调理脾胃法对糖尿病肾病患者淋巴细胞损伤的修复  

Clinical observation on repair of lymphocyte injury in patients with diabetic nephropathy treated by regulating spleen-stomach needling

作　　者：张智龙[1] 赵淑华[2] 李鑫[3] 杨元庆[1] 陈宏[1] 王漫[1] 

机构地区：[1]天津市中医药研究院附属医院针灸科,天津300120 [2]天津中医药大学第二附属医院 [3]天津市北辰区中医院

出　　处：《中国针灸》2013年第12期1065-1070,共6页Chinese Acupuncture & Moxibustion

基　　金：天津市北辰区科委发展计划项目:bswc 2010-1

摘　　要：目的:观察调理脾胃针法对糖尿病肾病(diabetic nephropathy,DN)患者的治疗作用及作用机制。方法:采用多中心、随机对照、盲法原则,将144例DN患者按随机数字表法分为观察组和对照组,每组72例。在常规糖尿病治疗的基础上,观察组采用调理脾胃针法,取中脘、曲池、合谷、血海等穴;对照组参照《针灸学》教材取肾俞、太溪、三阴交、阳陵泉等穴,两组均每日治疗2次,6天为一疗程,休息1天后,继续第2个疗程,共治疗6周。观察两组DN患者治疗前后的临床症状体征、血糖(FBG)、尿白蛋白排泄率(UAER)、尿微球蛋白(β2-MG)、血单核细胞趋化蛋白-1(MCP-1)、淋巴细胞膜胆固醇、丙二醛(MDA)、羰基(PCO)、8-羟基脱氧鸟苷(8-OHdG)、超氧化物歧化酶(SOD)及CD+3、CD+4、CD+8、CD+4/CD+8的变化情况。结果:在改善临床症状、体征等方面,观察组总有效率84.29%(59/70),对照组55.56%(40/72),两组比较差异有统计学意义(P<0.01);两组在调节DN患者的糖代谢[(6.25±0.32)mmol/L vs(8.09±0.63)mmol/L]、降低尿蛋白排泄率[(154.43±55.14)mg/24hvs(268.91±77.65)mg/24h]、抑制MCP-1过度表达[(137.59±36.15)pg/mL vs(166.89±42.82)pg/mL]、调整氧化应激水平、抑制细胞内蛋白的氧化、调节T淋巴细胞亚群数量及活性异常等方面,观察组均优于对照组(P<0.05,P<0.01)。结论:调理脾胃针法可改善糖代谢异常造成的进行性肾损害。其作用机制可能是针刺可改善DN患者肾小球的滤过功能,降低其尿蛋白排泄率,抑制MCP-1过度表达,调整氧化应激水平,抑制细胞内蛋白的氧化,增加膜的保护性,调节T淋巴细胞亚群数量及活性异常,从而修复淋巴细胞损伤,改善淋巴细胞免疫表达,因而延缓了肾损害。Objective To explore therapeutic effect and action mechanism of regulating spleen-stomach needling on diabetic nephropathy （DN）. Methods Using multi-centric, randomized, controlled and blind principles, 144 cases of DN were divided into an observation group and a control group according to random digital tab, 72 cases in each one. Based on regular treatment of diabetes, the regulating spleen-stomach needling was applied at Zhongwan （CV 12）, Quchi （LI 11）, Hegu （LI 4） and Xuehai （SP 10）, etc. in the observation group while Shenshu （BL 23）, Taixi （KI 3）, Sanyinjiao （SP 6）, Yanglingquan （GB 34）, etc. were selected in the control group by refer- ence of Acupuncture and moxibustion. The treatment was given twice a day, six days as a treatment session with interval of one day between sessions. Totally six weeks were required. Changes of clinical symptoms and signs, fast blood glucose （FBG）, urinary albumin excretion rate （UAER）, β2-microglobulin （β2-MG）, monocyte chemo- tactic protein-1 （MCP-1）, lymphocyte membrane cholesterol, propanediol （MDA）, PCO, 8-hydroxydeoxy guanosine （8-OHdG）, superoxide dismutase （SOD）, CD3＋ , CD4＋ , CD8＋ , and CD4＋/CD8＋ were observed before and after treatment in two groups. Results As for improving clinical symptoms and signs, total effective rate was 84.29%（59/70） in the observation group and 55.56%（40/72） in the control group, which had statistical difference between two groups （P〈0.01）. As for regulating glycometabolism [（6.25±0.32） mmol/L vs （8. 09±0.63） mmol/L], reducing UAER [（154.43±55.14） mg/24h vs （268.91±77.65） mg/24h], restraining over-expression of MCP-1 [（137.59± 36.15） pg/mL vs （166.89±42.82） pg/mL], regulating level of oxidative stress, prohibiting oxidation of protein and ad justing quantity and activity of T lymphocyte subgroup, the observation group was superior to the control group （P~ 0.05, P^0.01）. Conclusion The regulating spleen-stomach needling

关 键 词：糖尿病肾病 针灸疗法 淋巴细胞损伤 免疫损伤 调理脾胃针法 

分 类 号：R246.1[医药卫生—针灸推拿学]