艾灸神阙穴(CV8)、济生肾气丸联合西药对慢性肾脏病3~4期疗效及免疫功能的影响

Effect of moxibustion at Shenque(CV8),oral administration Jisheng Shenqi Pill and Western medicine on the efficacy and immune function of chronic kidney disease stage 3~4

关键词:  灸法  神阙  济生肾气丸  慢性肾脏病  慢性肾功能衰竭  脾肾阳虚  免疫功能

Key words:  moxibustion therapy  Shenque(CV8)  Jisheng Shenqi Pill  chronic kidney disease  chronic renal failure  yang-deficiency of spleen and kidney  immune function

摘要:

[目的] 观察艾灸神阙穴（CV8）、口服济生肾气丸联合西药对慢性肾脏病 3~4期中医辨证属脾肾阳虚证患者的临床疗效以及免疫功能的影响。[方法] 选取96例天水市中西医结合医院收治的确诊为慢性肾脏病3~4期、中医辨证属脾肾阳虚证患者，按照随机数字表法将患者分为两组，对照组给予口服复方α-酮酸等，观察组在此基础上艾灸神阙穴、口服济生肾气丸，疗程为8周，监测患者治疗前后的中医症状积分、血肌酐（Scr）、尿素氮（BUN）、内生肌酐清除率（Ccr）、24 h尿蛋白定量、免疫球蛋白IgG、IgA、IgM、T细胞亚群CD4⁺、CD8⁺、CD4⁺/CD8⁺变化。[结果] 治疗后，观察组各项症状积分显著低于治疗前（P<0.05），且低于对照组治疗后（P<0.05）；Scr、BUN、24 h尿蛋白定量下降水平及Ccr上升水平均优于治疗前及对照组治疗后（P<0.05）；观察组患者总有效率高于对照组，差异具有统计学意义（P<0.05）；观察组IgG、IgA、IgM、CD4⁺、CD4⁺/CD8⁺水平显著高于同组治疗前（P<0.05）。[结论] 艾灸神阙穴、口服济生肾气丸联合西药能有效缓解慢性肾脏病3~4期中医辨证属脾肾阳虚证患者的症状，改善患者肾功能及免疫功能。

Abstract:

[Objective] To investigate the effects of moxibustion at Shenque(CV8), oral administration Jisheng Shenqi Pills and Western medicine on the efficacy and immune function of chronic kidney disease stage 3~4 those of yang-deficiency of spleen and kidney.[Methods] The 96 cases with chronic kidney disease stage 3~4 those of yang-deficiency of spleen and kidney were selected in our hospital. The patients were divided into two groups according to the random number method. The control group was prescribed with oral administration of compound α-ketoacid tablets and so on. On this basis, the treatment group was increased by moxibustion at Shenque (CV8) and oral administration Jisheng Shenqi Pills. The course of treatment was 8 weeks. Traditional Chinese medicine (TCM) symptom score, clinical efficacy, the changes of serum creatinine(Scr), urea nitrogen (BUN), endogenous creatinine clearance rate (Ccr), 24 h urinary protein quantitative, IgG, IgA, IgM, CD4⁺, CD8⁺, CD4⁺/CD8⁺ in two groups of patient were compared before and after treatment.[Results] After treatment, the score of TCM symptom were significantly lower than that before treatment in treatment group and after treatment in control group (P<0.05).The levels of Scr, BUN and 24-hour urinary protein quantitative in the treatment group were lower than those in the control group, and the Ccr level was higher than that in the control group (P<0.05). The total effective rate in treatment group was significantly better than the control group, the difference was statistically significant (P<0.05). The IgG, IgA, IgM, CD4⁺, CD8⁺, CD4⁺/CD8⁺ levels in treatment group were higher than the levels before treatment (P<0.05).[Conclusion] Moxibustion at Shenque(CV8), oral administration Jisheng Shenqi Pills and Western medicine can improve the effect of symptoms and renal function of patients with chronic kidney disease stage 3~4 those of yang-deficiency of spleen and kidney, and strengthen immunity.