目的 探讨健脾生血颗粒联合左卡尼汀注射液治疗慢性肾衰竭肾性贫血的临床疗效。方法 选取2017年8月-2018年4月于天津医科大学中新生态城医院治疗的82例慢性肾衰竭肾性贫血患者作为研究对象，采用随机数字表法将患者分为对照组和治疗组，每组各41例。对照组患者静脉推注左卡尼汀注射液，将1 g溶于10 mL注射用水中，3次/周；治疗组在对照组的基础上口服健脾生血颗粒，1袋/次，3次/d。两组患者持续治疗8周。观察两组患者的临床疗效，同时比较两组治疗前后的肾功能指标、贫血指标和铁代谢水平。结果 治疗后，对照组和治疗组的总有效率分别为82.93%、95.12%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者血清中血肌酐（Scr）、尿素氮（BUN）水平均显著降低，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组肾功能指标显著低于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者的血红蛋白（Hb）、红细胞压积（HCT）和红细胞（RBC）水平均显著升高，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组Hb、HCT和RBC水平明显高于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者血清转铁蛋白受体（sTfR）水平显著降低，血清铁蛋白（SF）、转铁蛋白饱和度（TSAT）水平均显著升高，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组sTfR、SF和TSAT水平明显优于对照组，两组比较差异具有统计学意义（P<0.05）。结论 健脾生血颗粒联合左卡尼汀注射液治疗慢性肾衰竭肾性贫血具有较好的临床疗效，能够显著提高肾功能，改善患者铁缺乏状态，且安全性好，具有一定的临床推广应用价值。

Objective To explore the clinical effect of Jianpi Shengxue Granules combined with Levocarnitine Injection in treatment of renal anemia with chronic renal failure. Methods Patients (82 cases) with renal anemia with chronic renal failure in Sino-Singapore Eco-City Hospital of Tianjin Medical University from August 2017 to April 2018 were randomly divided into control and treatment groups, and each group had 41 cases. Patients in the control group were given intravenous injection with Levocarnitine Injection, 1 g dissolved into water for injection 10 mL, 3 times weekly. Patients in the treatment group were po administered with Jianpi Shengxue Granules on the basis of the control group, 1 bag/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacy was evaluated, and the renal function indexes, anemia indexes, and iron metabolism levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 82.93% and 95.12%, and there were differences between two groups (P<0.05). After treatment, Scr and BUN levels were significantly decreased in two groups, and there were differences in the same group (P<0.05). After treatment, the renal function indexes in the treatment group were significantly lower than those in the control group, and there were differences between two groups (P<0.05). After treatment, the levels of Hb, HCT, and RBC in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). After treatment, the levels of Hb, HCT, and RBC in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, the sTfR levels in two groups were significantly decreased, but SF and TSAT levels were significantly increased, and the difference was statistically significant in the same group (P<0.05). After treatment, the levels of sTfR, SF, and TSAT in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). Conclusion Jianpi Shengxue Granules combined with Levocarnitine Injection has clinical curative effect in treatment of renal anemia with chronic renal failure, can improve renal function and iron deficiency, and has good safety, which has a certain clinical application value.