目的 观察肾衰宁胶囊联合司维拉姆治疗血液透析患者高磷血症的临床疗效。方法 选择2022年11月—2023年03月在山东大学齐鲁医院（青岛）治疗的80例高磷血症的血液透析患者，按照随机数字表法将患者分为对照组和治疗组，每组各40例。对照组患者口服碳酸司维拉姆片，3次/d，起始剂量每次1片或2片。治疗组在对照组的治疗基础上口服肾衰宁胶囊，3粒/次，3次/d。两组均连续治疗16周。观察两组患者临床疗效，比较治疗前后两组患者血磷、血钙、钙磷乘积和甲状旁腺激素（iPTH）水平。结果 治疗后，治疗组总有效率为72.50%，明显高于对照组47.50%（P＜0.05）。治疗后，治疗组患者血磷水平持续下降，从第4周开始显著低于治疗前（P＜0.05），从第12周开始血磷水平明显低于对照组（P＜0.05）。治疗后，两组患者的血钙水平均显著低于治疗前（P＜0.05）。治疗后，治疗组患者的钙磷乘积水平较治疗前持续下降（P＜0.05），治疗组内比较和两组间比较与血磷变化趋势一致。结论 肾衰宁胶囊联合司维拉姆能有效治疗血液透析患者的高磷血症，并有效降低钙磷乘积，且无明显不良反应。

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