龙杞方加减联合穴位贴敷治疗早中期糖尿病肾病的效果研究

Research on Effect of Modified Longqi Fang Combined with Acupoint Application in Treatment of Early-and Middle-Stage Diabetic Kidney Disease

目的:探讨龙杞方加减联合穴位贴敷治疗早中期糖尿病肾病(DKD)的临床效果。方法:选取2021年1月—2022年10月南京市高淳中医院收治的78例早中期DKD患者作为研究对象,根据随机数字表法分为观察组与对照组,各39例。对照组给予厄贝沙坦片治疗,观察组在对照组基础上给予龙杞方加减联合穴位贴敷治疗,比较两组治疗效果、肾功能指标、中医证候积分、血糖水平。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前,两组血肌酐(SCr)、尿素氮(BUN)、24 h尿蛋白定量、血清白蛋白(ALB)水平比较,差异无统计学意义(P>0.05);治疗后,观察组SCr、BUN、24 h尿蛋白定量低于对照组,ALB水平高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组腰膝酸软、倦怠乏力、口干、夜尿频多中医证候积分均低于对照组,差异有统计学意义(P<0.05)。治疗前,两组空腹血糖(FBG)、餐后2 h血糖(2 hPBG)、糖化血红蛋白(HbA_(1c))水平比较,差异无统计学意义(P>0.05);治疗后,两组FBG、2 hPBG、HbA_(1c)水平均低于治疗前,差异有统计学意义(P<0.05)。结论:龙杞汤加减联合穴位贴敷治疗早中期DKD效果显著,能够明显改善患者的肾功能指标和临床症状,稳定血糖水平。

Objective:To explore clinical effect of modified Longqi Fang combined with acupoint application in treatment of earlyand middle-stage diabetic kidney disease(DKD).Methods:From January 2021 to October 2022,78 patients with early-and middle-stage DKD treated in Nanjing Gaochun Hospital of Traditional Chinese Medicine were selected as the subjects.They were divided into control group and observation group according to random number table method,with 39 cases in each group.The control group was treated with irbesartan tablets and the observation group was treated with modified Longqi Fang combined with acupoint application on the basis of the control group.The treatment effect,renal function index,TCM syndrome score and blood glucose level of the two groups were compared.Results:The total effective rate of treatment in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Before treatment,there were no significant differences in serum creatinine(SCr),urea nitrogen(BUN),24 h urine protein quantification and serum albumin(ALB)levels between the two groups(P>0.05).After treatment,the SCr,BUN and 24 h urine protein quantification in the observation group were lower than those in the control group,and the ALB level in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the scores of TCM syndromes such as soreness and weakness of waist and knee,fatigue,dry mouth,frequent nocturnal urination in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).Before treatment,there was no significant difference in the fasting blood glucose(FBG),2 h postprandial blood glucose(2 hPBG)and glycated hemoglobin(HbA_(1c))levels between the two groups(P>0.05).After treatment,the levels of FBG,2 hPBG,and HbA1c in the two groups were lower than those before treatment,and the difference was statistically significant(P<0.05).Conclusion:Modified Longqi Fang combined with acupoint application in treatment of early-and middle-stage DKD has significant effects,it can obviously improve renal function indicators and clinical symptoms of patients,and stabilize blood glucose level.