温阳补肾灸辅助治疗对糖尿病肾病患者的影响

Influences of Adjuvant Therapy with Warming Yang and Tonifying Kidney Moxibustion for Patients with Diabetic Nephropathy

目的观察探讨温阳补肾灸辅助治疗对糖尿病肾病(DN)患者的影响。方法秦皇岛市中医医院2019年6月—2020年6月收治的DN患者63例为观察对象,通过抽签法随机分为治疗组32例和对照组31例,两组患者均给予DN常规西医治疗,治疗组在此基础上给予温阳补肾灸辅助治疗,比较两组患者治疗后的临床疗效、中医证候积分、肾功能指标、认知功能障碍和自我管理行为评分变化。结果治疗后,治疗组患者总有效率为90.63%(29/32),对照组为67.74%(21/31),两组比较差异有统计学意义(P<0.05);两组患者中医证候各方面积分及总分均较治疗前显著降低(P<0.05),且治疗组与对照组比较差异有统计学意义(P<0.05);两组患者24 h尿蛋白(24h-Upro)、尿微量白蛋白(MALB)和血肌酐(Scr)水平均较治疗前显著降低(P<0.05),且治疗组与对照组比较差异有统计学意义(P<0.05);两组患者简易精神状态检查量表(MMSE)评分和蒙特利尔认知评估量表(MoCA)评分均较治疗前显著升高(P<0.05),且治疗组与对照组比较差异有统计学意义(P<0.05);两组患者用药管理、饮食管理、血糖管理、运动管理及足部管理评分均较治疗前显著升高(P<0.05),其中观察组中饮食管理、运动管理和足部管理评分与对照组比较差异有统计学意义(P<0.05)。结论温阳补肾灸辅助治疗可有效缓解DN患者临床症状,延缓肾功能进展,改善患者认知功能障碍,有助于提升其自我管理行为,临床疗效显著。

Objective To observe and explore the effect of the adjuvant therapy with warming Yang and tonifying kidney moxibustion on patients with diabetic nephropathy(DN).Methods Totally 63 patients with DN admitted to Qinhuangdao Hospital of Traditional Chinese Medicine between June 2019 and June 2020 were the observation subjects,and they were randomly divided into the treatment group(32 cases)and the control group(31 cases)by lottery,and both groups were given DN conventional western medicine treatment.The treatment group was given the adjuvant therapy with warming Yang and tonifying kidney moxibustion on this basis.The clinical efficacy,TCM syndromes scores,renal function indicators,cognitive dysfunction and self-management behaviors scores were compared between the two groups after treatment.Results After treatment,the total effective rate was 90.63%(29/32)in the treatment group and 67.74%(21/31)in the control group(P<0.05).The scores of TCM symptoms and total score in the two groups were significantly decreased compared with those before treatment(P<0.05),and the differences between the two groups were significant(P<0.05).The levels of 24-hour urinary protein quantity(24 h-Upro),urine microalbumin(MALB)and serum creatinine(Scr)in the two groups of patients were significantly lower than those before treatment(P<0.05),and there were significant differences between treatment group and control group(P<0.05).The Mini-mental State Examination(MMSE)score and Montreal Cognitive Assessment(MoCA)score of the two groups were significantly higher than those before treatment(P<0.05)and the differences were significant between the two groups(P<0.05).The scores of medication management,diet management,blood glucose management,exercise management and foot management in the two groups of patients were significantly increased compared with those before treatment(P<0.05),and the scores of diet management,exercise management and foot management in the treatment group were significantly different from those in the control group(P<0.05).Conclusion The adjuvant therapy with warming Yang and tonifying kidney moxibustion can effectively alleviate the clinical symptoms of patients with DN,delay the progression of renal function,improve the cognitive dysfunction and help to improve the self-management behaviors,with a significant clinical efficacy.