加味真武汤联合温针灸治疗脾肾阳虚型糖尿病肾病的疗效及对炎症因子的影响

Therapeutic Effect of Modified Zhenwu Decoction combined with Warm Acupuncture on Diabetes Nephropathy of Spleen Kidney Yang Deficiency Type and Its Influence on Inflammatory Factors

目的探讨加味真武汤联合温针灸治疗脾肾阳虚型糖尿病肾病的疗效及对炎症因子的影响。方法选取黑龙江省中医药科学院2021年1月至2022年12月收治的脾肾阳虚型糖尿病肾病患者60例作为研究对象,根据治疗方法不同分为对照组与观察组,各30例。对照组给予加味真武汤治疗,观察组给予加味真武汤+温针灸治疗。比较两组患者疗效、中医证候积分、肾功能、血糖及炎症因子。结果在疗效方面,观察组与对照组治疗有效率[96.67%vs.80.00%],差异有统计学意义(P<0.05)。在中医证候积分方面,观察组治疗后尿频、精神萎靡、腰膝酸软、食欲不振积分明显低于对照组(P<0.05)。在肾功能方面,观察组治疗后血肌酐(Scr)、血清尿素氮(BUN)明显低于对照组(P<0.05)。在血糖水平方面,治疗后观察组空腹血糖(FBG)、餐后2 h血糖(2h PBG)明显低于对照组(P<0.05)。在炎症反应方面,观察组治疗后炎症因子白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)明显低于对照组(P<0.05)。结论在脾肾阳虚型糖尿病肾病治疗中,加味真武汤联合温针灸治疗,可持续性有效改善患者中医证候积分、肾功能及血糖水平等情况,具有显著的应用价值。

Objective To explore the curative effect of modified Zhenwu Decoction combined with warm acupuncture on spleen and kidney Yang deficiency type diabetic nephropathy and its influence on inflammatory factors.Methods Sixty patients with spleen-kidney-yang deficiency type diabetic nephropathy treated in Heilongjiang Academy of Chinese Medicine from January 2021 to December 2022 were selected as the study objects,and were divided into control group and observation group according to different treatment methods,with 30 cases in each group.The control group was given modified Zhenwu decoction treatment,and the observation group was given modified Zhenwu decoction+warm acupuncture treatment.The efficacy,TCM syndrome score,renal function,blood glucose and inflammatory factors were compared between the two groups.Results In terms of therapeutic effect,the effective rate of the observation group and the control group was 96.67%vs.80.00%,and the difference was statistically significant(P<0.05).In terms of TCM syndrome scores,the scores of urinary frequency,lethargy,waist and knee tenderness and loss of appetite in the observation group were significantly lower than those in the control group after treatment(P<0.05).In terms of renal function,serum creatinine(Scr)and serum urea nitrogen(BUN)in the observation group were significantly lower than those in the control group after treatment(P<0.05).In terms of blood glucose level,fasting blood glucose(FBG)and 2 h postprandial blood glucose(2hPBG)in the observation group were significantly lower than those in the control group after treatment(P<0.05).In terms of inflammation,the inflammatory factors interleukin-6(IL-6),C-reactive protein(CRP)and tumor necrosis factor-α(TNF-α)in the observation group were significantly lower than those in the control group after treatment(P<0.05).Conclusion In the treatment of spleen and kidney yang deficiency type diabetes nephropathy,the combination of Jiawei Zhenwu Decoction and warm acupuncture can effectively improve the TCM syndrome score,kidney function and blood sugar level of patients in a sustainable manner,and has significant application value.