运脾补血方辅助治疗缺铁性贫血患儿的临床效果分析

钱雄; 张银敏; 陈锴

doi:10.16766/j.cnki.issn.1674-4152.002819

运脾补血方辅助治疗缺铁性贫血患儿的临床效果分析

doi: 10.16766/j.cnki.issn.1674-4152.002819

嘉兴市中医医院儿科, 浙江嘉兴 314001

基金项目:

浙江省中医药科技计划项目 2020ZB254

详细信息

通讯作者:
钱雄, E-mail: qianxiongjx_qx@163.com

中图分类号: R556.3 R256.3
计量
- 文章访问数: 129
- HTML全文浏览量: 41
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2022-01-16
- 网络出版日期: 2023-04-07

Clinical effect of Yunpi Buxue Decoction in the treatment of children with iron deficiency anaemia

Department of Pediatrics, Jiaxing Hospital of Traditional Chinese Medicine, Jiaxing, Zhejiang 314001, China

摘要

摘要: 目的探讨运脾补血方辅助治疗缺铁性贫血患儿的近远期疗效及对铁代谢指标的影响。方法选取2019年9月—2020年6月嘉兴市中医医院收治的80例脾胃虚弱证营养性缺铁性贫血患儿，按随机数字表法分为对照组(40例)和观察组(40例)。对照组给予维生素C、右旋糖酐铁口服液治疗，在此基础上观察组加用运脾补血方。比较2组近远期疗效、不良反应、铁代谢及实验室指标水平。结果观察组临床总有效率为92.50%，明显高于对照组的75.00%(χ²=4.501，P < 0.05)；治疗后，观察组平均红细胞血红蛋白浓度、平均红细胞体积、血红蛋白、血清铁、转铁蛋白饱和度[(328.45±32.84)g/L、(85.74±9.20)fL、(130.88±15.66)g/L、(16.65±3.12)μmol/L、(35.74±6.20)%]明显高于对照组[(304.74±30.22)g/L、(75.33±8.82)fL、(118.30±17.26)μmol/L、(13.84±3.05)分、(30.55±6.84)%]，均P < 0.05；治疗后6个月，观察组复发率为7.50%，明显低于对照组的27.50%(χ²=5.541，P < 0.05)；观察组不良反应发生率(17.50%)与对照组(12.50%)相比差异无统计学意义(χ²=0.392，P>0.05)。结论运脾补血方辅助治疗缺铁性贫血患儿效果显著，能够有效调节机体血细胞及铁代谢情况，且安全性较好。
- 运脾补血方 /
- 维生素C /
- 右旋糖酐铁 /
- 缺铁性贫血 /
- 近远期疗效
Abstract: Objective This study aims to investigate the short-term and long-term curative effect of Yunpi Buxue Decoction in the treatment of children with iron deficiency anaemia and its influence on iron metabolism indexes to provide reference for their clinical treatment. Methods Eighty children with nutritional iron deficiency anaemia of spleen-stomach weakness syndrome who were admitted to Jiaxing Hospital of Traditional Chinese Medicine from September 2019 to June 2020 were selected and divided into the control group (n=40) and observation group (n=40) using the random number table method. The control group was treated with vitamin C combined with iron dextran oral liquid, and the observation group was treated with Yunpi Buxue Decoction based on the control group. The short-term and long-term efficacy, adverse reactions, iron metabolism indexes and laboratory index levels were compared between the 2 groups of children. Results The total clinical effective rate of the observation group (92.50%) was apparently higher in comparison with that of the control group (75.00%, χ²=4.501, P < 0.05). After treatment, the mean corpuscular haemoglobin concentration, mean corpuscular volume, haemoglobin, serum iron and transferrin saturation in the observation group [(328.45±32.84) g/L, (85.74±9.20) fL, (130.88±15.66) g/L, (16.65±3.12) μmol/L, and (35.74±6.20) %] were apparently higher compared with those in the control group [(304.74±30.22) g/L, (75.33±8.82) fL, (118.30±17.26) g/L, (13.84±3.05) μmol/L, and (30.55±6.84) %], all P < 0.05. Six months after treatment, the recurrence rate of the observation group (7.50%) was significantly lower in comparison with that of the control group (27.50%; χ²=5.541, P < 0.05). The incidence of adverse reactions in the observation group (17.50%) was not statistically significant compared with that in the control group (12.50%; χ²=0.392, P>0.05). Conclusion Yunpi Buxue Decoction combined with vitamin C and iron dextran oral liquid has a significant short-term and long-term curative effect on children with iron deficiency anaemia, which can effectively regulate the body' s blood cells and iron metabolism, and it has a better safety.
- Yunpi Buxue Decoction /
- Vitamin C /
- Iron dextran /
- Iron deficiency anaemia /
- Short-term and long-term effect

HTML全文

表 1 2组缺铁性贫血患儿一般资料比较

Table 1. Comparison of general data between two groups of children with iron deficiency anemia

组别	例数	性别(例)		年龄(x±s, 岁)	病程(x±s, 月)	贫血程度(例)
组别	例数	男	女	年龄(x±s, 岁)	病程(x±s, 月)	轻度	中度
观察组	40	25	15	4.23±1.34	5.84±1.55	24	16
对照组	40	23	17	4.42±1.52	5.63±1.73	26	14
统计量		0.208^a		-0.593^b	0.572^b	0.213^a
P值		0.648		0.555	0.569	0.644
注：^a为χ²值, ^b为t值。

下载: 导出CSV

表 2 2组缺铁性贫血患儿近期临床总有效率比较[例(%)]

Table 2. Comparison of near-term clinical total effective rate in two groups of children with iron deficiency anemia[cases (%)]

组别	例数	显效	有效	无效	总有效
观察组	40	21(52.50)	16(40.00)	3(7.50)	37(92.50)
对照组	40	15(37.50)	15(37.50)	10(25.00)	30(75.00)
注：2组总有效率比较，χ²=4.501，P=0.034。

下载: 导出CSV

表 3 2组缺铁性贫血患儿实验室指标比较(x ±s)

Table 3. Comparison of laboratory indexes in two groups of children with iron deficiency anemia(x ±s)

组别	例数	MCHC(g/L)		MCV(fL)		Hb(g/L)
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
观察组	40	268.74±25.82	328.45±32.84^a	62.34±8.53	85.74±9.20^a	92.43±18.34	130.88±15.66^a
对照组	40	265.33±28.45	304.74±30.22^a	63.15±7.72	75.33±8.82^a	95.20±16.74	118.30±17.26^a
t值		0.561	3.360	0.445	5.166	0.706	3.414
P值		0.576	0.001	0.657	<0.001	0.483	0.001
注：与同组治疗前比较，^aP < 0.05。

下载: 导出CSV

表 4 2组缺铁性贫血患儿铁代谢指标比较(x ±s)

Table 4. Comparison of iron metabolism indexes in two groups of children with iron deficiency anemia(x ±s)

组别	例数	SI(μmol/L)		TSAT(%)
组别	例数	治疗前	治疗后	治疗前	治疗后
观察组	40	8.52±1.92	16.65±3.12^a	20.45±4.26	35.74±6.20^a
对照组	40	8.20±1.84	13.84±3.05^a	21.38±5.12	30.55±6.84^a
t值		0.761	4.073	-1.114	3.556
P值		0.449	<0.001	0.269	0.001
注：与同组治疗前比较，^aP < 0.05。

下载: 导出CSV

参考文献(22)

[1]	徐帆, 胡乃中, 梅俏. 可溶性转铁蛋白受体及其复合参数在诊断炎症性肠病合并缺铁性贫血中的临床价值[J]. 安徽医科大学学报, 2018, 53(7): 1110-1114. https://www.cnki.com.cn/Article/CJFDTOTAL-YIKE201807025.htm XU F, HU N Z, MEI Q. The diagnostic clinical value of sTFR and its compound parameters in the inflammatory bowel disease combined with iron deficiency anemia[J]. Acta Universitatis Medicinalis Anhui, 2018, 53(7): 1110-1114. https://www.cnki.com.cn/Article/CJFDTOTAL-YIKE201807025.htm
[2]	郭平, 姚欢迎. 小儿营养性缺铁性贫血的相关因素分析[J]. 中华全科医学, 2018, 16(2): 257-259, 295. doi: 10.16766/j.cnki.issn.1674-4152.000072 GUO P, YAO H Y. Analysis of related factors of nutritional iron deficiency anemia in children[J]. Chinese Journal of General Practice, 2018, 16(2): 257-259, 295. doi: 10.16766/j.cnki.issn.1674-4152.000072
[3]	周蕾. 蛋白琥珀酸铁口服液联合金双歧三联活菌片对营养性缺铁性贫血患儿血清SI、SF、TRF水平变化的影响[J]. 中国妇幼保健, 2018, 33(21): 4921-4924. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201821041.htm ZHOU L. Effects of protein succinate oral liquid combined with Jinshuangqi triple live slices on changes of serum SI, SF and TRF levels in children with nutritional iron deficiency anemia[J]. Maternal and Child Health Care of China, 2018, 33(21): 4921-4924. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201821041.htm
[4]	SIMBRUNNER B, BRRE A, WRAN K, et al. Portal hypertensive gastropathy is associated with iron deficiency anemia[J]. Wien Klin Wochenschr, 2020, 132(1-2): 1-11. doi: 10.1007/s00508-019-01593-w
[5]	张芳, 王彤, 田渤. 右旋糖酐铁联合乳铁蛋白、维生素C/E治疗早产儿贫血的疗效观察[J]. 中南医学科学杂志, 2018, 46(2): 136-138, 141. https://www.cnki.com.cn/Article/CJFDTOTAL-HYYY201802006.htm ZHANG F, WANG T, TIAN B. Effect of iron dextran combined with lactoferrin and vitamin C/E on anemia of premature infants[J]. Medical Science Journal of Central South China, 2018, 46(2): 136-138, 141. https://www.cnki.com.cn/Article/CJFDTOTAL-HYYY201802006.htm
[6]	胡振波, 裴学军, 肖飞, 等. 健脾生血颗粒/片安全性研究解析[J]. 世界中医药, 2018, 13(1): 233-235. https://www.cnki.com.cn/Article/CJFDTOTAL-SJZA201801065.htm HU Z B, PEI X J, XIAO F, et al. Analysis on the Safety of Jianpi Shengxue Granules/Tablets[J]. World Chinese Medicine, 2018, 13(1): 233-235. https://www.cnki.com.cn/Article/CJFDTOTAL-SJZA201801065.htm
[7]	张长忠. 健脾生血颗粒联合蛋白琥珀酸铁口服溶液对缺铁性贫血患儿血清SF Hb SI水平变化及生活质量的影响[J]. 中国药物与临床, 2018, 18(1): 22-25. https://www.cnki.com.cn/Article/CJFDTOTAL-YWLC201801009.htm ZHANG C Z. Effects of Jianpi Shengxue granule and Iron proteinsuccinylate oral solution on levels of SF, Hb and SI and quality of life in children with iron deficiency anemia[J]. Chinese Remedies & Clinics, 2018, 18(1): 22-25. https://www.cnki.com.cn/Article/CJFDTOTAL-YWLC201801009.htm
[8]	中华儿科杂志编辑委员会, 中华医学会儿科学分会血液学组, 中华医学会儿科学分会儿童保健学组. 儿童缺铁和缺铁性贫血防治建议[J]. 中华儿科杂志, 2008, 46(7): 502-504. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201008040.htm Editorial Committee of Chinese Journal of Pediatrics, Hematology Group, Child Health Group, Pediatrics Society of Chinese Medical Association. Recommendations for prevention and treatment of iron deficiency and iron deficiency anemia in children[J]. Chinese Journal of Pediatrics, 2008, 46(7): 502-504. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201008040.htm
[9]	国家中医药管理局. 中医儿科病证诊断疗效标准[S]. 南京: 南京大学出版社, 1994: 77-78. National Administration of Traditional Chinese Medicine (NATCM) Diagnostic and Therapeutic Criteria of TCM Paediatric Diseases[S]. Nanjing: Nanjing University Press, 1994: 77-78.
[10]	EPSTEIN D, BOROHOVITZ A, MERDLER I, et al. Prevalence of iron deficiency and iron deficiency anemia in strenuously training male army recruits[J]. Acta Haematol, 2018, 139(3): 141.
[11]	ANAND I S, PANKAJ G. Anemia and iron deficiency in heart failure[J]. Circulation, 2018, 138(1): 80-98.
[12]	祝丹, 余文. 维生素A在铁缺乏及缺铁性贫血治疗中的作用[J]. 中国儿童保健杂志, 2021, 29(1): 56-59. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO202101016.htm ZHU D, YU W. Role of vitamin A in the treatment of iron deficiency and iron deficiency anemia[J]. Chinese Journal of Child Health Care, 2021, 29(1): 56-59. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO202101016.htm
[13]	郎海燕, 陈信义, 杨文华. 缺铁性贫血中医药防治康复一体化专家共识[J]. 中华中医药杂志, 2018, 33(8): 3487-3492. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY201808073.htm LANG H Y, CHEN X Y, YANG W H. Expert Consensus on the Integration of TCM Prevention and Treatment for Iron Deficiency Anemia[J]. China Journal of Traditional Chinese Medicine and Pharmacy, 2018, 33(8): 3487-3492. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY201808073.htm
[14]	武永斌. 右旋糖酐铁口服液治疗营养性缺铁性贫血患儿的效果观察[J]. 医药论坛杂志, 2020, 41(2): 139-141. https://www.cnki.com.cn/Article/CJFDTOTAL-HYYX202002039.htm WU Y B. Effect of dextran iron oral liquid on children with nutritional iron deficiency anemia[J]. Journal of Medical Forum, 2020, 41(2): 139-141. https://www.cnki.com.cn/Article/CJFDTOTAL-HYYX202002039.htm
[15]	BASU T, PANJA S, SHENDGE A K, et al. A natural antioxidant, tannic acid mitigates iron-overload induced hepatotoxicity in Swiss albino mice through ROS regulation[J]. Environ Tox, 2018, 33(5-6): 603-618.
[16]	MAN S, ELBERS P, STRAATEN O V. Making sense of early high-dose intravenous vitamin C in ischemia/reperfusion injury[J]. Criti Care, 2018, 22(1): 70.
[17]	陈滔, 周红芬. 维生素C联合维生素B₆治疗对缺铁性贫血患儿铁代谢的影响[J]. 中国妇幼保健, 2020, 35(1): 77-79. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB202001031.htm CHEN T, ZHOU H F. Effect of vitamin C combined with vitamin B₆ on iron metabolism in children with iron deficiency anemia[J]. Maternal and Child Health Care of China, 2020, 35(1): 77-79. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB202001031.htm
[18]	董琳娜, 舒恋婷, 王郁玲. 维生素C和维生素E水平与子痫前期的相关性[J]. 中华全科医学, 2019, 17(8): 1353-1355, 1402. doi: 10.16766/j.cnki.issn.1674-4152.000942 DONG L N, SU L T, WANG Y L. Correlation between vitamin C and vitamin E levels and preeclampsia[J]. Chinese Journal of General Practice, 2019, 17(8): 1353-1355, 1402. doi: 10.16766/j.cnki.issn.1674-4152.000942
[19]	张利平, 呼改琴, 周艳红, 等. 蛋白琥珀酸铁联合维生素C治疗对妊娠合并缺铁性贫血孕妇铁调素、促红细胞生成素的影响[J]. 中国妇幼保健, 2018, 33(11): 2442-2445. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201811014.htm ZHANG L P, HU G Q, ZHOU Y H, et al. Effect of iron succinate combined with vitamin C on ferrimodulin and erythropoietin in pregnant women with iron deficiency anemia[J]. Maternal and Child Health Care of China, 2018, 33(11): 2442-2445. https://www.cnki.com.cn/Article/CJFDTOTAL-ZFYB201811014.htm
[20]	周振环, 郎立新, 刘震, 等. 缺铁性贫血患者红细胞参数与中医证型相关性分析[J]. 河南中医, 2018, 38(5): 743-745. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZY201805026.htm ZHOU Z H, LANG L X, LIU Z, et al. An Analysis of Correlation Between Erythrocyte Parameters and TCM Syndromes in Patients with Iron Deficiency Anemia[J]. Henan Traditional Chinese Medicine, 2018, 38(5): 743-745. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZY201805026.htm
[21]	饶艳辉, 王迎春, 梁悦, 等. 多糖铁复合物胶囊联合复方硫酸亚铁叶酸片治疗妊娠缺铁性贫血的效果分析[J]. 中国医药, 2018, 13(10): 1563-1566. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYG201810031.htm RAO Y H, WANG Y C, LIANG Y, et al. Effect analysis of polysaccharide iron complex capsules combined with compound ferrous sulfate folic acid tablets in the treatment of pregnancy iron deficiency anemia[J]. China Medicine, 2018, 13(10): 1563-1566. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGYG201810031.htm
[22]	华海应, 高华强, 朱文艳, 等. 补肾健脾化瘀中药对难治/复发再生障碍性贫血患者骨髓单个核细胞集落形成的影响[J]. 山东医药, 2018, 58(38): 84-86. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYY201838028.htm HUA H Y, GAO H Q, ZHU W Y, et al. Effect of Tonifying kidney and invigorating spleen and removing blood stasis on colony formation of bone marrow mononuclear cells in refractory/recurrent aplastic anemia patients[J]. Shandong Medical Journal, 2018, 58(38): 84-86. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYY201838028.htm