健脾益肾针刺法联合实脾固肾化瘀方治疗慢性肾炎蛋白尿的临床研究

Clinical study of acupuncture of invigorating spleen and benefiting kidney combined with Shipi Gushen Huayu Recipe in the treatment of chronic nephritis proteinuria

目的观察健脾益肾针刺法联合实脾固肾化瘀方治疗慢性肾炎蛋白尿的临床疗效。方法将72例慢性肾炎蛋白尿患者随机分为治疗组和对照组,每组36例。对照组在一般治疗的基础上口服实脾固肾化瘀方治疗,治疗组在对照组治疗措施的基础上加用健脾益肾针刺法。4周为1个疗程,两组均连续治疗2个疗程,观察临床疗效,比较中医证候积分、尿蛋白定量、肾功能相关指标(尿素氮、肌酐)及eGFR、尿蛋白/肌酐值的变化情况。结果①治疗组、对照组总有效率分别为91.7%、54.6%;治疗组临床疗效优于对照组(P<0.05)。②治疗1个疗程、治疗2个疗程与治疗前组内比较,两组中医证候积分、尿蛋白定量均有明显改善(P<0.05)。治疗1个疗程组间比较,中医证候积分、尿蛋白定量差异无统计学意义(P>0.05);治疗2个疗程组间比较,中医证候积分、尿蛋白定量差异有统计学意义(P<0.05)。③治疗1个疗程、治疗2个疗程与治疗前组内比较,治疗组血尿素氮、肌酐水平及尿蛋白/肌酐值差异有统计学意义(P<0.05),对照组仅血肌酐水平差异有统计学意义(P<0.05)。治疗1个疗程、治疗2个疗程组间比较,血尿素氮水平及尿蛋白/肌酐值差异有统计学意义(P<0.05)。结论健脾益肾针刺法联合实脾固肾化瘀方治疗慢性肾炎蛋白尿疗效满意,能有效改善患者的临床症状,降低尿蛋白水平,保护肾功能。

Objective To observe the clinical efficacy of acupuncture of invigorating spleen and benefiting kidney combined with Shipi Gushen Huayu Recipe in the treatment of chronic nephritis proteinuria. Methods Seventy-two patients with chronic nephritis proteinuria were randomly divided into the treatment group(36 cases) and control group(36 cases). On the basis of general treatment, the control group was orally treated with Shipi Gushen Huayu Recipe, and the treatment group was treated with acupuncture of invigorating spleen and benefiting kidney based on the treatment for the control group. Four weeks were taken as one course of treatment, and two consecutive courses of treatment were performed in both groups. The clinical efficacy was observed, and the changes of Chinese medical syndrome score, urinary protein quantity, renal function related indexes(urea nitrogen and creatinine), eGFR and ratio of urinary protein to creatinine were compared. Results ①The total effective rates of the treatment group and the control group were 91.7% and 54.6% respectively, and the clinical efficacy of the treatment group was better than that of the control group(P<0.05). ②After one course of treatment and two courses of treatment, compared with treatment before, the Chinese medical syndrome score and urine protein quantity were significantly improved in the two groups(P<0.05). After one course of treatment, there were no statistically significant differences in the Chinese medical syndrome score and urine protein quantity between the two groups(P>0.05). After two courses of treatment, there were statistically significant differences in Chinese medical syndrome score and urine protein quantity between the two groups(P<0.05). ③After one course of treatment and two courses of treatment, compared with treatment before, there were statistically significant differences in blood urea nitrogen, creatinine and ratio of urinary protein to creatinine in the treatment group(P<0.05), and there was statistically significant difference in serum creatinine in the control group(P<0.05). After one course of treatment and two courses of treatment, there were statistically significant differences in blood urea nitrogen and ratio of urinary protein to creatinine between the two groups(P<0.05). Conclusion Acupuncture of invigorating spleen and benefiting kidney combined with Shipi Gushen Huayu Recipe shows good efficacy in the treatment of chronic nephritis proteinuria,which can effectively improve the clinical symptoms of patients,reduce the level of urinary protein and protect the renal function.