当归补血汤联合回旋灸对CKD 3—5期非透析糖尿病肾病合并肾性贫血的临床研究  

Clinical Study of Danggui Buxue Decoction Combined with Circling Moxibustion in CKD 3-5 Non-Dialysis Diabetes Nephropathy Complicated with Renal Anemia

作　　者：邹训霞 赵娜妹 蒋晓涵 李陈达 何美杉 ZOU Xunxia;ZHAO Namei;JIANG Xiaohan;LI Chenda;HE Meishan(Dept.of Nephropathy and Rheumatology,Baoding No.1 Hospital of Traditional Chinese Medicine,Hebei Baoding 071000,China;Dept.of Internal Medicine of Traditional Chinese Medicine,Baoding No.1 Hospital of Traditional Chinese Medicine,Hebei Baoding 071000,China)

机构地区：[1]保定市第一中医院肾病风湿科,河北保定071000 [2]保定市第一中医院中医内科,河北保定071000

出　　处：《中国医院用药评价与分析》2024年第4期431-434,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：河北省科学技术研究与发展计划项目(No.202101A068);保定市社发类项目(No.2241ZF271)。

摘　　要：目的:探讨当归补血汤联合回旋灸对慢性肾脏病(CKD)3—5期非透析糖尿病肾病合并肾性贫血患者肾小球滤过功能,血管钙化、肠源性内毒素水平及铁调素-25(hepcidin-25)、β-羟丁酸(β-HB)的影响。方法:研究对象为2021年12月至2023年2月于该院肾内科就诊的CKD 3—5期非透析糖尿病肾病合并肾性贫血患者102例,根据随机数字表法分为研究组和对照组,各51例。在常规治疗(控制饮食、适量运动、口服罗沙司他)基础上,对照组患者给予回旋灸治疗,研究组患者在对照组的基础上服用当归补血汤,两组患者均连续治疗3个月。治疗结束后统计两组患者的疗效,比较两组患者肾小球滤过功能、血管钙化评分,外周血内毒素(LPS)、白细胞介素6(IL-6)、hepcidin-25和β-HB水平。结果:研究组患者的总有效率为96.08%(49/51),明显较对照组的84.31%(43/51)更高,差异有统计学意义(P<0.05)。相较于对照组,研究组患者治疗后肾小球滤过率估计值更高,腹主动脉血管钙化程度评分更低,外周血中LPS、IL-6、hepcidin-25和β-HB水平更低,外周血中血红蛋白、铁蛋白、转铁蛋白饱和度和转铁蛋白水平更高,差异均有统计学意义(P<0.05)。结论:对于CKD 3—5期非透析糖尿病肾病合并肾性贫血患者,当归补血汤联合回旋灸改善贫血的疗效较好,且可提高肾小球滤过功能,减轻血管钙化程度,其作用机制可能与降低肠源性内毒素水平、调节hepcidin-25和β-HB水平有关。OBJECTIVE:To probe into the effects of Danggui Buxue decoction combined with circling moxibustion on glomerular filtration function,vascular calcification,intestinal endotoxin level and hepcidin-25,β-hydroxybutyrate(β-HB)in patients with chronic kidney disease(CKD)3-5 non-dialysis diabetes nephropathy complicated with renal anemia.METHODS:A total of 102 patients with CKD 3-5 non-dialysis diabetes nephropathy complicated with renal anemia admitted into nephropathy and rheumatology department of the hospital from Dec.2021 to Feb.2023 were extracted and divided into the research group and control group by random number table method,with 51 patients in each group.On the basis of routine treatment(diet control,moderate exercise,oral rosastatin),the control group was treated with circling moxibustion,while the research group received Danggui Buxue decoction on the basis of the control group.Both groups were treated continuously for 3 months.After treatment,the efficacy of two groups was analyzed,and the glomerular filtration function,vascular calcification score,peripheral blood lipopolysaccharide(LPS),interleukin-6(IL-6),hepcidin-25 andβ-HB levels were compared between two groups.RESULTS:The total effective rate of the research group was 96.08%(49/51),significantly higher than that 84.31%(43/51)of the control group,the difference was statistically significant(P<0.05).Compared with the control group,patients in the research group after treatment had higher glomerular filtration rate,lower abdominal aortic vascular calcification score,lower LPS,IL-6,hepcidin-25 andβ-HB levels in peripheral blood,and higher hemoglobin,ferritin,transferrin saturation and transferrin contents in peripheral blood,the differences were statistically significant(P<0.05).CONCLUSIONS:The efficacy of Danggui Buxue decoction combined with circling moxibustion for improving anemia in patients with CKD 3-5 non-dialysis diabetes nephropathy complicated with renal anemia is significant,which can improve the glomerular filtration function and reduc

关 键 词：糖尿病肾病 肾性贫血 非透析 当归补血汤 回旋灸 肾小球滤过功能 血管钙化 

分 类 号：R932[医药卫生—生药学]