赵海京 张秀媛 倪青 桂建华

摘要 目的：觀察针灸辅助治疗肥胖相关性肾病的效果及对患者糖脂代谢的影响。方法：选取2015年9月至2017年6月北京中医医院顺义医院收治的肥胖相关性肾病患者100例作为研究对象进行回顾性分析，根据治疗方法的不同分为对照组和观察组，每组50例。对照组给予基础西医疗法，观察组在对照组基础上给予针灸辅助加味升降散治疗，2组均治疗3个月。比较2组治疗后的临床疗效;比较2组治疗前后的糖脂代谢、肾功能、炎症介质变化。结果：治疗3个月后，观察组总有效率为94.00%，高于对照组的80.00%（P<0.05）。治疗3个月后，2组血清血糖（Glu）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）及24 h尿蛋白水平均较治疗前降低，且观察组低于对照组（P<0.01）;而2组血清HDL-C水平均较治疗前升高，且观察组高于对照组（P<0.01）。结论：对肥胖相关性肾病患者辅以针灸治疗可明显改善其临床症状，减轻机体炎症反应，纠正其糖脂代谢紊乱状态，效果佳。

关键词 针灸;肥胖相关性肾病;糖脂代谢;炎症介质;效果

Clinical Effect of Acupuncture and Moxibustion on Glucose and Lipid Metabolism in Obesity Related Nephropathy Patients

ZHAO Haijing1，2，ZHANG Xiuyuan1，NI Qing3，GUI Jianhua1

（1 Department of Endocrinology，Beijing Hospital of Traditional Chinese Medicine Shunyi Branch，Beijing 101300，China; 2 Beijing University of Chinese Medicine，Beijing 101300，China; 3 Department of Endocrinology，Guang′anmen Hospital，China Academy of Chinese Medical Sciences，Beijing 100053，China）

Abstract Objective：To investigate the effect of acupuncture and moxibustion on glucose and lipid metabolism in the treatment of obesity related nephropathy.Methods：A retrospective study was conducted in 100 patients with obesity related nephropathy treated in Beijing Hospital of Traditional Chinese Medicine Shunyi Branch between September 2015 and June 2017.According to different treatment methods，the enrolled patients were divided into an observation group and a control group，with 50 cases in each group.The control group was given basic Western medicine therapy，while the observation group was given basic Western medicine therapy with acupuncture and moxibustion as auxiliary treatment.Both groups were treated for 3 months.The clinical effects of the 2 groups after 3 months of treatment were statistically analyzed.The glucose，lipid metabolism，renal function and inflammatory factors changes between the two groups before and after 3 months of treatment were compared.Results：After 3 months of treatment，compared with the control group，the total effective rate of the observation group was higher（94.00% vs 80.00%，P<0.05）.After 3 months of treatment，the serum Glu，TC，LDL-C，IL-6，TNF-α and 24 h urine protein levels in the 2 groups were lower than those before treatment，and the observation group were lower than the control group（P<0.01）.While the serum HDL-C levels in the 2 groups were higher than those before treatment，and the observation group was higher（P<0.01）.Conclusion：The combined acupuncture and moxibustion therapy for patients with obesity related nephropathy can obviously alleviate the clinical symptoms，reduce the inflammatory reaction of the body and correct the disorder of glycolipid metabolism state effectively.

Keywords Acupuncture and moxibustion; Obesity related nephropathy; Glycolipid metabolism; Inflammatory factors; Effect

中图分类号：R256.5;R259;R245文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.04.024

肥胖相关性肾病于1974年被首次提出，是以肥胖、高血压、蛋白尿及高脂血症为主要临床表现，目前，随着全球肥胖人数的增多，使得该病的患病率逐年攀升[1-2]。以往临床对肥胖相关性肾病患者主要采用西医药物进行治疗，但部分患者效果不佳，甚者可出现多种不良反应。随着中医对肥胖相关性肾病研究的不断深入，中医理论认为，依据肥胖相关性肾病的临床症状應归属“肥胖”“尿浊”“精微下泄”以及“虚劳”等范畴[3]，多因脾胃虚弱、行气不畅使得湿浊内停所致，亦有文献记载，该病与饮食不节、先天禀赋不足等多因素有关[4]。有学者报道，加味升降散可发挥显著的健脾胃、行气血、祛痰湿等作用，针灸则能够通经络、调气机[5]。本研究对纳入的肥胖相关性肾病患者在常规西药治疗基础上给予针灸辅助加味升降散治疗，以观察其对患者糖脂代谢状态的调节作用。……