title: [Effect of combination of bushen jianpi recipe and erythropoietin on serum tumor necrosis factor alpha in patients with anemia].
abstract: OBJECTIVE
  To study the effect of treatment of renal anemia by combination of Bushen Jianpi Recipe (BJR, a Chinese experience recipe for supplementing Shen and supporting Pi) and low dosage erythropoietin (EPO), and the influence of treatment on change of serum tumor necrosis factor alpha (TNF-alpha) so as to explore the possible mechanism of integrative Chinese and western medicine (ICWM) in treating renal anemia.
  
  
  METHODS
  Patients with renal anemia were randomly divided into two groups, the ICWM group and the control group, symptomatic and supporting treatment such as dialysis, supplementing of ferrous, foliac acid and vitamin B12, was given to both groups. Additionally, to the ICWM group, 50 IU/kg of EPO subcutaneous injection for twice every week, and oral intake of BJR, one dose per day taken in two parts, were given, and to the control group, EPO alone, 50 IU/kg by subcutaneous injecting, 3 times per week, was given. The therapeutic course for two groups was 3 months. Blood levels of hemoglobin (Hb), hematocrit (Hct), TNF-alpha were measured before treatment and the therapeutic effect was observed.
  
  
  RESULTS
  After treatment, the levels of Hb and Hct increased significantly in both groups (P < 0.01), comparison between the two groups in Hb and Hct after being treated for 3 months showed significant difference (P < 0.05). The serum level of TNF-alpha was markedly higher than normal range in both groups before treatment, it significantly lowered after treatment in the ICWM group (P < 0.05), but unchanged in the control group.
  
  
  CONCLUSIONS
  Combination of BJR and EPO could significantly inhibit the production of TNF-alpha, this may be an important factor for ICWM in effectively improving sensitivity to EPO.
authors.affiliation: Department of Nephrology, Hangzhou Hospital of TCM, Hangzhou 310000.
authors.forename: Qiu-fen
authors.initials: QF
authors.lastname: Li
authors.forename: Qiong-ying
authors.initials: QY
authors.lastname: Ma
authors.forename: Cai-feng
authors.initials: CF
authors.lastname: Zhu
mesh_terms: D000328:Adult; D000740:Anemia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use; D004920:Erythropoiesis / Q000187:drug effects; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D005921:Glomerulonephritis / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy; D011994:Recombinant Proteins; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
chemical_list: D004365:Drugs, Chinese Herbal; D011994:Recombinant Proteins; D014409:Tumor Necrosis Factor-alpha; D004921:Erythropoietin