生血合剂治疗肾性贫血的疗效观察

发布时间：2018-04-14 00:15

本文选题：肾性贫血 + 生血合剂　；参考：《青岛大学》2017年硕士论文

【摘要】：目的:采用前瞻性随机对照临床研究方法,观察生血合剂联合促红细胞生成素治疗肾性贫血的临床疗效及安全性。方法:选取慢性肾脏病5期肾性贫血患者80例,以数字随机法分为对照组和治疗组,对照组采用促红细胞生成素(EPO)联合铁剂治疗,治疗组在对照组治疗的基础上加用口服中药生血合剂,两组患者均按需补充叶酸、维生素B12,并在维持性血液透析的基础上治疗16周。观察对照组及治疗组患者治疗前后的EPO用量、全血红细胞计数(RBC)、血红蛋白(Hb)、红细胞比容(HCT)、C反应蛋白(CRP)、血清铁蛋白、血白蛋白、尿素氮、肌酐、白细胞、谷丙转氨酶(ALT)等临床检测指标,以评价其疗效及安全性。所有数据均采用SPSS17.0统计软件进行处理,P0.05表示结果有统计学差异,P0.05表示结果无统计学差异。结果:1、两组患者的红细胞计数(RBC)、血红蛋白(Hb)、红细胞压积(HCT)等指标在治疗2周后明显升高,与治疗前比较有明显差异(p0.05),两组患者之间比较无明显差异(p0.05)。2、治疗组患者促红细胞生成素用量较治疗前明显减少(p0.05),且较对照组明显减少(p0.05)。3、治疗组患者血白蛋白在治疗第12周时较治疗前明显升高,与治疗前比较有明显差异(p0.05),且较对照组明显升高(p0.05)。4、治疗组患者血CRP在治疗12周时就较治疗前明显降低,与治疗前比较有明显差异(p0.05),且较对照组明显降低(p0.05)。5、治疗组患者EPO相关性高血压发生率明显低于对照组(p0.05)。6、两组患者治疗过程中腹痛、腹泻、恶心、呕吐等临床副反应发生率无明显差异(p0.05)。结论:生血合剂用于治疗肾性贫血,可以升高红细胞计数(RBC)、血红蛋白(Hb)、红细胞压积(HCT);减少促红细胞生成素用量;升高血白蛋白水平,改善患者营养状态;减轻患者的微炎症反应状态;明显降低EPO相关性高血压的发生率;且安全性好,对治疗肾性贫血有一定的临床意义。
[Abstract]:Objective: a prospective randomized controlled clinical research methods, clinical efficacy and safety of Shengxue mixture combined with erythropoietin in the treatment of renal anemia. Methods: 80 cases of 5 renal anemia in patients with chronic kidney disease were selected, were randomly divided into control group and treatment group, the control group using erythropoietin Su (EPO) combined with iron therapy, the treatment group in the control group were treated based on the use of oral medicine Shengxue mixture, two groups of patients according to the need of folic acid, vitamin B12, and based on maintenance hemodialysis treatment for 16 weeks. Before and after treatment group and EPO dosage were observed, blood the red blood cell count (RBC), hemoglobin (Hb), hematocrit (HCT), C reactive protein (CRP), serum ferritin, serum albumin, urea nitrogen, creatinine, white blood cells, alanine aminotransferase (ALT) and other clinical indexes, to evaluate its efficacy and safety. The data were processed using statistical software SPSS17.0, P0.05 said the results were statistically significant difference, P0.05 said the difference was not statistically significant. Results: 1, the red blood cell count of two groups of patients (RBC), hemoglobin (Hb), hematocrit (HCT) and other indicators in 2 weeks after treatment was significantly increased, there was significant difference compared with before treatment (P0.05), between the two groups had no significant difference (.2, P0.05) patients treated with erythropoietin dosage were significantly lower than that before treatment (P0.05), and significantly reduced compared with the control group (P0.05.3), the patients in the treatment group the serum albumin in the treatment of twelfth weeks was significantly higher than that before treatment, there are significant differences compared with before treatment (P0.05), and was significantly higher than the control group (P0.05.4), the patients in the treatment group blood CRP was significantly lower than that before treatment in the treatment of 12 weeks, there was significant difference compared with before treatment (P0.05), and significantly lower than the control group (P0.05.5), the treatment group Patients with EPO associated hypertension was significantly lower than the control group (P0.05.6), abdominal pain, two groups of patients during the treatment of diarrhea, nausea, vomiting and other clinical adverse reaction incidence was no significant difference (P0.05). Conclusion: Shengxue mixture for the treatment of renal anemia, increased red blood cell count (RBC), hemoglobin (Hb), hematocrit (HCT); reduce the dosage of EPO; elevated serum albumin level, improve the nutritional status of patients; reduce inflammation in patients; significantly reduce the incidence of EPO related hypertension; and good safety, has certain clinical significance for the treatment of renal anemia.

【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R692

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