针刺配合济生肾气丸治疗阴阳两虚糖尿病肾病的临床观察

目的观察针刺配合济生肾气丸治疗阴阳两虚糖尿病肾病(DKD)的临床疗效。方法将88例阴阳两虚DKD患者按照随机分组原则分为观察组和对照组,每组44例。对照组予以西医常规治疗,观察组在西医常规治疗基础上加用针刺配合济生肾气丸,两组均连续治疗12周。观察两组患者治疗前后中医证候评分及单一症状评分、糖代谢指标空腹血糖(FPG)、餐后2 h血糖(2hPG)和糖化血红蛋白(HbA1c)]、肾功能指标血肌酐(Scr)、血尿素氮(BUN)、尿微量白蛋白(mALB)和尿白蛋白排泄率(UAER)]和炎性因子超敏C反应蛋白(hs-CRP)和肿瘤坏死因子-α(TNF-α)]水平的变化。结果观察组临床总有效率明显高于对照组(P<0.05),观察组治疗后中医证候总评分及单一症状评分均显著低于对照组(均P<0.05),观察组治疗后糖代谢指标(FPG、2hPG、HbAlc)、肾功能指标(Scr、BUN、UAER、mALB)和炎性因子(hs-CRP、TNF-α)水平均低于对照组(P<0.05)。结论在西医常规治疗基础上,针刺配合济生肾气丸治疗阴阳两虚糖尿病肾病患者的疗效明确,可明显改善形寒肢冷、大便泄泻、面色苍白、面目浮肿和腰酸耳鸣,改善糖代谢,降低尿蛋白排泄率,延缓肾脏功能进行性损害,可能与降低炎性因子有关。

Clinical Observation of Acupuncture Combined with Ji Sheng Shen Qi Pills for Diabetic Kidney Disease due to Dual Deficiency of Yin and Yang

Objective To observe the clinical efficacy of acupuncture plus Ji Sheng Shen Qi pills in treating diabetic kidney disease(DKD)due to dual deficiency of yin and yang.Method Eighty-eight patients with DKD due to dual deficiency of yin and yang were allocated to an observation group and a control group by the randomized grouping method,with 44 cases in each group.The control group was intervened by conventional Western medicine treatment,and the observation group was given additional acupuncture plus Ji Sheng Shen Qi pills,both for 12 consecutive weeks.The symptom and sign score of traditional Chinese medicine(TCM)and each individual symptom score,and the levels of glycometabolism indexesfasting plasma glucose(FPG),2 h postprandial plasma glucose(2hPG)and glycated hemoglobin(HbAlc)],kidney function parametersserum creatinine(SCr),blood urea nitrogen(BUN),urine microalbumin(mALB)and urinary albumin excretion rate(UAER)],and inflammatory factorshigh-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor(TNF)-α]were observed before and after treatment in the two groups.Result The clinical total effective rate was significantly higher in the observation group than in the control group(P<0.05).After treatment,the total TCM symptom and sign score and individual symptom scores were significantly lower in the observation group than in the control group(P<0.05);the levels of glycometabolism indexes(FPG,2hPG and HbAlc),kidney function parameters(Scr,BUN,UAER and mALB)and inflammatory factors(hs-CRP and TNF-α)were lower in the observation group than in the control group(P<0.05).Conclusion Based on the conventional Western medicine treatment,acupuncture plus Ji Sheng Shen Qi pills is effective in treating DKD due to dual deficiency of yin and yang;it can notably improve the symptoms like cold limbs,loose stool,pale complexion,puffy face and eyes and soreness of waist and tinnitus,ameliorate glycometabolism,reduce UAER and delay the progressive injury to kidney function,and the mechanism may be associated with the down-regulation of inflammatory factors.