'treatment were higher than those before treatment,the RBC,HCT and HGB in the observation group after 6 and 8 weeks'treatment were higher than those at 4 weeks after treatment,the RBC,HCT and HGB in the observation group after 8 weeks'treatment were higher than those at 6 weeks

关 键 词：肾性贫血 重组人促红素注射液 补肾健脾降浊汤 中西医结合 促红素反应性 

分 类 号：R692.5[医药卫生—泌尿科学]