生血宁片联合促红细胞生成素对Ⅴ期糖尿病肾脏疾病患者肾性贫血的疗效观察

Efficacy of Shengxuening tablets combined with erythropoietin in treatment of renal anemia of diabetic kidney disease stage V patients

目的观察生血宁片联合促红细胞生成素治疗V期糖尿病肾脏疾病（diabetic kidney disease，DKD）患者肾陡贫血的疗效。方法选择2013年1月至2014年3月在河南省中医院肾内科就诊的60例V期DKD患者，随机分为治疗组与对照组。治疗组应用生血宁片联合促红细胞生成素，对照组应用琥珀酸亚铁联合促红细胞生成素，3个月后评价疗效，并比较2组患者治疗前后的血红蛋白（hemoglobin，Hb）、红细胞比容（hematocrit value，Hct）、血清铁蛋白（serum ferritsn，SF）、转铁蛋白饱和度（transferrin saturation，TA盯）、肝肾功能、电解质中丙氨酸氨基转移酶（alanine aminotransferase，ALT）、血肌酐（SCr）、血清钾等指标。结果治疗3个月后，治疗组显效17例，有效11例，无效2例，总有效率90．0％；对照组显效14例，有效11例，无效5例，总有效率83．3％。2组总有效率相比，差异有统计学意义（P〈0．05）。治疗组和对照组的Hb、Hct、SF、TAST、ALT、SCr、血钾治疗前比较差异均无统计学意义（P〉0．05）；经治疗，2组患者血清Hb、Hct、SF、TAST均较治疗前升高，差异均有统计学意义（P〉0．05）；而治疗组血清Hb、Hct、SF、TAST指标均明显高于对照组，2组以上指标比较差异均有统计学意义（P〈0．05）；2组患者血清ALT、SCr、血钾在治疗前后无明显变化，差异无统计学意义（P〉0．05）。结论生血宁片联合促红细胞生成素是治疗Ⅴ期DKD患者肾性贫血的有效方法，能明显提高患者Hb、Hct、SF、TAST水平，改善铁代谢，纠正肾性贫血，不良反应发生率少，安全有效。

Objective To observe the efficacy of Shengxuening tablets combined with erythropoietin in treatment of renal anemia of diabetic kidney disease stage V patients. Methods Sixty patients with stage-V diabetic kidney disease were randomly divided into treatment group and control group. The treatment group was given Shengxuening tablets combined with erythropoietin, and the control group given ferrous succinate combined with erythropoietin. The patients were followed up for 3 months. Hemoglobin （Hb）, hematocrit （Hct）, serum ferritin （SF）, and transferrin saturation （TSAT） were detected before and after the treatment. The indexes of ALT, SCr and K＋ were detec- ted before and after the treatment. Results The efficacy in the treatment group was more satisfactory than the control group. The total effective rate in the control group was 83. 3%, and that in the treatment group reached 90% （P〈0. 05）. The indexes of ALT, SCr and K＋ showed no obvious change before and after the treatment （P 〉 0. 05）. Conclusions The effect of Shengxuening combined with erythropoietin in treating renal anemia of stage-Ⅴ diabetic nephropathy is evident. Shengxuening combined with erythropoietin can significantly increase hemoglobin （Hb）, Hct, serum iron （SF） and transferrin saturation （TAST） levels, improve the iron metabolism and correct the renal anemia, but has no significant impact on liver function, renal function and serum potassium. Shengxuening com- bined with erythropoietin is safe and effective, and has less adverse reaction.