| Objective: chronic kidney disease (CKD) caused by various of reasons with the decline in renal function, there could anemia, renal anemia.therefore renal anemia is not an independent disease. renal anemia can occur in earlier period of CKD, by CKD5 period renal anemia is a very common situation, especially on patients of long-term maintenance hemodialysis. Even though the blood purification technology can extend the lives of patients, but it should not significantly improved anemia. in recent years ,Study shows that RA including patients of long-term maintenance hemodialysis the main reason is lack of the erythropoietin (EPO). therefore the most fundamental measure is to add enough EPO . At present, recombinant human erythropoietin (rHuEPO) for replacement therapy of this disease has achieved the exact effect, but many side-effects of itself have impact on its efficacy and clinical application. At the same time many medices in the history of chinese indigenous medicine in clinical practice have accumulated much valuable experience in the treatment and remain mass of the effective prescription. owadays ,Developing efficient and convenient Chinese patent medicines is the main research aspect of Chinese medicine treatment of renal anemia, and has broad prospects. ZiShenShengXue Chongji is an effective medical prescription produced by my tutor on the basis of its pathogenesis to treat Renal Anemia patients of chronic hemodialysis. It has the ffects of Zishen Tianjing, Jiedu Jiangzhuo, Huoxue Huayu. my tutor has observed The clinical efficacy of ZiShenShengXue Chongji on Renal Anemia patients of chronic hemodialysis, and it has pr- oved to have a better effect. But clinical data is incomplete, it has difficult to make an accurate assessment of efficacy onproving this treatment of scientific. we carried out clinical observation on treatment of renal anemia of hemodialysis patients with Zishen Shengxue Chongji and rHuEPO. To this, make the right evaluation on clinical efficacy and the possible mechanism. Clinical application of the method to provide a scientific basis.Methods: has been confirmed 60 cases of renal anemia patients from chronic hemodialysis were randomly divided into two groups of 30 cases. Zishen ShengXue Chongji combination of rHuEPO treatment group (treatment group), rHuEPO treatment group (control group), treatment group were given oral Zishen Shengxue Chongji 1 bag/ time,three times / day. Two groups of patients are given the regularity hemodialysis, two times / week, rHuEPO 3000IU, subcutaneous injection, two times / week. In addition, supplementary iron, folic acid, vitamin B12, high-quality low-protein diet, and other symptomatic and supportive care. So that two groups of patients in gender, age, original disease, duration and degree of anemia treatment by statistically no significant difference (P> 0.05), comparable, observation time of eight weeks. Both before and after medication at a patient's clinical symptoms points to the patient's weight, diet, gastrointestinal symptoms, subcutaneous fat and muscle the extent to which consumption of five aspects of subjective global nutritional assessment of patients with gastrointestinal dysfunction and the emergence of nausea, vomiting symptoms grading, eventually making its evaluation and comparative analysis of efficacy. Both before and after medication at pre-dialysis patients with simultaneously detected two groups of endogenous human erythropoietin (Epo), hemoglobin (Hgb), hematocrit (HCt), blood urea nitrogen (BUN), serum creatinine (Scr), serum albumin (PA), and to evaluate the efficacy. Statistical treatment: measurement data using t test, count data using x2 test using Ridit Level Data Analysis.Results:Eight weeks after the treatment, the Chinese medicine symptom score both decreased significantly,compared with it before treatment. but treatment group points to reduce the extremely significant p <0.01,there was distinctive difference betwe- en two groups after treatment (p <0.01). Eight weeks after the treatment , treatment group band control group nausea and vomiting grade (0°+ mild) than the percentage of the number of people have been reduced before treatment, but nausea and vo- miting grade treatment group (0 degrees + mild) of the percent- age than the control group, there is significant difference. These data illustrate the treatment group to improve digestion and the effect of significant dysfunction. After treatment, the nutritional status of subjective score has a very significant improvement (p <0.01), the control group before and after treatment no significant changes in points (p> 0.05). Has the table can be seen in patients with the treatment group after treatment significantly improved the nutritional status, efficacy was significantly superior to the control group. There has no significant difference before treatment between treatment group and control group, Hgb, HCt (P> 0.05). Eight weeks after the treatment , Hgb, HCt both have a marked increase of the treatment group and control group (P <0.01), but between the two groups three were significantly different (P <0.01), treatment group was significantly higher than that. Show that the combination of Zishen ShengXue Chongji with rHuEPO group has better effect than rHuEPO treatment group. Can be seen from Table treatment group and control group after treatment, BUN, Scr than before treatment had improved, but the control group after treatment than before treatment showed no significant difference (p> 0.05); the treatment group after treatment than before treatment were significantly difference (p <0.01), comparison between the two groups have significant difference. Note the treatment group in improving the long-term hemodialysis patients with residual renal function better than the control group. Treatment group and control group before treatment between the level of PA was no significant difference (P> 0.05). 8 weeks after medication PA than the control group no significant change before treatment (P> 0.05), but the PA than the drug treatment group was significantly increased (P <0.05), efficacy of the treatment group was significantly higher than that. Show that the combination of Zishen Shengxue Chongji rHuEPO group to improve the nutritional status of patients with superior rHuEPO treatment group. Before treatment EPO levels between the groups was no significant difference (P> 0.05). Eight weeks after administration, serum EPO levels of the control group than that before treatment had no significant improvement (P> 0.05), treatment group, serum EPO levels significantly higher than before treatment. And the control group there is significant difference (P <0.01). Show that the combination of Zishen Shengxue Chongji rHuEPO group can obviously improve the blood EPO concentrationConclusion: 1 ZiShen ShengXue Chongji can significantly reduce l chronic hemodialysis patients with clinical symptoms, signs point to improve the patient's clinical symptoms, allowing patients to significantly improve the quality of life. 2 ZiShen ShengXue Chongji can improve blood hemoglobin, hematocrit, serum EPO and serum prealbumin levels. Lower blood urea nitrogen, serum creatinine, to improve renal function in patients with anemia the level of 3 Zishen Shengxue Chongji be able to improve the level of serum prealbumin, improving the nutritional status of patients; the promotion of endogenous human erythropoietin secretion, improve the serum EPO level; lower blood urea nitrogen, serum creatinine, reducing uremic toxin on the inhibition of erythropoietin. Speculate Zishen Shengxue granules are combined with the role of rHuEPO group is superior to the possible mechanism of rHuEPO group. 4 ZiShen ShengXue Chongji Zishen is filled with sperm and Jiedu Jiangzhuo, huoxuehuayu side effects from traditional Chinese medicine group, reflects the traditional Chinese medicine with QuXie Fuzheng and facilities, specimens and the overall governance principles, with the simple application of rHuEPO phase than with the exact efficacy, less side effects, etc., there is a wide range of clinical applications.
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