针刺对糖尿病肾病血液流变学影响的临床随机对照研究

目的:通过观察针刺对糖尿病肾病(DN)血液流变学的影响,探讨针刺治疗DN的可能机制。方法:选取54例DN患者,按分层随机设计方法分为针刺组30例,对照组24例。对照组采用西药常规治疗,针刺组在西药常规治疗基础上,针刺肝俞、胃脘下俞、脾俞、肾俞、关元、足三里、阴陵泉、三阴交、太溪等穴,两组疗程均为30 d,观察治疗前后DN临床症状及血液流变学的变化。结果:针刺组30例中,16例有显著改善,12例有效,2例无效;对照组24例中,6例有显著改善,10例有效,8例无效。有效率分别为93.3%和66.7%,针刺组改善DN临床症状优于对照组(P<0.05)。针刺组全血低切黏度、血浆黏度及纤维蛋白原均较治疗前明显下降(P<0.05);而且针刺对全血低切黏度及纤维蛋白原的调节作用明显优于对照组(P<0.05)。结论:针刺能改善DN血液流变学,对延缓DN进展有一定作用。

Effect of Acupuncture on Hemorheology in Patients with Diabetic Nephropathy

OBJECTIVE: To explore the underlying mechanisms of acupuncture in treating diabetic nephropathy (DN) by observing the effect of acupuncture on blood rheology of DN. METHODS: A total of 54 cases of DN patients were randomly divided into control (n=24) and acupuncture group (n=30). Patients of control group were treated with diet-control, oral administration of Gliguidone (30-60 mg, t. i. d.) or subcutaneous injection of insulin, and those of acupuncture group treated with the same medication as those of control group and additional manual acupuncture stimulation of Ganshu (BL18), Pishu (BL20), Zusanli (ST 36), etc., once daily for 30 days. Hemorheology was detected with LBY-N6A Automatic Hemorheological Analyser. The treatment duration in 2 groups was 30 days. RESULTS: After the treatment, of the 24 and 30 cases in control and acupuncture groups, 6 (25.0%) and 16 (53.3%) cases experienced remarkable improvement in their symptoms; 10 (41.6%) and 12 (40.0%) had improvement, 8 (33.3%) and 2 (6.7%) failed, with the effective rates being 66.7% and 93.3% respectively. Self-comparison showed that after the treatment, no significant changes were found in lower shear rate (LSR) and higher shear rate (HSR) of whole blood viscosity, plasma viscosity (etap), hematocrit (HCT) and profibrin in control group; while LSR of whole blood viscosity, etap and profibrin in acupuncture group decreased significantly (P<0.05). The therapeutic effect of acupuncture group was significantly superior to that of control group in lowering LSR of whole blood viscosity and profibrin (P<0.05). CONCLUSION: Acupuncture can improve DN patients' clinical symptoms and blood rheology, and hence, has a certain effect in postponing the development of DN.