目的 觀察腎衰寧膠囊聯(lián)合司維拉姆治療血液透析患者高磷血癥的臨床療效。方法 選擇2022年11月—2023年03月在山東大學(xué)齊魯醫(yī)院（青島）治療的80例高磷血癥的血液透析患者，按照隨機(jī)數(shù)字表法將患者分為對(duì)照組和治療組，每組各40例。對(duì)照組患者口服碳酸司維拉姆片，3次/d，起始劑量每次1片或2片。治療組在對(duì)照組的治療基礎(chǔ)上口服腎衰寧膠囊，3粒/次，3次/d。兩組均連續(xù)治療16周。觀察兩組患者臨床療效，比較治療前后兩組患者血磷、血鈣、鈣磷乘積和甲狀旁腺激素（iPTH）水平。結(jié)果 治療后，治療組總有效率為72.50%，明顯高于對(duì)照組47.50%（P＜0.05）。治療后，治療組患者血磷水平持續(xù)下降，從第4周開始顯著低于治療前（P＜0.05），從第12周開始血磷水平明顯低于對(duì)照組（P＜0.05）。治療后，兩組患者的血鈣水平均顯著低于治療前（P＜0.05）。治療后，治療組患者的鈣磷乘積水平較治療前持續(xù)下降（P＜0.05），治療組內(nèi)比較和兩組間比較與血磷變化趨勢(shì)一致。結(jié)論 腎衰寧膠囊聯(lián)合司維拉姆能有效治療血液透析患者的高磷血癥，并有效降低鈣磷乘積，且無明顯不良反應(yīng)。

Objective To observe the clinical effect of Shenshuaining Capsules combined with sevelamer in treatment of hyperphosphatemia in hemodialysis patients. Methods A total of 80 hemodialysis patients with hyperphosphatemia treated in Qilu Hospital of Shandong University (Qingdao) from November 2022 to March 2023 were selected and divided into control group and treatment group according to random number table method, with 40 cases in each group. Patients in the control group were po administered with Sevelamer Carbonate Tablets, the initial dose was 1 or 2 tablets at a time, three times daily. Patients in the treatment group were po administered with Shenshuaining Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 16 weeks. After treatment, the clinical evaluations were evaluated, the levels of blood phosphorus, blood calcium, calcium-phosphorus product, and iPTH in two groups before and after treatment were compared. Results After treatment, the total clinical effective rate of the treatment group was 72.50%, which was significantly higher than that of the control group (47.50%, P< 0.05). After treatment, the level of serum phosphorus in the treatment group was continuously decreased, which was significantly lower than that before treatment from the 4th week (P < 0.05), and from the 12th week to the control group (P < 0.05). After treatment, the level of serum calcium in two groups was significantly lower than that before treatment (P< 0.05). After treatment, the level of calcium-phosphorus product in the treatment group continued to decrease as compared with that before treatment (P< 0.05). The comparison within the treatment group and between the two groups was consistent with the change trend of blood phosphorus. Conclusion Shenshuanning capsules combined with Sevelam can effectively treat hyperphosphatemia in hemodialysis patients and effectively reduce calcium-phosphorus product without obvious adverse reactions.

R973