参芪四物汤减少重度贫血患者输血的临床研究

The clinical application of Shenqisiwu Decoction to reduce blood transfusion of patients with severe anemia

目的临床观察参芪四物汤对重度贫血患者缺血缺氧症状及接受输血替代治疗的影响。方法选择慢性再生障碍性贫血(CAA)18例、骨髓增生异常综合征(MDS)20例、骨髓纤维化(MF)12例,共50名长期依赖输血的重度贫血患者,连服参芪四物汤3个月,以自身对照比较患者服药前后的自觉症状、需再次输血前的Hb浓度及输血间歇期等指标变化。结果CAA、MDS和MF3组患者服药后,患者自觉缺血缺氧症状均较前明显改善;再次输血时的平均Hb浓度分别由服药前的(57.4±6.9)、(60.4±7.7)、(55.8±3.4)g/L,下降到(50.4±8.3)、(54.4±7.9)、(50.6±7.4)g/L(P<0.05),再次输血的平均间歇期由服药前的(15.4±5.6)、(14.8±2.3)、(15.0±3.3)d延长到(19.8±6.4)、(18.9±6.2)、(20.3±5.8)d(P<0.05)。结论服参芪四物汤对于改善重度贫血患者的微循环和组织细胞缺血缺氧有一定作用,不失为降低输血风险、节约患者输血费用的1个有效手段。

Objective To observe and research the clinical influence of Shenqisiwu Decoction on the improvement of ischemia and oxygen-poor syndrome of severe anemia patients.Methods A total of 50 patients,who were dependent on long-term blood transfusion,were chosen,including Chronic Aplastic Anemia （CAA） 18 cases,Myelodysplastic Syndrome （MDS） 20 cases,and Myelofibrosis（MF）12 cases.After continuous administration of Shenqisiwu Decoction for three months,the subjective symptom,hemoglobin concentration before transfusion and transfusion interval of patients were observed.Results After continuous administration,subjective symptom of ischemia and poor-oxygen of the three groups patients improved obviously,average hemoglobin concentration before transfusion fall significantly（P〈0.05）,and average interval of blood transfusion extended significantly（P〈0.05）.Conclusion Shenqisiwu Decoction can improve the microcirculation of severe anemia patients,improve subjective symptom,decrease the frequency of blood transfusion,reduce blood transfusion risk,and save blood transfusion expenses.