循经穴位雷火灸治疗慢性肾脏病3期脾肾亏虚血瘀证的疗效观察

Observations on the effect of thunder-fire moxibustion with meridian point on deficiency of kidney and spleen,and blood stasis in chronic kidney diseases stage three

目的采用循经穴位雷火灸灸治疗脾肾亏虚血瘀证慢性肾脏病3期的足太阳膀胱经腰背部及任脉经腹部腧穴,观察其临床疗效。方法采用随机数字表法将60例脾肾亏虚血瘀证的慢性肾脏病3期患者分为研究组与对照组各30例。对照组采用控制血压、控制血脂、口服中药、改善营养等治疗,研究组在此基础上加雷火灸灸治足太阳膀胱经腰背部及任脉经腹部腧穴,每日灸治1次,2周为1个疗程,共2个疗程。观察2组患者研究前后血尿素氮、血肌酐、肾小球滤过率变化、中医证候积分、症状分级量化评分,并比较评价2组疗效。结果研究后4周,研究组患者中医证候积分[8(4,10)分]明显低于对照组[12(10,14)分],差异有统计学意义(Z=-3.706,P=0.000);研究组患者症状分级量化评分中腰膝酸软[0(0,2)分]、畏寒肢冷[0(0,2)分]、体倦乏力[0(0,0)分]明显低于对照组腰膝酸软[2(0,2)分]、畏寒肢冷[2(2,2)分]、体倦乏力[2(2,4)分],差异有统计学意义(Z=-2.625、-3.593、-4.609,P<0.01),研究组患者夜尿频多[2(0,2)分]较对照组[2(2,2)分]改善,差异有统计学意义(Z=-1.989,P<0.05),而研究组食少纳呆较对照组改善不明显,差异无统计学意义(P>0.05);而在临床疗效方面,研究组总有效率为93.3%(28/30),优于对照组73.3%(22/30),差异有统计学意义(χ^(2)=38.19,P=0.000)。结论雷火灸循经穴位灸治可有效改善脾肾亏虚血瘀证慢性肾脏病3期患者的腰膝酸软、畏寒肢冷、体倦乏力、夜尿频多等症状,提高临床疗效减轻患者不适,并不同程度改善其肾功能。

Objective To observe clinical effect of thunder-fire moxibustion with meridian point,including lumbar spinal cordacupoints of bladder meridian and abdominal acupoints of Ren channel,which treating on deficiency of kidney and spleen and blood stasis in chronic kidney diseases(CKD)stage 3.Methods Totally 60 patients were randomly divided into treatment and control group.30 patients in control were treated with blood pressure and lipid adjustment,Chinese medicine and nutritional therapy.30 patients in treatment group were treated with thunder-fire moxibustion with meridian point based on control.A moxibustion-treated course has 2 weeks,patients were treated every other day.Observe blood urea nitrogen(Bun),creatinine(Scr),glomerular filtration rate(eGFR),Chinese medicine syndrome and quantitative score,as well as clinical efficacy.Results After 4 weeks of intervention,the TCM syndrome score[8(4,10)]in the treatment group was significantly lower than that in the control group[12(10,14)],with a statistically significant difference(Z=-3.706,P=0.000);in the quantitative score of symptom classification,the patients in the treatment group were significantly lower than those in the control group[2(0,2)],chills[2(2,2)],fatigue[2(2,4)],the difference was statistically significant(Z=-2.625,-3.593,-4.609,P<0.01).The frequency of nocturia in the treatment group was significantly higher than that in the control group(Z=-1.989,P<0.05),while that in the treatment group was not significantly better than that in the control group(P>0.05).In terms of clinical efficacy,the total effective rate of the treatment group was 93.3%(28/30),which was better than73.3%(22/30)of the control group(χ^(2)=38.19,P=0.000).Conclusion Thunder-fire moxibustion with meridian point improve deficiency of kidney and spleen and blood stasis of patients in CKD stage3,such as weak waist,cold chills,poor appetite,weakness and nocturia,as well as ameliorate renal function.