中西医结合治疗维持性血透患者贫血和微炎症状态的临床研究

Observation on Curative Effects in Treatment for Micro-inflammatory State and Anemia by Maintenance Hemodialysis with Integrated Traditional Chinese and Western Medicine

目的:观察中西医结合治疗对尿毒症维持性血液透析患者贫血及微炎症状态的疗效,探讨其作用机制和临床适应证。方法:采用随机对照试验设计方案,以单纯西医治疗为对照,将78例患者随机分为单纯西医治疗组(39例)和中西医结合治疗组(39例),治疗12周,观察超敏C-反应蛋白(hs-CRP)、瘦素(Leptin)、白蛋白(Alb)、红细胞计数(RBC)、血红蛋白(Hb)及红细胞压积(Hct)等疗效指标及肝功能、不良事件等安全性指标。结果:两组的人口学特征及hs-CRP、Leptin、Alb、RBC计数、Hb及Hct差异无统计学意义。治疗12周后:1)单纯西医治疗组和中西医结合治疗组的RBC计数、Hb及Hct,hs-CRP、Leptin、Alb分别较治疗前均有改善,且中西医结合治疗组的疗效更显著(P<0.05)。2)相关分析表明血清hs-CRP浓度与Hb、Hct、Alb呈负相关(P<0.05或P<0.01)。3)观察过程中两组不良事件发生率差异无统计学意义,且均未发生严重不良事件。结论:中西医结合治疗可明显改善维持性血透患者的贫血状态和微炎症状态,无严重不良反应。

Objective：To find a more effectively therapy method for chronic renal Failure patients in maintain dialysis by comparing the effects of ameliorating micro-inflammatory and renal-anemia states with integrative traditional Chinese and western medicine or simple western medicine treatments. Methods：78 patients were divided into two groups averagely ,one group with integrated traditional Chinese and western medicine and the other with Western medicine treatments respectively for 12 weeks, detection the concentrations of hs-C-reactive protein, leptin, albumin, hemoglobin, red blood cell count, hematocrit, compare the differences between pre-treatment and past. Results：1）The micro-inflammatory and renal-anemia states of two groups were ameliorated, and the integrative traditional Chinese and western medicine was more effectively. 2）The micro-inflammatory index were significance correlated with Hb and Alb（P0.01）.3）No severe adverse event was found. Conclusion： Micro-inflammatory state was correlated with Renal-anemia closely, integrated traditional Chinese and western medicine was more effectively than simple western medicine treatments in ameliorating micro-inflammatory and renal-anemia states.