加味升降散联合针灸对肥胖相关性肾病患者胰岛素抵抗的影响  

Effect of Modified Shengjiang Powder Combined with Acupuncture on Insulin Resistance in Patients with Obesity Related Nephropathy

作　　者：贾军利[1] 郝玉杰 王秀梅 殷小文 张淑丽 郭红辉 董燕飞 田力铭 王运红 张佩星 JIA Junli HAO Yujie WANG Xiumei YIN Xiaowen ZHANG Shuli GUO Honghui DONG Yanfei TIAN Liming WANG Yunhong ZHANG Peixing(The Second Affiliated Hospital to Hebei North University, Zhangjiakou Hebei China 075100 The People＇s Hospital of Qian＇an City, Qian＇an Hebei China 064400 Traditional Medical Hospital of Qian＇an City, Qian＇an Hebei China 064400)

机构地区：[1]河北北方学院附属第二医院,河北张家口075100 [2]迁安市人民医院,河北迁安064400 [3]迁安市中医医院,河北迁安064400

出　　处：《中医学报》2017年第7期1333-1336,共4页Acta Chinese Medicine

基　　金：河北省科技厅基金项目(12277789)

摘　　要：目的:观察加味升降散联合针灸对肥胖相关性肾病(obesity related glomerulopathy,ORG)患者胰岛素抵抗(insulin resistance,IR)的影响。方法:将符合诊断标准的127例患者随机分为治疗组和对照组,对照组予阿托伐他汀钙片20 mg,替米沙坦片80 mg,均每日1次,口服;治疗组予加味升降散联合针灸的方法,连续治疗3个月,比较两组治疗前后体质量指数(body mass index,BMI)、血肌酐(serum creatinine,Scr)、血糖(glucose,Glu)、血总胆固醇(total cholesterol,TC)、三酰甘油(triacylglycerol,TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterin,LDL-C)、24小时尿蛋白、胰岛素(Insulin)及胰岛素抵抗指数(homeostasis model assessment-insulin resistance index,HOMA-IR)的变化。结果:治疗组有效率88.9%,对照组有效率68.8%,两组比较,差异有统计学意义(P<0.05),相比于治疗前,两组在降低BMI、TC、TG、LDL-C、24小时尿蛋白、Insulin及HOMA-IR,升高HDL-C方面均有改善,与对照组相比,治疗组改善情况更显著(P<0.05)。结论:加味升降散联合针灸治疗肥胖相关性肾病患者,可降低BMI、TC、TG、LDL-C、24小时尿蛋白、Insulin及HOMA-IR,升高HDL-C,效果显著。Objective：To observe the effect of modified Shengjiang Powder combined with acupuncture on the index of insulin resistance about patients with obesity related nephropathy.Methods：127 cases of patients were randomly divided into the treatment group and the control group.The control group was given Atorvastatin Calcium Tablets 20mg,Telmisartan Tablets 80 mg,once a day;while the treatment group was treated with supplemented Shengjiang San combining with acupuncture.After three months continuous treatment,compared creatinine（Scr）,blood glucose（Glu）,serum total cholesterol（TC）,three glycerol（TG）,high density lipoprotein cholesterol（HDL-C）,low density lipoprotein cholesterol（LDL-C）,24 hour urinary protein,insulin and insulin resistance index（HOMA-IR）of the two groups before and after treatment.Results：The effective rate of two group was respectively 88.9%（treatment group）,68.8%（control group）.Compared with before treatment,two groups both had a certain degree improvement on those indexes,and improvement in the treatment group was significantly better than the control group（P〈0.05）.Conclusion：The therapeutic method of modified Shengjiang Powder combined with acupuncture can reduce the level of BMI,TC,TG,LDL-c,24 hours urine protein,insulin and HOMA-IR,and increase HDL-C.

关 键 词：肥胖相关性肾病 胰岛素抵抗 加味升降散 健脾利湿化浊法 针灸治疗 

分 类 号：R245.87[医药卫生—针灸推拿学]