保和丸加减联合铁剂治疗脾胃虚弱型缺铁性贫血的临床观察

发布时间：2018-01-05 20:13

本文关键词：保和丸加减联合铁剂治疗脾胃虚弱型缺铁性贫血的临床观察　出处：《广州中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：背景：缺铁性贫血(IDA)是最常见的营养素缺乏症,各年龄阶段均有发病,其高危人群为妇女、婴幼儿和儿童。铁是合成血红蛋白的必须元素,同时又在生物氧化等过程中起重要作用。铁元素的缺乏不仅会使血红蛋白的合成减少,还会影响细胞和组织内含铁酶和铁依赖酶的活性,进一步则会影响细胞组织代谢、降低机体免疫力及引起其他组织器官的多种表现,从而危害人体健康。目前铁剂治疗缺铁性贫血疗效确切。但铁剂的副作用不可避免的影响了铁剂的使用,从而使部分缺铁性贫血患者不能恢复健康,因此寻找有效且能降低铁剂副作用发生的治疗方法成为目前最常面对的内科问题之一。目的：通过保和丸联合铁剂治疗脾胃虚弱型缺铁性贫血,系统分析治疗前后临床症状积分、铁剂副作用发生率及相关实验室检查变化,了解保和丸加减联合铁剂治疗脾胃虚弱型缺铁性贫血对临床症状及降低铁剂副作用的情况,并运用中西医理论分别阐述脾胃虚弱型缺铁性贫血患者采用保和丸加减联合铁剂治疗降低铁剂副作用发生的机理,为其可行性提供理论及实践基础,为治疗缺铁性贫血寻求更为安全有效的治疗方案。方法：将34例合格受试对象随机分为两组,试验组17例,对照组17例,试验组给予保和丸加减联合多糖铁复合物胶囊(力蜚能),疗程30天。对照组给予多糖铁复合物胶囊(力蜚能),疗程30天。观察两组治疗前后临床症状、血常规和铁代谢指标的变化,以及治疗中铁剂副作用的发生情况。成果：1.按中医症候疗效判定标准：两组治疗后中医症状积分降低,临床症状改善。其中,试验组总治愈率为41.17%,对照组总治愈率为17.65%,经非参数检验差别有统计学意义(PO.05),说明两组治疗方法在中医症候疗效上有差别。两组治疗中试验组铁剂副作用发生率较低,经Fisher确切概率法检验差别有统计学意义(P0.05),说明两组在降低铁剂副作用上差异明显。2.按西医疗效判定标准：由统计结果可见,两组对治疗缺铁性贫血均有显著疗效。其中,试验组治愈率17.65%,对照组治愈率35.29%,经非参数检验差异无统计学意义(P0.05),说明两组在治疗缺铁性贫血的西医临床疗效上无明显差异。在铁代谢方面,两组治疗后血清铁、铁蛋白、转铁蛋白饱和度均较治疗前升高,经配对t检验比较,差异有统计学意义(P0.05),说明两组均能显著提高患者铁代谢相关指标。同时试验组与对照组治疗后铁代谢方面指标经t检验比较,差异无统计学意义(PO.05),说明两组治疗缺铁性贫血在提高铁代谢相关指标上无差异。结论：保和丸加减联合铁剂治疗脾胃虚弱型缺铁性贫血在中医症候疗效方面明显优于单纯铁剂治疗,并可有效降低铁剂副作用的发生。
[Abstract]:Background: iron deficiency anemia (Ida) is the most common nutritional deficiency. It occurs at all ages. The high risk groups are women, infants and children. Iron is the essential element in the synthesis of hemoglobin. Iron deficiency not only reduces the synthesis of hemoglobin, but also affects the activities of ferritin and iron dependent enzymes in cells and tissues. Further, it will affect cell tissue metabolism, reduce the body's immunity and cause a variety of manifestations of other tissues and organs. So as to endanger human health. Iron treatment of iron deficiency anemia is effective. But the side effects of iron inevitably affect the use of iron, so that some iron deficiency anemia patients can not recover their health. Therefore, it is one of the most common medical problems to find an effective and effective way to reduce the side effects of iron. Objective: to treat the iron deficiency anemia of spleen and stomach with Baohe pills combined with iron. The clinical symptom scores, the incidence of iron side effects and the changes of laboratory examination before and after treatment were systematically analyzed. Objective: to understand the clinical symptoms and reduce the side effects of Baohe pills combined with iron in the treatment of iron deficiency anemia of deficiency of spleen and stomach. And using the theory of traditional Chinese and western medicine to explain the spleen and stomach iron deficiency anemia patients with Baohe plus subtraction combined with iron treatment to reduce the occurrence of side effects of iron, to provide a theoretical and practical basis for its feasibility. Methods: 34 eligible subjects were randomly divided into two groups: the experimental group (n = 17) and the control group (n = 17). The experimental group was treated with Baohe pills combined with polysaccharide-iron complex capsule for 30 days, while the control group was given the polysaccharide iron compound capsule for 30 days. The clinical symptoms were observed before and after treatment. Changes in blood routine and iron metabolism indexes, and the occurrence of iron side effects in treatment. Results: 1. According to TCM symptom efficacy criteria: two groups of TCM symptoms after treatment scores decreased, clinical symptoms improved. The total cure rate of the test group was 41.17 and that of the control group was 17.65.The difference was statistically significant by non-parametric test (P < 0.05). Two groups of treatment methods in the treatment of TCM symptoms and efficacy differences. Two groups of treatment in the treatment of iron side effects are lower, by the Fisher exact probability test the difference is statistically significant (P 0.05). According to the criteria of western medicine efficacy: from the statistical results, we can see that the two groups of iron deficiency anemia treatment has a significant effect. Among them. The cure rate was 17.65 in the test group and 35.29 in the control group. There was no significant difference between the two groups by non-parametric test (P0.05). In iron metabolism, the serum iron, ferritin and transferrin saturation in the two groups after treatment were higher than those before treatment, compared with the paired t test. The difference was statistically significant (P 0.05), indicating that the two groups can significantly improve the related indexes of iron metabolism. At the same time, the test group and the control group after treatment of iron metabolism indicators were compared by t test. The difference was not statistically significant (P < 0.05). The results showed that there was no difference between the two groups in the improvement of iron metabolism. Conclusion: Baohe pills combined with iron in the treatment of deficiency of spleen and stomach iron deficiency anemia in the treatment of traditional Chinese medicine symptoms significantly better than simple iron treatment. And can effectively reduce the occurrence of side effects of iron.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R556.3

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