归脾汤对心脾两虚型贫血患者红细胞携氧能力影响的临床研究

Clinical study of the effects of guipi decoction on oxygen carry capacity of red blood cells in the patients with anemia of heart and spleen deficiency

目的研究归脾汤提高心脾两虚型贫血患者红细胞携氧能力的作用机制。方法心脾两虚型贫血患者35例,随机分成治疗组20例和对照组15例,治疗组给予归脾汤口服,对照组给予安慰剂口服,疗程均为1周。用药前后采用酶联免疫吸附法(ELISA)检测血浆2,3-二磷酸甘油酸(2,3-Diphosphoglycerate,2,3-DPG)浓度、化学比色法检测红细胞Na^+-K^+-ATP酶活性,综合评价红细胞携氧能力。结果治疗后,治疗组Hb、RET#均有所上升与治疗前比较,差异有统计学意义(P<0.05);且治疗组RET#增高与对照组比较,差异有统计学意义(P<0.05)。治疗组中度贫血患者2,3-DPG浓度上升与治疗前比较,差异有统计学意义(P<0.05)。治疗组体倦乏力、头晕目眩、心悸的症状积分下降与治疗前比较,差异有统计学意义(P<0.01);且治疗组体倦乏力、头晕目眩的症状积分下降与对照组比较,差异有统计学意义(P<0.05)。两组红细胞Na^+-K^+-ATP酶活性与治疗前比较均无明显改变,差异无统计学意义(P>0.05);两组间红细胞Na^+-K^+-ATP酶活性变化比较,差异无统计学意义(P>0.05)。治疗后两组中医证候疗效比较,差异有统计学意义(P<0.05)。结论归脾汤对红细胞Na^+-K^+-ATP酶的活性无明显影响,但有增加2,3-DPG浓度的趋势,尤其对中度贫血患者2,3-DPG水平升高明显。提示归脾汤改善缺氧症状可能与其改善红细胞携氧能力有关。

Objective To study the effect mechanism of decoction on oxygen carry capacity of red blood cells in the patients with anemia of heart and spleen deficiency.Methods A total of 35 patients with anemia of heart and spleen deficiency were randomized into a treatment group(20 cases)and a control group(15 cases).In the treatment group,guipi decoction was taken orally.In the control group,placebo was taken orally.The duration of treatment was 1 week.Before and after medication,ELISA was used to determine the concentration of 2,3-Diphosphoglycerate(2,3-DPG).The chemical colorimetry was adopted to determine the enzymatic activity of Na^+-K^+-ATP.The oxygen carry capacity of red blood cells was evaluated comprehensively.Results After treatment,Hb and RET#were all increased as compared with those before treatment in the treatment group,indicating the significant difference(P<0.05).The increase of RET#in the treatment group was significant statistically as compared with the control group(P<0.05).For the patients with moderate anemia in the treatment group,the increase of 2,3-DPG concentration was different significantly than the control group(P<0.05).In the treatment group,the symptom scores of lassitude,dizziness,vertigo and palpitation were reduced as compared with those before treatment,indicating the significant differences(P<0.01).The decrease of the symptom scores in the treatment group was significant statistically as compared with the control group(P<0.05).The enzymatic activity of Na^+-K^+-ATP did not change obviously as compared with that before treatment in the two groups,without statistical significance(P>0.05).The difference was not significant between the two groups(P>0.05).After treatment,the therapeutic effects on TCM symptom were different significantly between the two groups(P<0.05).Conclusion Guipi decoction has no obvious influence on the enzymatic activity of Na^+-K^+-ATP.It increases the concentration of 2,3-DPG,especially in the patients with moderate anemia.It is suggested that guipi decoction relieves the symptoms of anoxia and improves oxygen carry capacity of red blood cells.