方药联合温针灸治疗脾肾气虚兼血瘀型糖尿病肾病的疗效及对肾脏纤维化指标的影响

Efficacy of Formulae Combined with Warm Acupuncture in The Treatment of Diabetic Nephropathy with Spleen-Kidney Qi Deficiency and Blood Stasis and The Effect on Renal Fibrosis Index

关键词:  糖尿病肾病  脾肾气虚兼血瘀型  自拟健脾益肾活血方  温针灸  肾脏纤维化

Key words:  Diabetic nephropathy  Qi deficiency in the spleen and kidney with blood stasis  Self-designed formula for strengthening the spleen, benefiting the kidney and invigorating blood  Warm acupuncture  Kidney fibrosis

摘要:

目的：观察和分析自拟方药联合温针灸治疗脾肾气虚兼血瘀型糖尿病肾病患者的临床疗效以及对肾脏纤维化指标的影响。方法：选取脾肾气虚兼血瘀型糖尿病肾病患者60例，采取随机数字表法分为对照组和治疗组各30例。对照组予以西医基础治疗加用厄贝沙坦口服；治疗组在对照组基础上予以中药汤剂自拟健脾益肾活血方联合温针灸治疗。两组均以4周为1个疗程，连续治疗2个疗程。比较两组患者经过两个疗程治疗之后的血肌酐（SCr）、尿素氮（BUN）、24小时尿蛋白定量、总胆固醇（TC）、三酰甘油（TG）、空腹血糖（FBG）、糖化血红蛋白（HbA1c）、胱抑素C（CysC）、金属蛋白酶抑制剂-1（TIMP-1）、转化生长因子-β1（TGF-β1）、Ⅳ型胶原（CⅣ）的变化情况。结果：两组SCr、BUN、24小时尿蛋白定量、TC、TG、FBG、HbA1c、CysC、TIMP-1、TGF-β1、CⅣ水平均降低（P<0.05），且治疗组指标更低于对照组（P<0.05）。治疗组中医证候疗效评价总有效率明显高于对照组（P<0.05）。结论：自拟健脾益肾活血方联合温针灸治疗可减轻糖尿病肾病肾脏损伤，减轻尿蛋白，延缓肾脏纤维化进展，从而提高患者生存质量。

Abstract:

Objective: To observe and recognize the clinical efficacy of formulae combined with warm acupuncture in the treatment of diabetic nephropathy patients with spleen-kidney qi deficiency cum blood stasis and the effect on renal fibrosis indexes.Method: Sixty-four patients with diabetic nephropathy with blood stasis and spleen-kidney qi deficiency were selected and divided into 32 cases in the control group and 32 cases in the treatment group by the random number table method. The control group was treated with western medicine and oral Irbesartan; the treatment group was treated with Chinese herbal soup formula combined with warm acupuncture on the basis of the control group to strengthen the spleen and kidney and activate blood. Both groups were treated with 4 weeks as a course of treatment for 2 consecutive courses. The blood creatinine (SCr), urea nitrogen (BUN), 24-hour urine protein quantification, total cholesterol (TC), triacylglycerol (TG), fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), cystatin C (CysC), metalloproteinase inhibitor-1 (TIMP-1), transforming growth factor-β1 (TGF-β1), and type IV hemoglobin were compared between the two groups after two courses of treatment. -β1), and collagen type IV (CIV).Results: SCr, BUN, 24-hour urine protein quantification, TC, TG, FBG, HbA1c, CysC, TIMP-1, TGF-β1, and C IV levels were reduced in both groups(P<0.05), and the indexes in the treatment group were lower than those in the control group(P<0.05). The total effective rate of Chinese medicine evidence efficacy evaluation in the treatment group was significantly higher than that in the control group (P<0.05).Conclusion: The self-developed formula of strengthening the spleen, benefiting the kidney and invigorating the blood, combined with warm acupuncture treatment can reduce kidney damage in diabetic nephropathy, reduce urinary protein and delay the progression of kidney fibrosis, thus improving the quality of survival of patients.