口服铁剂联合鸡血藤水煎液治疗缺铁性贫血对机体铁代谢的临床疗效及安全性分析

目的 对口服铁剂联合鸡血藤水煎液治疗改善缺铁性贫血机体铁代谢的临床疗效及安全性进行研究。 方法 选取2014年5月—2015年5月缺铁性贫血患者120例，将其按照随机数字法分为中药鸡血藤组、口服铁剂组以及联合治疗组，每组40例，中药鸡血藤组给予鸡血藤水煎液15 g/d，口服铁剂组给予力蜚能150 mg，1次/d，联合治疗组给予鸡血藤水煎液15 g/d，力蜚能150 mg，1次/d，3组均治疗42 d；观察3组患者治疗前后红细胞计数(RBC)、血红蛋白(Hb)、红细胞压积(Hct)、血清铁(SI)、血清铁蛋白(SF)、血清转铁蛋白(Tf)、总铁结合力(TIBC)、血清铁调素(Hepcidin)指标变化，并对患者的血常规、尿常规、心、肝、肾功能进行观察。 结果 治疗42 d后，中药鸡血藤组、口服铁剂组、联合治疗组的痊愈率分别为60.0%、65.0%和75.0%，3组痊愈率比较差异具有统计学意义(χ2=8.309,P＜0.05)。与治疗前相比，治疗后3组RBC、Hb、Hct、SI、SF、Tf、TIBC、血清Hepcidin均显著改善(t≥3.56，均P＜0.05)；且治疗后3组以上指标比较差异有统计学意义(F≥4.89，均P＜0.05)；治疗后联合治疗组各指标均显著高于中药鸡血藤组和口服铁剂组(t≥2.38，均P＜0.05)。治疗过程中3组患者的心、肝、肾功能均在正常范围内，口服铁剂组、联合治疗组、中药鸡血藤组不良反应发生率分别为15%、10%、0%；3组不良反应发生率比较差异有统计学意义(χ2=6.109,P＜0.05)。 结论 鸡血藤可显著改善缺铁性贫血患者临床症状和机体铁代谢，联合口服铁剂效果更佳。 

Mechanism study of using Caulis Spatholobi combined with iron to treat iron-deficiency anemia

Objective To study the clinical effects and safety of oral iron with decoction of Caulis Spatholobi in the treatment of iron-deficiency anemia. Methods From May 2014 to May 2015 in our hospital 120 patients with iron deficiency anemia were selected and randomly divided into Caulis Spatholobi group,oral iron group and combination group(40 cases in each group);The Caulis Spatholobi group was given suberect spatholobus stem water decoction 15 g/day,the oral iron group was given niferex 150 mg/day,while the combination group was given suberect spatholobus stem water decoction 15 g/day and niferex 150 mg/day,which were all treated for 42 d;Before and after the treatment,red blood cell(RBC) count,hemoglobin(Hb),haematocrit(Hct),serum iron(SI),serum ferritin(SF),serum transferrin(Tf),total iron binding force(TIBC),serum Hepcidin index changes of all three groups were recorded and compared,as well as the routine blood tests,routine urine tests,heart and liver and kidney functions. Results Forty-two days after the treatment,the cure rates of the Caulis spatholobi group,oral iron group and combination group were 60.0%,65.0% and 75.0%,respectively,the differences among the three groupswere statistically significant(χ2=8.309,P<0.05).Compared with the levles before treatment,RBC,Hb,Hct,SI,SF,Tf,TIBC and serum Hepcidin of all three groups were all improved significantly (t≥3.56,all P<0.05),and the difference in RBC,Hb,Hct,SI,SF,Tf,TIBC and serum Hepcidin among the three groups was statistically significant(F≥4.89,all P<0.05);RBC,Hb,Hct,SI,SF,Tf,TIBC and serum Hepcidin in the combination group were all significantly higher than those in Caulis Spatholobi group and oral iron group after the treatment(t≥2.38,P<0.05).The tests for the functions of kidney and liver as well as heart were allwithin the normal range.The incidence of adverse reactions was 15% in the oral iron group,10%in the combination group and 0 in the Caulis spatholobi group,the difference was statistically significant(χ2=6.109,P<0.05). Conclusion Caulis spatholobi combined with oral iron agent can significantly improve clinical symptoms in patients with iron deficiency anemia and iron metabolism,which mechanism may be associated with raising serum iron Hepcidin.