Mao Jing-Yu, Yang Feng-Wen, Liu Hao, Gao Fei, Yang Bing, Zhang Yao, Tan Miao, Chen Su-Zhi, Yuan Guo-Dong, Zhao Mei-Jiao, Kong Yi-Ran, Tan Jin-Chuan
Graduate School of Hebei University of CM, Shijiazhuang 050200, China.
First Department of Nephrology, First Affiliated Hospital of Hebei University of CM, Shijiazhuang 050011.
Zhongguo Zhen Jiu. 2021 Nov 12;41(11):1216-20. doi: 10.13703/j.0255-2930.20200907-0005.
To compare the effect of moxibustion combined with basic treatment and simple basic treatment on the clinical symptoms, renal function and hypercoagulable state in patients with idiopathic membranous nephropathy (IMN) of low to medium risk with spleen-kidney deficiency and blood stasis.
A total of 60 patients with IMN of low to medium risk with spleen-kidney deficiency and blood stasis were randomized into an observation group (30 cases, 2 cases dropped off) and a control group (30 cases, 1 case dropped off). In the control group, the conventional basic treatment of anti-hypertension, regulating blood lipid and anti-coagulation was adopted. On the basis of the control group, moxibustion was applied at Shenshu (BL 23), Pishu (BL 20), Guanyuan (CV 4), Zusanli (ST 36) and Sanyinjiao (SP 6) in the observation group, once a day, 5 days a week continuously with 2 day interval. The treatment of 6 months was required in the both groups. Before treatment and 3 and 6 months into treatment, the total TCM syndrome score, the renal function indexes (24-hour urinary protein quantity [UTP], albumin [ALB], urea nitrogen [BUN] and creatinine [Scr]), the blood coagulation indexes (fibrinogen [FIB], D-Dimer [D-D], p-selection and von Willebrand factor [vWF]), total cholesterol (TC) and triacylglycerol (TG) levels were observed, and the therapeutic efficacy was evaluated on 3 and 6 months into treatment in the two groups.
The effective rates of 3 and 6 months into treatment were 78.6% (22/28) and 89.3% (25/28) in the observation group, which were higher than 62.1% (18/29) and 75.9% (22/29) in the control group respectively (<0.05). On 3 and 6 months into treatment, the total TCM syndrome scores were decreased compared before treatment in the both groups (<0.05), and those in the observation group were lower than the control group (<0.05). On 3 months into treatment, the levels of UTP, FIB, D-D, P-selection and vWF were decreased (<0.05), the level of ALB was increased (<0.05) compared before treatment in the observation group; the levels of UTP and FIB were decreased compared before treatment in the control group (<0.05); the level of ALB in the observation group was higher than that in the control group (<0.05), the levels of FIB and vWF in the observation group were lower than those in the control group (<0.05). On 6 months into treatment, the levels of UTP, FIB, D-D, P-selection, vWF, TC and TG were decreased (<0.05), the levels of ALB were increased (<0.05) compared before treatment in the both groups (<0.05); the levels of UTP, FIB, D-D, P-selection, vWF, TC and TG in the observation group were lower than those in the control group, the level of ALB in the observation group was higher than that in the control group (<0.05).
Moxibustion combined with basic treatment can effectively improve the clinical symptoms, renal function and renal microcirculation in patients with idiopathic membranous nephropathy of low to medium risk with spleen-kidney deficiency and blood stasis, the therapeutic effect is superior to the simple basic treatment.
比较艾灸联合基础治疗与单纯基础治疗对脾肾亏虚兼血瘀型中低风险特发性膜性肾病(IMN)患者临床症状、肾功能及高凝状态的影响。
将60例脾肾亏虚兼血瘀型中低风险IMN患者随机分为观察组(30例,脱落2例)和对照组(30例,脱落1例)。对照组采用抗高血压、调节血脂及抗凝的常规基础治疗。观察组在对照组基础上,艾灸肾俞(BL 23)、脾俞(BL 20)、关元(CV 4)、足三里(ST 36)和三阴交(SP 6),每日1次,每周连续5天,间隔2天。两组均需治疗6个月。在治疗前及治疗3个月、6个月时,观察中医证候总积分、肾功能指标(24小时尿蛋白量[UTP]、白蛋白[ALB]、尿素氮[BUN]和肌酐[Scr])、凝血指标(纤维蛋白原[FIB]、D-二聚体[D-D]、p-选择素和血管性血友病因子[vWF])、总胆固醇(TC)和三酰甘油(TG)水平,并在治疗3个月、6个月时评估两组的治疗效果。
观察组治疗3个月、6个月时的有效率分别为78.6%(22/28)和89.3%(25/28),分别高于对照组的62.1%((18/29))和75.9%(22/29)((<0.05))。治疗3个月、6个月时,两组中医证候总积分均较治疗前降低((<0.05)),且观察组低于对照组((<0.05))。治疗3个月时,观察组UTP、FIB、D-D、p-选择素和vWF水平较治疗前降低((<0.05)),ALB水平升高((<0.05));对照组UTP和FIB水平较治疗前降低((<0.05));观察组ALB水平高于对照组((<0.05)),观察组FIB和vWF水平低于对照组((<0.05))。治疗6个月时,两组UTP、FIB、D-D、p-选择素、vWF、TC和TG水平均较治疗前降低((<0.05)),ALB水平升高((<0.05));观察组UTP、FIB、D-D、p-选择素、vWF、TC和TG水平低于对照组,观察组ALB水平高于对照组((<0.05))。
艾灸联合基础治疗能有效改善脾肾亏虚兼血瘀型中低风险特发性膜性肾病患者的临床症状、肾功能及肾脏微循环,治疗效果优于单纯基础治疗。