艾灸联合中药治疗糖尿病肾病的疗效观察OA
Observation on the efficacy of moxibustion plus Chinese herbal medicine for diabetic nephropathy
目的 观察艾灸联合保元固本汤加减治疗Ⅲ和Ⅳ期糖尿病肾病的临床疗效及对患者肠道菌群及肾纤维化的影响.方法 将 159 例糖尿病肾病患者随机分为艾灸组、中药组和联合组,每组 53 例.3 组均接受常规治疗,艾灸组另给予艾灸治疗,中药组另给予口服保元固本汤加减治疗,联合组另给予艾灸联合口服保元固本汤加减治疗.观察 3 组治疗前后肾功能指标[血肌酐、尿β2 微球蛋白、24 h 尿蛋白定量和尿微量蛋白水平]、肾血流指标[段间动脉搏动指数、段间动脉和叶间动脉血流阻力指数以及肾舒张末期的血流速度]以及肾纤维化指标[Ⅲ型胶原、Ⅲ型前胶原、血小板衍生生长因子和结缔组织生长因子水平]的变化,比较3 组临床疗效.结果 联合组总有效率为 98.0%,高于艾灸组的70.0%和中药组的 86.8%,差异有统计学意义(P＜0.05).治疗后,联合组血肌酐、24 h尿蛋白定量、尿微量蛋白、肾段间动脉和叶间动脉搏动指数、段间动脉搏动指数、Ⅲ型胶原、Ⅲ型前胶原、血小板衍生生长因子、结缔组织生长因子的水平均低于艾灸组和中药组(P＜0.05),联合组尿β2 微球蛋白、肾舒张末期的血流速度均高于艾灸组和中药组(P＜0.05).结论 在常规治疗基础上,艾灸联合保元固本汤加减治疗Ⅲ和Ⅳ期糖尿病肾病的临床疗效优于单纯艾灸治疗和单纯口服保元固本汤加减治疗,可明显改善患者的肾功能,提高肾血流速度,缓解肾纤维化.
Objective To observe the clinical efficacy of moxibustion plus modified Bao Yuan Gu Ben decoction for stage Ⅲ and Ⅳ diabetic nephropathy and its effect on intestinal flora and renal fibrosis in the patients.Method One hundred and fifty-nine patients with diabetic nephropathy were randomized to a moxibustion group,a Chinese herbal medicine group and a combination group,with 53 cases in each group.All groups received conventional treatment.In addition,the moxibustion group received moxibustion treatment;the Chinese herbal medicine group received oral administration of modified Bao Yuan Gu Ben decoction;the combination group received moxibustion plus modified Bao Yuan Gu Ben decoction.Renal function indicators(blood creatinine,urine β2-microglobulin,24-hour urine protein quantification and urine microalbumin),renal blood flow indicators(intersegmental artery pulsation index,intersegmental and interlobar artery blood flow resistance index and end-diastolic renal blood flow velocity)and renal fibrosis indicators(type Ⅲ collagen,type Ⅲ procollagen,platelet-derived growth factor and connective tissue growth factor)were observed in the three groups before and after treatment.The clinical therapeutic effects were compared between the three groups.Result The total efficacy rate was 98.0%in the combination group,which was higher than 70.0%in the moxibustion group and 86.8%in the Chinese herbal medicine group with statistically significant differences(P＜0.05).After treatment,blood creatinine,24-hour urine protein quantification,urine microalbumin,renal intersegmental and interlobar artery pulsation index,intersegmental artery pulsation index,type Ⅲ collagen,type Ⅲ procollagen,platelet-derived growth factor and connective tissue growth factor were lower and urine β2-microglobulin and end-diastolic renal blood flow velocity were higher in the combination group than in the moxibustion and Chinese herbal medicine groups(P＜0.05).Conclusion On the basis of conventional treatment,moxibustion plus modified Baoyuan Guben decoction is clinically more effective than moxibustion or oral administration of modified Bao Yuan Gu Ben decoction alone in treating stage Ⅲ and Ⅳ diabetic nephropathy.It can markedly improve renal function,increase renal blood flow velocity and alleviate renal fibrosis in patients.
鲁燕;郭存霞;张国胜;张娟
河南省中医院,郑州 450002河南省中医院,郑州 450002河南省中医院,郑州 450002河南省中医院,郑州 450002
医药卫生
灸法糖尿病肾病肾功能肾纤维化肠道菌群血液流变学
Moxibustion therapyDiabetic nephropathyRenal functionRenal fibrosisIntestinal floraHemorheology
《上海针灸杂志》 2026 (4)
403-409,7
河南省中医药科学研究专项课题(2024ZY2056)
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