芪参通络化瘀方联合针刺治疗早期糖尿病肾病的临床观察

Clinical Observation on the Qishen Tongluo Huayu Prescription Combined with Acupuncture in the Treatment of Early Diabetic Kidney Disease

【目的】观察芪参通络化瘀方联合针刺治疗早期糖尿病肾病(DKD)的临床疗效。【方法】将92例早期DKD患者随机分为研究组和对照组,每组各46例,两组均给予常规西医控制血压、血脂、血糖治疗,对照组给予芪参通络化瘀方治疗,研究组在对照组治疗的基础上,给予针刺治疗,共治疗8周。治疗8周后,评价2组临床疗效,观察2组患者治疗前后中医证候评分包括口渴喜饮、腰膝酸冷、尿浊、肢体浮肿、神疲乏力、手足心热等的变化情况,以及空腹血糖(FPG)、餐后2h血糖(2hPG)、血肌酐(Scr)、尿素氮(BUN)、尿微量白蛋白排泄率(UAER)的情况。比较2组患者治疗前后血清壳多糖酶3样蛋白1(CHI3L1)、细胞因子信息传导抑制因子3(SOCS3)水平的变化情况。【结果】(1)治疗后,2组患者的中医证候评分明显改善(P<0.05),且研究组在改善中医证候评分方面明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者FPG、2hPG、Scr、BUN、UAER水平均显著降低(P<0.05),且研究组在改善FPG、2hPG、Scr、BUN、UAER水平方面明显优于对照组,差异均有统计学意义(P<0.05)。(3)治疗后,2组患者血清CHI3L1、SOCS3水平均明显改善(P<0.05),且研究组在改善血清CHI3L1、SOCS3水平方面明显优于对照组,差异均有统计学意义(P<0.05)。(4)研究组总有效率为95.65%(44/46),对照组为78.26%(36/46),研究组疗效明显优于对照组,差异有统计学意义(P<0.05)。【结论】芪参通络化瘀方联合针刺治疗早期糖尿病肾病,能明显改善患者的临床症状,有效调节患者血糖,改善患者的肾功能,调节血清CHI3L1、SOCS3水平,疗效显著。

Objective To observe the clinical efficacy of Qishen Tongluo Huayu Prescription combined with acupuncture in the treatment of early diabetic kidney disease(DKD).Methods Nighty-two patients with early DKD were randomly divided into study group and control group,46 patients in each group.The control group was treated with Qishen Tongluo Huayu Prescription,and the study group was treated with acupuncture on the basis of the control group.Both group were treated for 8 weeks.After 8 weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes in the traditional Chinese medicine(TCM)syndrome scores of the patients in the two groups before and after treatment,including thirst and thirst for drinking,coldness in the waist and knees,turbidity in the urine,oedema of limbs,fatigue,and heat in the hands and feet were observed,as well as the changes in the fasting plasma glucose(FPG),2-hour postprandial glucose(2hPG),blood creatinine(Scr),urea nitrogen(BUN),and urinary microalbumin excretion rate(UAER)were observed.The changes of serum chitosanase 3-like protein 1(CHI3L1)and suppressor of cytoking signaling 3(SOCS3)levels were compared before and after treatment in the two groups of patients.Results(1)After treatment,the TCM syndrome scores of patients in the two groups were significantly improved(P<0.05),and the study group was significantly superior to the control group in improving TCM syndrome scores,and the difference was statistically significant(P<0.05).(2)After treatment,the levels of FPG,2hPG,Scr,BUN,and UAER of patients in the two groups were significantly reduced(P<0.05),and the research group was significantly superior to the control group in improving the levels of FPG,2hPG,Scr,BUN,and UAER,and the differences were all statistically significant(P<0.05).(3)After treatment,the serum CHI3L1 and SOCS3 levels of patients in the two groups were significantly improved(P<0.05),and the study group was significantly superior to the control group in improving serum CHI3L1 and SOCS3 levels,and the differences were all statistically significant(P<0.05).(4)The total effective rate was 95.65%(44/46)in the study group and 78.26%(36/46)in the control group,and the efficacy of the study group was significantly superior to that of the control group,and the difference was statistically significant(P<0.05).Conclusion Qishen Tongluo Huayu Prescription combined with acupuncture in the treatment of DKD can significantly improve patients’clinical symptoms,effectively regulate patients’blood glucose,improve patients’renal function,regulate the levels of serum CHI3L1 and SOCS3,and the therapeutic efficacy is remarkable.