肾移植术后红细胞增多症的中西医综合治疗(附82例报告)

Comprehensive treatment of traditional Chinese and western medicine on erythrocytosis after renal transplantation (a report of 82 cases)

目的探讨中西医综合治疗肾移植术后红细胞增多症的疗效和不良反应。方法 1991年至2012年解放军第281医院泌尿外科收治的510例肾移植患者中,符合肾移植术后红细胞增多症诊断标准的患者82例,对其临床资料进行回顾性分析。根据患者病情,予以中药心脑欣口服,每次1.0g,每日3次,辅以西药缬沙坦或贝那普利、卡托普利,氨茶碱。用药4个月后行血常规检查,比较治疗前、后外周血血红蛋白及红细胞压积,评价中西医综合治疗的疗效和不良反应。结果肾移植术后红细胞增多症的发生率为16.1%(82/510)。疗效显著的患者占26%(21/82),有效的占61%(50/82),无效的占13%(11/82)。药物不良反应:9%(7/82)的患者有轻度血小板减少,11%(9/82)的患者发生头晕、头痛、直立性脑缺血,10%(8/82)的患者出现干咳或胃肠道不适,予以对症支持治疗后均缓解。结论中西医综合治疗肾移植术后红细胞增多症疗效显著,且无严重不良反应,有一定的临床应用价值。

Objective To investigate the curative effect and adverse reaction of comprehensive treatment of traditional Chinese combined with western medicine on erythrocytosis after renal transplantation. Methods Five hundred and ten patients underwent renal transplantation in the Department of Urology in the PLA 281 Hospital from 1991 to 2012. Clinical data of 82 cases who developed erythroeytosis after renal transplantation were analyzed retrospectively. Patients were given Chinese medicine Xinnaoxin capsule （ 1.0 g per time, 3 times a day ） by oral with the western medicine valsartan or benazepril, captopril and aminophylline. The blood routine was detected 4 months after medication. The hemoglobin and hematocrit before and after treatment were compared. The curative effect and adverse reaction of treatment of traditional Chinese medicine combined with western medicine were evaluated. Results The incidence of erythrocytosis after renal transplantation was 16. 1% （82/510） . The therapeutic effect of 26% （21/82） patients was significant, 61% （50/82） was effective, and 13 % （11/82） was invalid. For the adverse drug reaction, 9% （7/82） of the patients had mild thromboeytopenia, 11% （9/82） had dizziness, headache, orthostatic cerebral ischemia, and 10% （8/82）had dry cough or gastrointestinal discomfort. All patients relieved after symptomatic treatment. Conclusions Comprehensive treatment of traditional Chinese combined with western medicine on erythrocytosis after renal transplantation is markedly effective with certain clinical value without serious adverse reactions.