健脾益肾、化瘀降浊法治疗肾性贫血铁缺乏的临床研究
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摘要
目的：通过观察健脾益肾、化瘀降浊法治疗脾肾阳虚兼血瘀型肾性贫血的临床疗效和对肾性贫血患者铁缺乏的疗效,探讨中医中药在治疗肾性贫血铁缺乏中的作用,为临床治疗肾性贫血铁缺乏探索更安全有效的方法。
方法：临床观察肾性贫血脾肾阳虚兼血瘀证患者60例,随机分为治疗组和对照组,每组各30例,两组均给予基础治疗的同时,治疗组以健脾益肾、化瘀降浊为法,用生血方联合EPO,对照组给予血太联合EPO,观察治疗前后血清铁蛋白、血清铁、血红细胞、血红蛋白、红细胞压积、血肌酐、血尿素氮、中医证候积分变化及总体疗效,用统计学软件分析两组间治疗前后各项指标的差异。
结果：(1)贫血的改善情况比较,治疗组与对照组在治疗前后差异均有统计学意义(P<0.01),治疗后组间比较差异无统计学意义(P>0.05)；(2)两组的血清铁与血清铁蛋白在治疗前后对比差异有统计学意义(P<0.001),治疗后优于治疗前；治疗后组间对比,差异无统计学意义(P>0.05)；(3)在降低中医证候总积分方面,.治疗组在治疗前后差异有统计学意义(P<0.05),对照组治疗前后差异无统计学意义(P>0.05),组间比较差异有统计学意义(P<0.001),治疗组优于对照组；(4)在降低血肌酐、尿素氮方面,治疗组在治疗前后差异有统计学意义(P<0.01),对照组在治疗前后差异无统计学意义(P>0.05),治疗后组间比较差异有统计学意义(P<0.05),治疗组优于对照组；(5)不良反应发生率治疗组明显少于对照组,差异有统计学意义(P<0.01)。
结论：健脾益肾、化瘀降浊法在治疗脾肾阳虚兼血瘀型肾性贫血铁缺乏中效果较好,改善贫血和铁缺乏状况与血太没有显著差别,但在改善肾功能、降低血肌酐和尿素氮方面明显优于血太,而且减轻患者临床中医症状方面优于血太,不良反应发生率明显低于血太
Objective:The goal of this clinical observation is to probe the clinical effect and safety of strengthen spleen and kidney and remove blood stasis and expel toxin theory in treating renal anemia iron deficiency. To provide scientific basis and more efficient and safer method in treating of renal anemia iron deficiency.
Methods:60 cases of renal anemia iron deficient patients with the syndrome of deficiency both spleen Yang and kidney Yang and blood stasis. They were divided into treatment group and control group randomly in proper order, both two groups were given minimal care, at the same time we gave treatment group Sheng Xue Fang combined EPO treatment guide by the strengthen spleen and kidney and remove blood stasis and expel toxin theory, but for the control group, we gave Xue Tai combined EPO treatment, the whole treatment last two months. We measured the SF、SI、RBC、Hb、HCT、BUN、Scr before and after the treatment. The changes of accumulating grades of TCM syndrome were observed at the same time.
Result:(1)In the improving of renal anemia, compared with prior treatment there was significant difference in both groups (P<0.01) after the treatment but no significant difference between the two groups post-treatment (P>0.05); (2) The SF and SI of the two groups were both markedly improved after the treatment(P< 0.001), but there was no significant difference between the two groups post-treatment; (3) In reducing the accumulating grade of TCM syndrome, there was significant difference in treatment group after the treatment (P<0.05) but not the control group (P> 0.05), there was significant difference between the two groups in the accumulating grades of TCM syndrome after the treatment(P <0.001), the treatment group was better; (4) The BUN and Scr of the treatment group was remarkably decreased after the treatment(P<0.01), but not the control group. There was significant difference between the two groups post-treatment(P< 0.05);(5)The treatment group's adverse effects were less than the other, the difference between them has statistical significance.
Conclusion:The theory of strengthen spleen and kidney and remove blood stasis and expel toxin was very effective in treating renal anemia iron deficiency with the syndrome of deficiency both spleen Yang and kidney Yang and blood stasis. There was no much difference in improving the renal anemia and iron deficiency between the Sheng Xue Fang and the Xue Tai. But compare with Xue Tai, the Sheng Xue Fang had obvious advantages in curing the CRF and reducing the BUN and Scr. The Sheng Xue Fang also enjoyed distinct advantages in reducing the accumulating grade of TCM syndrome and less adverse effects.
方法：临床观察肾性贫血脾肾阳虚兼血瘀证患者60例,随机分为治疗组和对照组,每组各30例,两组均给予基础治疗的同时,治疗组以健脾益肾、化瘀降浊为法,用生血方联合EPO,对照组给予血太联合EPO,观察治疗前后血清铁蛋白、血清铁、血红细胞、血红蛋白、红细胞压积、血肌酐、血尿素氮、中医证候积分变化及总体疗效,用统计学软件分析两组间治疗前后各项指标的差异。
结果：(1)贫血的改善情况比较,治疗组与对照组在治疗前后差异均有统计学意义(P<0.01),治疗后组间比较差异无统计学意义(P>0.05)；(2)两组的血清铁与血清铁蛋白在治疗前后对比差异有统计学意义(P<0.001),治疗后优于治疗前；治疗后组间对比,差异无统计学意义(P>0.05)；(3)在降低中医证候总积分方面,.治疗组在治疗前后差异有统计学意义(P<0.05),对照组治疗前后差异无统计学意义(P>0.05),组间比较差异有统计学意义(P<0.001),治疗组优于对照组；(4)在降低血肌酐、尿素氮方面,治疗组在治疗前后差异有统计学意义(P<0.01),对照组在治疗前后差异无统计学意义(P>0.05),治疗后组间比较差异有统计学意义(P<0.05),治疗组优于对照组；(5)不良反应发生率治疗组明显少于对照组,差异有统计学意义(P<0.01)。
结论：健脾益肾、化瘀降浊法在治疗脾肾阳虚兼血瘀型肾性贫血铁缺乏中效果较好,改善贫血和铁缺乏状况与血太没有显著差别,但在改善肾功能、降低血肌酐和尿素氮方面明显优于血太,而且减轻患者临床中医症状方面优于血太,不良反应发生率明显低于血太
Objective:The goal of this clinical observation is to probe the clinical effect and safety of strengthen spleen and kidney and remove blood stasis and expel toxin theory in treating renal anemia iron deficiency. To provide scientific basis and more efficient and safer method in treating of renal anemia iron deficiency.
Methods:60 cases of renal anemia iron deficient patients with the syndrome of deficiency both spleen Yang and kidney Yang and blood stasis. They were divided into treatment group and control group randomly in proper order, both two groups were given minimal care, at the same time we gave treatment group Sheng Xue Fang combined EPO treatment guide by the strengthen spleen and kidney and remove blood stasis and expel toxin theory, but for the control group, we gave Xue Tai combined EPO treatment, the whole treatment last two months. We measured the SF、SI、RBC、Hb、HCT、BUN、Scr before and after the treatment. The changes of accumulating grades of TCM syndrome were observed at the same time.
Result:(1)In the improving of renal anemia, compared with prior treatment there was significant difference in both groups (P<0.01) after the treatment but no significant difference between the two groups post-treatment (P>0.05); (2) The SF and SI of the two groups were both markedly improved after the treatment(P< 0.001), but there was no significant difference between the two groups post-treatment; (3) In reducing the accumulating grade of TCM syndrome, there was significant difference in treatment group after the treatment (P<0.05) but not the control group (P> 0.05), there was significant difference between the two groups in the accumulating grades of TCM syndrome after the treatment(P <0.001), the treatment group was better; (4) The BUN and Scr of the treatment group was remarkably decreased after the treatment(P<0.01), but not the control group. There was significant difference between the two groups post-treatment(P< 0.05);(5)The treatment group's adverse effects were less than the other, the difference between them has statistical significance.
Conclusion:The theory of strengthen spleen and kidney and remove blood stasis and expel toxin was very effective in treating renal anemia iron deficiency with the syndrome of deficiency both spleen Yang and kidney Yang and blood stasis. There was no much difference in improving the renal anemia and iron deficiency between the Sheng Xue Fang and the Xue Tai. But compare with Xue Tai, the Sheng Xue Fang had obvious advantages in curing the CRF and reducing the BUN and Scr. The Sheng Xue Fang also enjoyed distinct advantages in reducing the accumulating grade of TCM syndrome and less adverse effects.
引文
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