益肾活血泄浊方联合陆氏针灸治疗糖尿病肾病Ⅲ期临床疗效观察
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摘要
目的:研究观察糖尿病肾病Ⅲ期患者在经过益肾活血泄浊方单独和联合陆氏针灸治疗前后患者临床的疗效。方法:采用前瞻性随机对照临床研究的方法,选取2017年1月至2018年12月上海中医药大学附属第七人民医院收治的肾病糖尿病患者90例作为研究对象,按照随机对照的原则分为A组:A组给予西药常规治疗,B组:B组在西药治疗基础上加益气活血泄浊方口服,C组:C组在中西药治疗的基础上加上针灸治疗。3组都以2个月为1个疗程,共治疗3个疗程,观察3组患者治疗前及治疗后2、4、6个月尿微量白蛋白、肾功能(血肌酐、肾小球滤过率、血尿酸),C-反应蛋白、纤维蛋白原、胰岛素抵抗指数)以及炎性细胞因子,评价临床疗效,为中西药联合陆氏针灸内外合治早期糖尿病肾病提供科学依据。结果:经过比较治疗前后的各项指标,A、B、C 3组患者治疗后症状均得到了一定的缓解,临床效果比较C组好于B组,B组好于A组,C组患者各项生理指标均改善最明显,效果最显著。结论:中西医联合针灸综合疗法对于治疗早期的糖尿病肾病临床效果更加显著。
Objective: To observe the clinical efficacy of patients with phase Ⅲ diabetic nephropathy before and after treatment with Yishen Huoxue Xiezhuo decoction alone and combined with Lu's acupuncture and moxibustion. Methods: Using a prospective randomized controlled clinical study approach,90 patients of diabetic nephropathy admitted to the Seventh People's Hospital of Chinese medicine from January 2017 to December 2018 were selected as subjects. According to the principle of randomized control,they were divided into group A: western medicine control group was given conventional western medicine,group B: Chinese and western medicine treatment group was given Yishen Huoxue Xiezhuo decoction on the basis of western medicine treatment,group C:Chinese and western medicine combined with Lu's acupuncture and moxibustion treatment group on the basis of Chinese and western medicine. All of the 3 groups were treated with 2 months as a course of treatment,and a total of 3 courses were treated. The urinary microalbumin,renal function( serum creatinine,glomerular filtration rate,blood uric acid) C-reactive protein,fibrinogen,insulin resistance index and inflammatory cytokines were observed before treatment and after 2,4 and 6 months after treatment,evaluating the efficacy and providing a scientific basis for the treatment of early diabetic nephropathy by Chinese and western medicine combined with Lu's acupuncture. Results: After comparing the indicators before and after treatment,the symptoms of patients in group A,B,and C were all relieved after treatment. The clinical effect in the group C was better than those in the group B,and the clinical effect in the group B was better than those in the group A,the physiological indexes of patients in group C were the most obvious,and the effect was the most significant. Conclusion: Chinese and western medicine combined acupuncture and moxibustion therapy is more effective in treating early diabetic nephropathy.
Objective: To observe the clinical efficacy of patients with phase Ⅲ diabetic nephropathy before and after treatment with Yishen Huoxue Xiezhuo decoction alone and combined with Lu's acupuncture and moxibustion. Methods: Using a prospective randomized controlled clinical study approach,90 patients of diabetic nephropathy admitted to the Seventh People's Hospital of Chinese medicine from January 2017 to December 2018 were selected as subjects. According to the principle of randomized control,they were divided into group A: western medicine control group was given conventional western medicine,group B: Chinese and western medicine treatment group was given Yishen Huoxue Xiezhuo decoction on the basis of western medicine treatment,group C:Chinese and western medicine combined with Lu's acupuncture and moxibustion treatment group on the basis of Chinese and western medicine. All of the 3 groups were treated with 2 months as a course of treatment,and a total of 3 courses were treated. The urinary microalbumin,renal function( serum creatinine,glomerular filtration rate,blood uric acid) C-reactive protein,fibrinogen,insulin resistance index and inflammatory cytokines were observed before treatment and after 2,4 and 6 months after treatment,evaluating the efficacy and providing a scientific basis for the treatment of early diabetic nephropathy by Chinese and western medicine combined with Lu's acupuncture. Results: After comparing the indicators before and after treatment,the symptoms of patients in group A,B,and C were all relieved after treatment. The clinical effect in the group C was better than those in the group B,and the clinical effect in the group B was better than those in the group A,the physiological indexes of patients in group C were the most obvious,and the effect was the most significant. Conclusion: Chinese and western medicine combined acupuncture and moxibustion therapy is more effective in treating early diabetic nephropathy.
引文
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[2]Zimmet P,KG Alberti,Shew J.Global and societal implications of the diabetepidemic[J].Nature,2001,414(6865):782-787.
[3]REUTENS AT,ATKINSTKINS RC.Epidemiology of diabetic nephropathy[J].Conttrib Nephrol,2011,170(1):1-7.
[4]张彤,盖云,杨晓萍,等.益气软坚泄浊方对糖尿病肾病的影响研究[J].中医药信息,2013,30(3):71-73.
[5]吴瑜霞,龚兰,陈振宇,等.多项指标联合检测对糖尿病早期肾损害的诊断价值[J].现代医院,2010,10(12):65-67.
[6]Sarafidis PA,Bakris GL.Microalbuminuria and chronic kidney disease as risk factors for cardiovascular disease[J].Nephrol Dial Transplant,2006,21(9):2366-2374.
[7]Weir MR.Microalbuminuria and Cardiovascular disease[J].Clin JAm Soc Nephrol,2(3):581-590.
[8]陈烨,王旭.中医药治疗糖尿病肾病研究[J].吉林中医药,2011,31(1):17-18.
[9]张庆飞,王祥生.谈糖尿病肾病从瘀论治[J].现代中医药,2018,38(6):90-92.
[10]卢伟波,杨丕坚,李舒敏,等.丹参多酚酸盐对早期糖尿病肾病患者炎性反应细胞因子及肾血管内皮功能的影响[J].中国实验方剂学杂志,2014,20(2):184-187.