| Objective: According to clinical observation to explore the treatment effect of Heidihuang Wan in improving renal anemia and analyze the relationship between the effect and parathyroid hormone, then through the experiments to do the further discussions and studies. This study provided a new ideal and method for clinical treatment of renal anemiaMethods:(1) Clinical observation: 60 eligible patients were selected, and randomly divided into experimental group and control group. The control group was on western medicine basic treatment and the test group took the baise treatment and Heidihuang Wan, oral medication for 12 weeks treatment. Observe the clinical symptoms, Red Blood Cell(RBC), Hemoglobin(HB), and Serum Intact Parathyroid Hormone(IPTH) and analyze the linear correlation between Hb and i PTH in both groups.(2)Experiment research: select 60 healthy male Wistar rats, weighing rat before modeling. All rats were divided into 6 groups with 10 rats in each group, including Heidihuang Wan high/low dose group, calcitriol group, Hongyuanda+ Erythropoietin group, model group and normal group according to the average weight. All groups adopted international 5/6 nephrectomy model to establish renal anemia model except normal group. The medicines were given after modeling successfully(oral medicine 1 time a day, injection 1 time a week), including Heidihuang Wan dose(0.648 g /100 g d, 0.162 g / 100 g. D), Calcitriol(20ng/100g·d),Hongyuanda(1.625mg/100g·d), Erythropoietin(1.625iu/100g·w).Detecting RBC?HB?IPTH on the third week after modeling and on the twelfth week after pharmacological intervention, then to conduct Statistical analysis.Results: 1. Clinical observation:(1) The total efficiency of experimental group was 75.0%, contrarily control group was 44.8%. Syndrome curative effect in the experimental group(89.3%) is better than that in control group(65.5%), and total integral in the symptoms of experimental group is better than that in control group(P<0.05). The experimental group was better than control group in improving body weight, shortness of breath and lazy words, lumbar debility(P<0.05).(2) The blood RBC, Hb level increased significantly(P<0.05) and i PTH level significantly decreased(P<0.05) in the two groups after the treatment, and the experimental group is better than that of control group(P<0.05), the Heidihuang Wan can improve renal anemia, correcting the role of secondary hyperthyroidism.(3) Hb and i PTH linear correlation analysis: on the scatter plot, there was a linear negative correlation between Hb and i PTH both in the control group(r=0.878,P<0.05) and experimental group(r=0.801,P<0.05), it showed that the mechanism of Heidihuang Wan improve renal anemia may be associated with parathyroid hormone.2. Experiment research:(1) On the third week of modeling operation, blood RBC and HB of treatment group was obviously lower than normal group(P<0.05), blood BUN and SCR was significantly higher than normal group(P<0.05), that revealed renal anemia building was successful.(2) IPTH rats of 3 weeks model group and treatment group were significantly higher than the normal group(P<0.05),however there was no significance between the model group and the treatment group(P>0.05).It was said that rats had secondary hyperparathyroidism after modeling.(3) With 12 weeks of drug intervention, the RBC and HB lever of all groups increased compared with model group(P<0.05).The HB lever of Hongyuanda+ Erythropoietin group increased obviously compared with Heidihuang Wan high dose group(P<0.05).(4)Compared with model group, IPTH of all treatment groups reduced(P<0.05) except Hongyuanda + Erythropoietin group. Significant difference can be observed when Hongyuanda+ Erythropoietin group and calcitriol group compared with Heidihuang Wan high dose group(P<0.05).There were statistically significant differences between calcitriol group and other groups(P<0.05).In conclusion, in the treatment of secondary hyperparathyroidism, calcitriol groupies best, in addition to Hongyuanda + Erythropoietin group, the rest of the treatment group were moderate that revealed Heidihuang pill can reduce the i PTH effect and treat secondary hyperparathyroidism. 3.Hb and i PTH linear correlation analysis: on the scatter plot, high and low group, model group, calcitriol group shows linear negative correlation between i PTH and Hb(r=-0.982,-0.910,-0.895,-0.921,-0.814,P<0.05). There was no obvious correlation between HB and IPTH of Hongyuanda + Erythropoietin group(r=0.153,P>0.153).That revealed that the mechanism of Heidihuang Wan improving renal anemia may be associated with parathyroid hormone.Conclusion: 1.Through clinical observation and experimental study, the Heidihuang Wan can improve renal anemia and reduce the effect of i PTH. 2. There was a linear negative correlation trend between Hb and i PTH, illustrate the mechanism of Heidihuang Wan improving renal anemia may be associated with parathyroid hormone, therefore in the clinical treatment of renal anemia we should pay attention to correct secondary hyperparathyroidism at the same tome. |
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