| Objective: This topic combines the overall concept of traditional Chinese medicine and syndrome differentiation and treatment with modern medical clinical observation and experimental methods to observe clinic effect of CKD3-5 stage renal anemia with the therapeutic method of nourishing kidney,promoting blood circulation,enforcing spleen and invigorating Qi;under the guidance of "renal deficiency and blood stasis theory" and "invigorating the kidney and activating blood method".To verify that the the therapeutic method of nourishing kidney,promoting blood circulation,enforcing spleen and invigorating Qi can correct the anemia status of patients with CKD3-5 stage renal anemia,improve the renal function,reduce adverse reactions,improve the prognosis of patients with CKD stage3-5 renal anemia,and improve their quality of life,by comparing and analyzing the levels and the Chinese medicine symptom complex score of Hb,RBC,HCT,MCV,Scr,UREA,D-Dimer,FIB and TCM in the observation group and the control group before and after treatment,and evaluate the therapeutic effect of it.Methods: According to the inclusion and exclusion criteria of this subject,64 clinical cases of renal anemia in CKD stage 3-5 were collected and divided into an observation group and a control group according to the random number table method,with 32 cases in each group.Both of them received treatment for 8 weeks.In the course of treatment,the control group was given basic treatment and subcutaneous injection of rhu EPO 100IU/kg TIW;the observation group was combined the basic treatment and subcutaneous injection of rhu EPO100IU/kg BIW with the treatment of nourishing kidney,promoting blood circulation,enforcing spleen and invigorating Qi.The laboratory observation indexes such as blood cell analysis,renal function and D-Dimer,TCM syndrome scores and safety indexes before and after the experiment in the two groups were observed and recorded.Use SPSS 24.0 statistic software to deal with data and draw a conclusion.result:1.Laboratory indicators: Comparison within the group before and after treatment,the Hb,RBC,HCT,UA,e GFR,D-Dimer and FIB of the two groups of patients were statistically significant(P<0.05),but there was a statistical difference in Scr and UREA in the observation group(P<0.05),but there was no statistical difference in Scr and UREA in the control group(P>0.05),and there was no statistical difference in MCV between the two groups(P>0.05).Comparison of Hb,RBC,HCT,Scr,UREA,e GFR and D-Dimer between the two groups was statistically significant(P<0.05),but there was no statistical difference in MCV,UA and FIB(P>0.05).The comparison results showed that both groups had curative effect,but the curative effect of the observation group was significantly better than that of the control group.2.Comprehensive clinical efficacy: the total effective rate in the observation group was87.5%,6 cases were markedly effective,18 cases were effective,4 cases were stable,and 4cases were ineffective;the total effective rate in the control group was 73.3%,5 cases were markedly effective,11 cases were effective,and 6 cases were stable.Invalid 8 cases.Comparing the two groups,the observation group was better than the control group.3.The efficacy of TCM syndromes: the total effective rate in the observation group was93.75%,2 cases were clinically controlled,7 cases were markedly effective,21 cases were effective,and 2 cases were ineffective;the total effective rate in the control group was 66.7%,0 cases were clinically controlled,1 case was markedly effective,and effective 19 cases and10 invalid cases.Comparing the two groups,the observation group was significantly better than the control group.4.Safety analysis: Before and after treatment,there were no abnormalities in safety indicators such as liver function and electrocardiogram in the two groups of patients,and no adverse reactions such as electrolyte disturbance and allergy occurred.conclusion:1.The treatment of CKD3-5 renal anemia with the method of nourishing kidney,promoting blood circulation,enforcing spleen and invigorating Qi can significantly improve the clinical symptoms of the patients.2.The treatment of CKD3-5 stage renal anemia with the method of nourishing kidney,promoting blood circulation,enforcing spleen and invigorating Qi can significantly reduce the levels of Scr,UREA and D-Dimer,and significantly increase the levels of e GFR,Hb and RBC.3.The treatment of CKD3-5 renal anemia with the method of nourishing kidney,promoting blood circulation,enforcing spleen and invigorating Qi can reduce the frequency of patients using rhu EPO.4.The treatment of CKD3-5 renal anemia with the method of nourishing kidney,promoting blood circulation,enforcing spleen and invigorating Qi may reduce the hypercoagulable state in blood.5.The treatment of CKD stage 3-5 renal anemia with the method of nourishing kidney,promoting blood circulation,enforcing spleen and invigorating Qi used in this project adopts the overall concept of traditional Chinese medicine and the treatment based on syndrome differentiation.The index and the TCM syndrome score scale were used as the standard for judging the efficacy.The statistical results before and after treatment were compared,and no adverse events occurred before and after treatment,which confirms that the method of nourishing kidney,promoting blood circulation,enforcing spleen and invigorating Qi can do better in correcting the state of renal anemia in patients with CKD,improving the renal function,reducing the frequency of patients using rhu EPO and the hypercoagulable state in blood,which is an effective method for the treatment of the disease. |
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