摘要
目的观察滋肾生血方治疗长期血液透析患者肾性贫血的疗效,探讨其作用机制。方法 60例长期血液透析肾性贫血患者随机分为治疗组和对照组各30例,治疗组以滋肾生血方口服配合重组人促红细胞生成素(rHuEPO)皮下注射,对照组仅皮下注射rHuEPO,疗程均为8周。观察患者治疗前后临床症状的变化并测定血红蛋白(Hgb)、前白蛋白(PA)、白蛋白(ALB)、内源性人促红细胞生成素(EPO)、残余肾功能(RRF)、血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)等指标的变化。结果治疗组总有效率90.00%,对照组总有效率80.00%。治疗组治疗后Hgb较治疗前明显升高(P<0.01),对照组亦有升高(P<0.05);治疗后2组比较,治疗组Hgb较对照组上升明显(P<0.05)。对照组治疗后ALB、PA变化不显著(P>0.05),治疗组ALB、PA较用药前有所提高,治疗后2组比较差异有统计学意义(P<0.05)。治疗组治疗后EPO水平较治疗前明显升高(P<0.01),而对照组无明显改变(P>0.05),治疗后2组间比较差异有统计学意义(P<0.01)。对照组治疗后RRF明显下降(P<0.05),治疗组RRF也有下降,但与治疗前比较差异无统计学意义(P>0.05),治疗后2组比较差异有统计学意义(P<0.05)。对照组治疗前后血清IL-6、TNF-α比较差异无统计学意义(P>0.05),治疗组治疗后血清IL-6、TNF-α明显降低(P均<0.05),治疗后2组间比较差异有统计学意义(P<0.05)。结论滋肾生血方能够改善长期血液透析患者的贫血状态。其可能机制为减轻尿毒症毒素对红细胞生成的抑制作用,升高内源性EPO水平,改善长期血液透析患者的微炎症和营养不良状态,延缓患者RRF的下降。
Objective To observe efficacy of Zishensbengxue prescription （ZSSX） on renal anemia in long-term hemodialysis patients and explore its action mechanism. Methods Sixty cases of renal anemia in long-term hemodialysis were randomly divided into a treatment group and a control group, 30 cases in each one. The treatment group was orally administrated with ZSSX and subcutaneously injected with rHuEPO, while the control group was only subcutaneously injected with rHuEPO, 8 weeks were required for the course of treatment. The change of clinical symptoms and indexes before and after the treatment was observed, including hemoglobin （Hgb）, prealbumin （PA）, albumin （ALB）, endogenous human erythropoiefin （EPO）, residual renal function （RRF）, serum interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α ）. Results The total effective rate was 90.00% in the treatment group and 80.00% in the control group. After the treatment, Hgb was significantly increased in the treatment group （P〈 0.01）, as well as in the control group （P〈 0.05）; Hgb in the treatment group ascended more obviously than that in the control group （P 〈 0.05）. After the treatment, ALBZ and PA in the control group had insignificant difference （P 〉 0.05）, while in the treatment group were raised, there was apparently difference between two groups （P 〈 0.05）. The level of EPO in the treatment group was obviously increased after the treatment （P 〈 0.01）, while had no obvious change in the control group （P〉 0.05）, there was significant difference between the groups （P〈 0.01）. RRF was apparently decreased in the control group （P〈 0. 05）, as well as in the treatment group with insignificant difference （P 〉 0.05）, it was more obvious in the control group and there was significant difference in RRF between the groups. It showed insignificant difference in serum IL-6 and TNF-a before and after the treatment in the control group （P 〉 0.05）, and those in the treatment group were obviously reduced after the treatment （both P 〈 0.05）, with significant between-group difference （P 〈 0,05）. Conclusion ZSSX could improve the anemia in long-term hemodialysis patients. The mechanism might be related with alleviating inhibition effect of uremia toxin on erythropoiesis, elevating the level of endogenous EPO, improving the condition of microinflammation and malnutrition, as well as delaying the decline of RRF.
出处
《北京中医药》
2013年第8期573-576,共4页
Beijing Journal of Traditional Chinese Medicine
基金
河北省中医药管理局科研计划项目(2010034)
关键词
长期血透
肾性贫血
滋肾生血方
中医药疗法
long-term hemodialysis
renal anemia
Zishenshengxue prescription
TCM therapy
