本文選題：腎性貧血 + 生血合劑��； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的:采用前瞻性隨機(jī)對(duì)照臨床研究方法,觀察生血合劑聯(lián)合促紅細(xì)胞生成素治療腎性貧血的臨床療效及安全性。方法:選取慢性腎臟病5期腎性貧血患者80例,以數(shù)字隨機(jī)法分為對(duì)照組和治療組,對(duì)照組采用促紅細(xì)胞生成素(EPO)聯(lián)合鐵劑治療,治療組在對(duì)照組治療的基礎(chǔ)上加用口服中藥生血合劑,兩組患者均按需補(bǔ)充葉酸、維生素B12,并在維持性血液透析的基礎(chǔ)上治療16周。觀察對(duì)照組及治療組患者治療前后的EPO用量、全血紅細(xì)胞計(jì)數(shù)(RBC)、血紅蛋白(Hb)、紅細(xì)胞比容(HCT)、C反應(yīng)蛋白(CRP)、血清鐵蛋白、血白蛋白、尿素氮、肌酐、白細(xì)胞、谷丙轉(zhuǎn)氨酶(ALT)等臨床檢測(cè)指標(biāo),以評(píng)價(jià)其療效及安全性。所有數(shù)據(jù)均采用SPSS17.0統(tǒng)計(jì)軟件進(jìn)行處理,P0.05表示結(jié)果有統(tǒng)計(jì)學(xué)差異,P0.05表示結(jié)果無(wú)統(tǒng)計(jì)學(xué)差異。結(jié)果:1、兩組患者的紅細(xì)胞計(jì)數(shù)(RBC)、血紅蛋白(Hb)、紅細(xì)胞壓積(HCT)等指標(biāo)在治療2周后明顯升高,與治療前比較有明顯差異(p0.05),兩組患者之間比較無(wú)明顯差異(p0.05)。2、治療組患者促紅細(xì)胞生成素用量較治療前明顯減少(p0.05),且較對(duì)照組明顯減少(p0.05)。3、治療組患者血白蛋白在治療第12周時(shí)較治療前明顯升高,與治療前比較有明顯差異(p0.05),且較對(duì)照組明顯升高(p0.05)。4、治療組患者血CRP在治療12周時(shí)就較治療前明顯降低,與治療前比較有明顯差異(p0.05),且較對(duì)照組明顯降低(p0.05)。5、治療組患者EPO相關(guān)性高血壓發(fā)生率明顯低于對(duì)照組(p0.05)。6、兩組患者治療過(guò)程中腹痛、腹瀉、惡心、嘔吐等臨床副反應(yīng)發(fā)生率無(wú)明顯差異(p0.05)。結(jié)論:生血合劑用于治療腎性貧血,可以升高紅細(xì)胞計(jì)數(shù)(RBC)、血紅蛋白(Hb)、紅細(xì)胞壓積(HCT);減少促紅細(xì)胞生成素用量;升高血白蛋白水平,改善患者營(yíng)養(yǎng)狀態(tài);減輕患者的微炎癥反應(yīng)狀態(tài);明顯降低EPO相關(guān)性高血壓的發(fā)生率;且安全性好,對(duì)治療腎性貧血有一定的臨床意義。
[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.

【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R692

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