温氏奔豚汤加味联合火龙灸对脾肾阳虚型肾性水肿的疗效分析

Analysis of the Curative Effect of Wen's Bentun Decoction with Some Addition of Ingredients and Combined with Huolong Moxibustion on Renal Edema of Spleen-Kidney Yang Deficiency Type

目的:探讨温氏奔豚汤加味联合火龙灸对脾肾阳虚型肾性水肿的疗效分析。方法:本次前瞻性研究的受试对象为2022年1月—2023年6月就诊于梧州市中医医院的80例肾性水肿患者,研究开始前按照就诊顺序选取信封分为治疗组和对照组,每组40例。对照组采取常规肾性水肿对症治疗方案,治疗组在此基础上行温氏奔豚汤加味联合火龙灸治疗。两组治疗周期为4周。比较两组患者中医证候评分变化及临床疗效;比较两组患者治疗前后双踝部周径、双侧大腿围周径、血浆白蛋白、血肌酐、24 h尿蛋白定量水平;比较两组患者治疗前后肌酐清除率(CCr)、β2-微球蛋白(β2-MG)含量;观察两组患者治疗期间安全性事件。结果:治疗后治疗组中医证候评分、双踝部周径、双侧大腿围周径、血肌酐、24 h尿蛋白定量、β2-MG均低于对照组(P<0.05,P<0.01)。治疗组总有效率95.00%(38/40)显著高于对照组80.00%(32/40)(P<0.05);治疗组血浆白蛋白、CCr明显高于对照组(P<0.05,P<0.01)。两组均未出现严重安全性事件。结论:温氏奔豚汤加味联合火龙灸对脾肾阳虚型肾性水肿患者疗效较好,可显著减轻患者水肿程度,改善微循环障碍,其机制可能与减轻肾小球和肾小管间质病变有关。

Objective:To investigate the effect of Wen's Bentun decoction with some addition of ingredients plus Huolong moxibustion on renal edema of spleen-kidney yang deficiency type.Methods:The subjects of this prospective study were 80 patients with renal edema who visited Wuzhou Hospital of Traditional Chinese Medicine from January 2022 to June 2023.The patients were divided into a treatment group and a control group in the order of visits,with 40 cases in each group.The control group was treated with routine symptomatic treatment of renal edema,and the treatment group was treated with the same plus Wen's Bentun decoction with some addition of ingredients plus Huolong moxibustion.The treatment period was 4 weeks.The changes of traditional Chinese medicine(TCM)syndrome score and clinical efficacy were compared between the two groups,and the circumference diameter of both ankles and both thighs before and after treatment were also compared.The quantitative levels of plasma albumin,blood creatinine,24 h urinary protein,creatinine clearance(CCr),β2-microglobulin(β2-MG)before and after treatment were compared between the two groups.The safety events during treatment were observed in the two groups.Results:The TCM syndrome score,ankle circumference,thigh circumference,blood creatinine,24 h urine protein quantification,andβ2-MG in treatment group were significantly lower than those in control group(P<0.01),the total effective rate of 95.00%(38/40)was significantly higher than the control group of 80.00%(32/40,P<0.05).Plasma albumin and CCr in the treatment group were significantly higher than those in the control group(P<0.01).No serious safety events occurred in either group.Conclusion:Wen's Bentun decoction with some addition of ingredients plus Huolong moxibustion has good effects on renal edema of spleen-kidney yang deficiency type.It can significantly reduce the degree of edema and improve microcirculation disorders,and its mechanism may be related to reducing glomerular and renal tubulointerstitial lesions.