Regulating and tonifying spleen and kidney traditional Chinese medicine in the treatment of chronic uric acid nephropathy: A systematic review

Objective:To systematically evaluate the efficacy and safety of traditional Chinese medicine for regulating spleen and kidney.Methods:We developed a search strategy and then retrieved the database including CNKI,Wanfang data knowledge service platform,VIP journals resource integration service platform,PubMed,Embasefor randomized controlled trial of regulating spleen and kidney traditional Chinese medicine compared with conventional western medicine in the treatment of chronic uric acid nephropathy.The search deadline was set to June 30,2020.For the included literature,we applied the cochrane collaboration network risk bias assessment tool to evaluate the methodological quality,and evaluated the level of evidence according to GRADE standards.Quantitative data was analyzed by RevMan5.3 software,and trial sequential analysis method was used to analyze its efficiency.Results:A total of 709 cases in 10 articles were included.Compared with the control group,the related traditional Chinese medicine group improved the effective rate[RR=1.45,95%CI(1.32,1.58)],reduced the level of UA[MD=-36.24,95%CI(-41.03,-31.45)],BUN[SMD=-1.27,95%CI(-1.47,-1.07)]and SCR[MD=-36.33,95%CI(-55.79,-16.87),P=0.0003],the difference between the two groups was statistically significant(P<0.05).There was no evidence that a significant adverse reaction occurred.The results of TSA analysis showed that the Chinese medicine group had definite evidence for improving the efficiency.According to the GRADE evaluation criteria,the efficiency,UA,BUN and SCR outcome indicators were extremely low-quality evidence.Conclusions:Traditional Chinese medicine for regulating spleen and kidney in the treatment of chronic uric acid nephropathy improved efficiency,reduced the level of UA,BUN,SCR.Meanwhile,the therapy was proved to be safe.Nevertheless,the conclusions need further high-quality evidence to support.

通调三焦针刺法配合围刺治疗女性黄褐斑的临床研究

目的:观察通调三焦针刺法配合围刺治疗女性黄褐斑的临床疗效及对患者生活质量的影响。方法:将60例女性黄褐斑患者随机分为针刺组和药物组,每组各30例,针刺组予以针刺治疗,主穴取膻中、中脘、天枢、气海、关元、水道、归来加局部围刺,每天1次,前两周每周5次,随后6周隔日1次,共治疗8周。药物组用维生素C和维生素E口服,连续服用8周。采用评分表观察患者治疗前后皮损评分、总积分及下降指数;治疗前后月经评分、精神状况的改善情况。结果:两组治疗前后的皮损积分差异有统计学意义(P<0.01),治疗后针刺组皮损评分低于药物组(P<0.05)。治疗后针刺组的月经评分比治疗前显著降低,差异有统计学意义(P<0.01),药物组变化无统计学意义(P>0.05)。治疗后针刺组的HAMA、HAMD、SDS评分显著降低,差异有统计学意义(P<0.01);药物组SDS评分降低,差异有统计学意义(P<0.05)。针刺组总有效率为93.3%,药物组为73.3%,针刺组疗效优于药物组,差异具有统计学意义(P<0.05)。结论:通调三焦针刺法配合围刺可明显改善女性黄褐斑患者的临床症状,提高患者的生活质量,总体疗效优于口服药物。

补肾调三焦法治疗盘源性腰痛急性期的临床疗效观察

【目的】探讨关宏刚教授基于中医藏象学说和脏腑别通理论的补肾调三焦法治疗盘源性腰痛急性期的临床疗效。【方法】将90例盘源性腰痛急性期患者随机分为治疗组和对照组,每组各45例。2组患者均给予中药玉龙散外敷及常规对症处理,在此基础上,对照组给予口服止痛药塞来昔布治疗,治疗组给予补肾调三焦法的中药方剂治疗,疗程为2周,并随访1个月。观察2组患者治疗前后及治疗后1个月末次随访时疼痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)评分的变化情况,并评价2组患者的疗效及安全性。【结果】(1)研究过程中,有3例患者退出,2例患者失访,最终有85例患者完成试验,其中治疗组43例,对照组42例。(2)治疗后1个月,治疗组与对照组的总有效率分别为88.4%和78.6%,治疗组的疗效明显优于对照组(P<0.05)。(3)治疗1周和2周后,2组患者的VAS评分和ODI评分均较治疗前明显降低(P<0.05),但组间比较,差异均无统计学意义(P>0.05);治疗后1个月,2组患者VAS评分和ODI评分仍较治疗前明显降低(P<0.05),且治疗组对VAS评分和ODI评分的降低作用均明显优于对照组(P<0.05)。(4)试验过程中,除3例患者皮肤对玉龙散过敏而暂停使用外,其余患者均未发现有明显不良反应。【结论】在外敷玉龙散及常规对症处理的基础上,应用补肾调三焦法治疗盘源性腰痛急性发作的短期疗效良好,能有效缓解患者疼痛,改善患者腰部功能,其作用优于采用西药治疗的对照组。