李金花 段志新 朱璐 魏林

【摘要】 目的：探討生血化浊方联合红细胞生成刺激剂（erythropoiesis-stimulating agents，ESA）治疗肾性贫血的临床效果及对微炎症因子和血清铁参数的影响。方法：将68例慢性肾脏病失代偿期伴中度肾性贫血患者按照随机数字表法分成对照组和观察组，每组34例。对照组给予ESA并补充铁剂治疗，观察组在对照组基础上加用生血化浊方治疗。比较两组患者治疗后的症候效果，比较两组患者治疗前后血红蛋白（Hb）、血细胞比容（HCT）、尿白蛋白排泄率（UAER）、血清肌酐（Scr）、白介素-6（IL-6）、C反应蛋白（CRP）、血清铁蛋白（SF）、血清铁（SI）、总铁结合力（TIBC）及转铁蛋白饱和度（TSAT），记录两组患者用药后的不良反应。结果：治疗后，观察组总有效率为88.2%，高于对照组的67.6%（P<0.05）。观察组治疗前后Hb、HCT、UAER、CRP、IL-6、SI、SF、TIBC及TSAT比较，差异均有统计学意义（P<0.05），治疗前后的Scr比较，差异无统计学意义（P>0.05）;对照组治疗前后Hb、HCT、SF及TIBC比较，差异均有统计学意义（P<0.05），治疗前后的Scr、UAER、CRP、IL-6、SI及TSAT比较，差异均无统计学意义（P>0.05）;两组治疗后Hb、HCT、UAER、CRP、IL-6、SF及TIBC相比，差异均有统计学意义（P<0.05），两组治疗后的Scr、SI及TSAT比较，差异均无统计学意义（P>0.05）。两组均无明显不良反应。结论：生血化浊方联合ESA可以有效改善患者的肾性贫血，减少尿蛋白排泄，调节铁代谢状态，改善微炎症状态，治疗安全性高。

【关键词】 生血化浊方 红细胞生成刺激剂 肾性贫血 铁代谢

The Effect of Shengxue Huazhuo Recipe Combined with Erythropoiesis Stimulating Agent on Renal Anemia and Its Effects on Micro Inflammatory Factors and Serum Iron Parameters/LI Jinhua， DUAN Zhixin， ZHU Lu， WEI Lin. //Medical Innovation of China， 2021， 18（29）： 0-098

[Abstract] Objective： To investigate the clinical effect of Shengxue Huazhuo Recipe combined with erythropoiesis stimulating agent （ESA） in the treatment of renal anemia and its effect on micro inflammatory factors and serum iron parameters. Method： A total of 68 patients with moderate renal anemia in decompensated stage of chronic kidney disease were randomly divided into the control group and observation group， with 34 cases in each group. The control group was treated with ESA and iron supplement， and the observation group was treated with Shengxue Huazhuo Recipe on the basis of the control group. The effect of patients after treatment between two groups was compared. Hemoglobin （Hb）， hematocrit （HCT）， urinary albumin excretion rate （UAER）， serum creatinine （Scr）， interleukin-6 （IL-6）， C-reactive protein （CRP）， serum ferritin （SF）， serum iron （SI）， total iron binding capacity （TIBC） and transferrin saturation （TSAT） were compared before and after treatment. The adverse reactions of the two groups were recorded. Result： After treatment， the total effective rate in the observation group was 88.2%， higher than 67.6% in the control group （P<0.05）. There were significant differences in Hb， HCT， UAER， CRP， IL-6， SI， SF， TIBC and TSAT before and after treatment in the observation group （P<0.05）， but there was no significant difference in Scr （P>0.05）; there were significant differences in Hb， HCT， SF and TIBC before and after treatment in the control group （P<0.05）， but there were no significant differences in Scr， UAER， CRP， IL-6， SI and TSAT （P>0.05）; there were significant differences in Hb， HCT， UAER， CRP， IL-6， SF and TIBC between the two groups after treatment （P<0.05）， but there were no significant differences in Scr， SI and TSAT （P>0.05 ）. There were no obvious adverse reactions in the two groups. Conclusion： Shengxue Huazhuo Recipe combined with ESA can effectively improve the clinical efficacy of renal anemia， reduce urinary protein excretion， regulate iron metabolism， improve micro inflammation， with high treatment safety.

[Key words] Shengxue Huazhuo Recipe ESA Renal anemia Iron metabolism

First-author’s address： Jiujiang Hospital of Traditional Chinese Medicine， Jiujiang 332000， China

doi：10.3969/j.issn.1674-4985.2021.29.023

肾性贫血（renal anemia，RA）是慢性肾衰竭中晚期患者最常见的并发症之一，且随着肾病进展发病率呈上升趋势，患者可出现乏力、疲倦、头晕等不适症状，严重影响患者的生活质量以及终点事件。西医治疗RA以……