泄浊养血法联合重组人促红素注射液治疗肾虚湿浊型慢性肾脏病3~5期肾性贫血患者的临床观察

Clinical observation on the treatment of renal anemia patients with kidney deficiency and dampness type CKD stage 3 to 5 by Xiezhuo Yangxue Prescription and Recombinant Human Erythropoietin Injection

关键词:  肾性贫血  泄浊养血方  重组人促红素注射液  CKD 3～5期

Key words:  renal anemia  Xiezhuo Yangxue Prescription  Recombinant Human Erythropoietin Injection  CKD stage 3 to 5

摘要:

[目的] 观察泄浊养血法联合重组人促红素注射液对慢性肾脏病（CKD）3～5期肾性贫血患者贫血改善及残余肾功能的干预作用。[方法] 选择2020年10月—2021年10月就诊于天津中医药大学第一附属医院的88例CKD3～5期肾性贫血患者，根据随机数字表法随机分为对照组（44例）和治疗组（44例）。对照组予重组人促红细胞生成素注射液及多糖铁复合物治疗，治疗组在此基础上联合泄浊养血法中药方治疗，连续服用3个月，观察治疗前后两组临床疗效、红细胞计数（RBC）、血红蛋白（Hb）、血清肌酐（Scr）、尿素氮（BUN）、肾小球滤过率（eGFR）、尿微量白蛋白（mALB）、丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）的变化，症状积分及不良反应发生率。[结果] 治疗3个月后，治疗组总有效率为86.36%，对照组为56.82%，治疗组临床疗效优于对照组（P＜0.05）；症状积分、RBC、Hb、Scr、BUN、mALB均较治疗前改善，且治疗组优于对照组（P＜0.05）；安全性指标中AST、ALT治疗前后数值变化，差异无统计学意义（P＞0.05）。两组病例中均未出现不良反应。[结论] 泄浊养血法联合重组人促红细胞生成素注射液治疗可以改善CKD3～5期非透析肾性贫血患者临床症状，提高临床疗效，延缓肾功能进展，且具有一定的安全性。

Abstract:

[Objective] To observe the interventional effects of draining and nourishing blood formula combined with recombinant human erythropoietin injection on the improvement of anemia and residual renal function in patients with chronic kidney disease(CKD) stage 3 to 5 nephrogenic anemia. [Methods] Eighty-eight patients with CKD stage 3 to 5 renal anemia attending the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from October 2020 to October 2021 were selected and divided into a control group(44 patients) and a treatment group(44 patients) according to the random number table method. The control group was treated with recombinant human erythropoietin injection and polysaccharide iron complex,and the treatment group was treated with the combination of traditional Chinese medicine to drain turbidity and nourish blood for 3 months,and the clinical efficacy,red blood cell count(RBC),hemoglobin (Hb),serum creatinine (Scr),urea nitrogen (BUN),glomerular filtration rate (eGFR),urinary microalbumin (mALB),alanine amino transferase(ALT),aspartate aminotransferase(AST) changes,symptom scores and incidence of adverse reactions. [Results] After 3 months of treatment,the total effective rate was 86.36% in the treatment group and 56.82% in the control group,and the clinical efficacy of the treatment group was better than that of the control group(P<0.05);the symptom score,RBC,Hb,Scr,BUN and mALB all improved compared with those before treatment,and the treatment group was better than the control group (P<0.05);the safety indexes of AST and ALT before and after treatment showed that the difference was not statistically significant(P>0.05). No adverse reactions were observed in both groups. [Conclusion] The combination of drainage and blood nourishment method with recombinant human erythropoietin injection can improve the clinical symptoms,improve the clinical efficacy,and delay the progression of renal function in patients with non-dialysis renal anemia in CKD stage 3 to 5,and has certain safety.