黑地黄丸对肾性贫血患者促红细胞生成素低反应性的影响

Effect of Hei Di-huang Bolus on Erythropoietin Hypo-Responsivenes in Renal Anemia Patients

目的:观察黑地黄丸治疗肾性贫血(RA)患者促红素低反应性的临床疗效。方法:56例促红素低反应性患者随机分为治疗组(各28例),疗程8周。观察两组治疗前后红细胞数(RBC)、血红蛋白(Hb)、红细胞压积(HCT)、治疗前后肾功能、计算内生肌酐清除率(CCr)、对RA的疗效、统计两组患者8周疗程人均重组人红细胞生成素(r Hu EPO)总用量及每周使用量,描绘r Hu EPO使用曲线图;计算促红素抵抗指数(ERI)并描绘ERI变化曲线图。结果:完成研究50例(治疗组26例,对照组24例);与对照组同期相比,治疗组RBC、Hb、HCT均高于对照组(P <0. 05);两组治疗后Cr、BUN、CCr组间比较差异均有统计学意义(P>0. 05);治疗组总有效率92. 31%,效果优于对照组(P <0. 01);治疗组人均使用r Hu EPO总量少于对照组(P <0. 01);r Hu EPO使用曲线图显示,治疗组r Hu EPO用量在前3周时呈上升趋势,3周后逐渐下降;在治疗的4~5周,治疗组ERI低于同期对照组(P <0. 05),在治疗的6~8 w,治疗组较对照组同期ERI明显下降(P <0. 01)。结论:中药黑地黄丸治疗促红素低反应性疗效确切,可改善贫血水平和肾功能,减少rh EPO用量,降低ERI,从而减轻促红素低反应性。

Objective: To observe the clinical effect of Hei Di-huang Bolus on erythropoietin hypo-responsivenes in renal anemia patients. Methods: 56 patients with erythropoietin hypo-responsivenes were randomly divided into treatment group and the control group( 28 cases each). The course of treatment was 8 weeks. The RBC,Hb,HCT,renal function,CCr,the efficacy of RA,total consumption and weekly usage of r Hu EPO and ERI were observed and diagrams of r Hu EPO use curve and ERI change curve were drew. Results: The study was completed in 50 cases( 26 cases in the treatment group and 24 cases in the control group). RBC,Hb and HCT in the treatment group were higher than those in the control group( P < 0. 05). The two groups had statistically significant differences in Cr,BUN and CCr after treatment( P > 0. 05). The total effective rate of the treatment group was 92. 31%,superior to the control group( P < 0. 01). The total amount of r Hu EPO used in the treatment group was less than that in the control group( P <0. 01). The curve showed that the dosage of r Hu EPO in the treatment group increased in the first three weeks and decreased gradually after that time. In the first 4 ~ 5 weeks,the ERI in the treatment group was lower than that in the control group( P < 0. 05) and the gap between the two groups dramatically expanded in 6 ~ 8 weeks. Conclusion: Hei Di-huang Bolus is effective in treating erythropoietin hypo-responsivenes,based on treating anemia and improving renal function,reducing r Hu EPO dosage and ERI.