归脾汤联合琥珀酸亚铁片和输血治疗用于重度缺铁性贫血患者的疗效及对血常规指标、铁代谢和免疫功能的影响  

Efficacy of Guipi Decoction Combined with Ferrous Succinate Tablets and Blood Transfusion in the Treatment of Severe Iron Deficiency Anemia and Its Effects on Blood Routine Indexes,Iron Metabolism and Immune Function

作　　者：陈哲[1] 崔冬梅[2] 张灵[1] 袁小飞[1] 张斌[3] 高炳华[1] CHEN Zhe;CUI Dongmei;ZHANG Ling;YUAN Xiaofei;ZHANG Bin;GAO Binghua(Dept.of Hematology,the First Hospital Affiliated to Hebei North University,Hebei Zhangjiakou 075061,China;Dept.of Hematology,Beijing Pinggu District Hospital,Beijing 101200,China;Dept.of Laboratory Medicine,The First Hospital Affiliated to Hebei North University,Hebei Zhangjiakou 075061,China)

机构地区：[1]河北北方学院附属第一医院血液科,河北张家口075061 [2]北京市平谷区医院血液科,北京101200 [3]河北北方学院附属第一医院检验科,河北张家口075061

出　　处：《中国医院用药评价与分析》2024年第4期439-442,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：河北省医学科学研究课题计划项目(No.20210203);张家口市科技计划项目(No.1921135H)。

摘　　要：目的:探讨归脾汤联合琥珀酸亚铁片和输血治疗用于重度缺铁性贫血患者的疗效及对血常规指标、铁代谢和免疫功能的影响。方法:选取2018年1月至2023年5月于河北北方学院附属第一医院就诊的重度缺铁性贫血患者130例,以信封抽签法随机分为观察组(65例)和对照组(65例)。两组患者均给予输血治疗,对照组患者口服琥珀酸亚铁片,观察组患者口服琥珀酸亚铁片和归脾汤。治疗4周后,对临床疗效进行评价,观察治疗前后两组患者的血常规指标[血红蛋白(Hb)、红细胞计数(RBC)、平均红细胞血红蛋白量(MCH)和平均红细胞体积(MCV)]、铁代谢指标[血清铁(SI)、血清铁蛋白(SF)和可溶性转铁蛋白受体(sTfR)]及免疫功能指标(CD3^(+)、CD4^(+)和CD8^(+)T淋巴细胞比例)水平,并记录不良反应。结果:与对照组[86.15%(56/65)]比较,观察组患者的总有效率[96.92%(63/65)]更高,差异有统计学意义(P<0.05)。治疗后,两组患者的Hb、RBC、MCH和MCV水平,SI、SF水平,CD3^(+)、CD4^(+)和CD8^(+)T淋巴细胞比例较治疗前明显升高,sTfR水平较治疗前明显降低;且观察组患者的Hb、RBC、MCH和MCV水平,SI、SF水平,CD3^(+)、CD4^(+)和CD8^(+)T淋巴细胞比例较对照组明显升高,sTfR水平较对照组明显降低,差异均有统计学意义(P<0.05)。对照组、观察组患者不良反应发生率比较[3.08%(2/65)vs. 4.62%(3/65)],差异无统计学意义(P>0.05)。结论:归脾汤联合琥珀酸亚铁片和输血治疗用于重度缺铁性贫血患者的疗效较好,可改善血常规指标、铁代谢情况及免疫功能,且安全性好。OBJECTIVE:To probe into the efficacy of Guipi decoction combined with Ferrous succinate tablets and blood transfusion in the treatment of severe iron deficiency anemia and its effects on blood routine indexes,iron metabolism and immune function.METHODS:A total of 130 patients with severe iron deficiency anemia admitted into the First Hospital Affiliated to Hebei North University from Jan.2018 to May 2023 were selected and divided into observation group(65 cases)and control group(65 cases)via envelope lottery method.Both groups were given blood transfusion,the control group was given Ferrous succinate tablets orally,the observation group was given Ferrous succinate tablets combined with Guipi decoction orally.After 4-week treatment,the clinical efficacy was evaluated,the blood routine indexes[hemoglobin(Hb),red blood cell count(RBC),mean corpuscular hemoglobin(MCH),mean corpuscular volume(MCV)],iron metabolism indexes[serum iron(SI),serum ferritin(SF),soluble transferrin receptor(sTfR)]and immune function(proportions of CD3^(+),CD4^(+)and CD8^(+)T lymphocytes)of both groups before and after treatment were observed,and the adverse drug reactions were recorded.RESULTS:Compared with control group(86.15%,56/65),the total effective rate of the observation group(96.92%,63/65)was higher,with statistically significant difference(P<0.05).After treatment,the Hb,RBC,MCH,MCV,SI,SF,proportions of CD3^(+),CD4^(+)and CD8^(+)T lymphocytes of both groups were significantly higher than those before treatment,while the sTfR was significantly lower than that before treatment;the Hb,RBC,MCH,MCV,SI,SF,proportions of CD3^(+),CD4^(+),CD8^(+)T lymphocytes of the observation group were significantly higher than those of the control group,while the sTfR was significantly lower than that of the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in incidences of adverse drug reactions between the control group and the observation group[3.08%(2/65)vs.4.62%(3/65),P>0.05].CONCLUSION

关 键 词：归脾汤 琥珀酸亚铁片 输血治疗 重度缺铁性贫血 

分 类 号：R932[医药卫生—生药学] R977.8[医药卫生—药学]