基于铁调素调节铁代谢机制观察补脾益肾活血方对促红细胞生成素抵抗的肾性贫血的作用  

Effects of Bupi Yishen Huoxue Decoction in Treatment of Erythropoietin Resistance in Patients with Renal Anemia based on the Mechanism of Hepcidin Regulating ion Metabolism

作　　者：张荣东 林莺 叶长寿 黄雯晖 ZHANG Rongdong;LIN Ying;YE Changshou;HUANG Wenhui(Ningde Municipal Hospital Affiliated of Ningde Normal University,Fujian Ningde 352100,China)

机构地区：[1]宁德师范学院附属宁德市医院,福建宁德352100

出　　处：《中医药临床杂志》2023年第7期1394-1398,共5页Clinical Journal of Traditional Chinese Medicine

基　　金：福建省自然科学基金面上项目(No:2020JO11348)。

摘　　要：目的:通过观察肾性贫血患者血清铁调素对铁代谢的调节作用,探讨补脾益肾活血方对促红细胞生成素(erythropoietin,EPO)抵抗的干预机制。方法:将60例EPO抵抗的肾性贫血患者按随机数字表法分为对照组和治疗组各30例,对照组给予常规治疗,治疗组在对照组治疗的基础上加用补脾益肾活血方,连续观察3个月,同时选取健康人群30例作为健康组。观察并比较各组治疗前后血清铁调素(Hepcidin)、铁蛋白(serum ferritsn,SF)、转铁蛋白饱和度(transferin saturation,TSAT)、血红蛋白(hemoglobin,Hb)、红细胞比容(hematocrit,Hct)、重组人促红细胞生成素(recombinant human erythropoietin,rHuEPO)用量、EPO抵抗指数(erythropoietin resistance index,ERI)的变化。结果:与健康组比较,对照组和治疗组患者的Hepcidin、SF均明显升高,TSAT明显降低(P<0.05)。与治疗前比较,治疗组治疗后的Hepcidin、SF、rHuEPO用量、ERI均明显降低,Hb、Hct、TSAT明显升高(P<0.05),而对照组变化不明显(P>0.05)。与对照组比较,治疗组治疗后的Hepcidin、SF、rHuEPO用量、ERI均明显降低,Hb、Hct、TSAT明显升高(P<0.05)。结论:肾性贫血患者的EPO抵抗与血清铁调素水平升高、铁代谢紊乱相关;补脾益肾活血方可以通过抑制机体铁调素的高表达来改善铁代谢,这可能是补脾益肾活血方改善患者贫血,改善EPO抵抗的机制之一。Objective:To explore the intervention mechanism of Bupi Yishen Huoxue Decoction on erythropoietin(EPO)resistance by observing the regulation effect of serum hepcidin on iron metabolism in patients with renal anemia.Method:Divide 60 patients with EPO-resistant renal anemia into a control group and a treatment group with 30 cases in each according to the random number table method.side,observed continuously for 3 months,and selected 30 cases of healthy people as the healthy group.Observe and compare serum hepcidin(Hepcidin),ferritin(serum ferritsn,SF),transferrin saturation(transferrin saturation,TSAT),hemoglobin(hemoglobin,Hb),hematocrit(hematocrit,Hct)in each group before and after treatment),the dosage of recombinant human erythropoietin(rHuEPO),and the changes of EPO resistance index(erythropoietin resistance index,ERI).Results:Compared with the healthy group,Hepcidin and SF in the control group and treatment group were significantly increased,and TSAT was significantly decreased(P<0.05).Compared with before treatment,the dosage of Hepcidin,SF,rHuEPO,and ERI in the treatment group were significantly decreased,and the levels of Hb,Hct,and TSAT were significantly increased(P<0.05),while the changes in the control group were not significant(P>0.05).Compared with the control group,the dosage of Hepcidin,SF,rHuEPO,and ERI in the treatment group were significantly decreased after treatment,while the levels of Hb,Hct,and TSAT were significantly increased(P<0.05).Conclusion:EPO resistance in patients with renal anemia is related to the increase of serum hepcidin level and iron metabolism disorder;Bupi Yishen Huoxue formula can improve iron metabolism by inhibiting the high expression of hepcidin in the body,which may be the effect of invigorating the spleen.One of the mechanisms by which Shenhuoxue prescription improves anemia in patients and improves EPO resistance.

关 键 词：铁调素 铁代谢 EPO抵抗 补脾益肾活血方 

分 类 号：R256.59[医药卫生—中医内科学]