针刺联合芪参解毒汤加减治疗脓毒症急性肾损伤的临床观察  

Clinical Observation of Acupuncture Combined with Qishen Jiedu Decoction in the Treatment of Septic Acute Kidney Injury

作　　者：宋妮 刘超 齐欢[1] 游越[2] SONG Ni;LIU Chao;QI Huan;YOU Yue(Dept.of Nephrology,Qinhuangdao Traditional Chinese Medicine Hospital,Qinhuangdao 066000 Hebei,China;Dept.of Rheumatology,Qinhuangdao Traditional Chinese Medicine Hospital,Qinhuangdao 066000 Hebei,China)

机构地区：[1]秦皇岛市中医医院肾病科,河北秦皇岛066000 [2]秦皇岛市中医医院风湿科,河北秦皇岛066000

出　　处：《广州中医药大学学报》2022年第12期2823-2828,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：秦皇岛市科学技术局资助项目(编号:201902A133)。

摘　　要：【目的】观察针刺联合芪参解毒汤加减治疗脓毒症急性肾损伤(AKI)的临床疗效。【方法】将80例脓毒症AKI患者随机分为观察组和对照组,每组各40例。2组均给予内科常规处理,对照组给予芪参解毒汤加减治疗,观察组在对照组治疗的基础上,联合针刺治疗。治疗1周为1个疗程,连续治疗7 d。治疗1周后,评价2组临床疗效,观察2组患者治疗前后急性生理学与慢性健康状况评分(APACHEⅡ)的变化情况,以及全身感染相关性器官功能衰竭评分(SOFA)的情况;比较2组患者治疗前后血尿素氮(BUN)、血肌酐(Scr)水平的变化情况;并记录2组患者住院时间。治疗结束后,随访28 d,记录2组患者死亡情况,并计算28 d病死率。【结果】(1)治疗7 d后,2组患者APACHEⅡ评分及SOFA评分均明显改善(P<0.05),且观察组在改善APACHEⅡ评分及SOFA评分方面均明显优于对照组,差异均有统计学意义(P<0.05)。(2)治疗后,2组患者BUN及Scr水平均明显改善(P<0.05),且观察组在改善BUN及Scr水平方面均明显优于对照组,差异均有统计学意义(P<0.05)。(3)观察组总有效率为87.50%(35/40),对照组为75.00%(30/40)。观察组疗效稍优于对照组,但差异无统计学意义(P>0.05)。(4)观察组住院时间更短,与对照组比较,差异有统计学意义(P<0.001)。随访28 d,2组病死率相比较,差异无统计学意义(P>0.05)。【结论】针刺联合芪参解毒汤加减治疗脓毒症AKI,可明显缩短患者生理功能恢复时间,促进肾功能快速恢复。Objective To observe the clinical efficacy of acupuncture combined with Qishen Jiedu Decoction in the treatment of septic acute kidney injury(AKI).Methods A total of 80 patients with septic AKI were randomly divided into the observation group and the control group,with 40 cases in each group.The control group was treated with Qishen Jiedu Decoction,while the observation group was treated with acupuncture on the basis of the treatment of the control group.The treatment lasted for 7 days for one week as a course of treatment.After one week of treatment,the clinical efficacy of the two groups was evaluated,and the changes of acute physiology and chronic health evaluation systemⅡ(APACHEⅡ)and sepsis-related organ failure assessment(SOFA)were observed in the two groups before and after treatment.The changes of blood urea nitrogen(BUN)and serum creatinine(Scr)levels were compared between the two groups before and after treatment.After treatment,the patients were followed up for 28 days,and the death rate of the two groups was recorded,and the 28-day mortality rate was calculated.Results(1)After 7 days of treatment,APACHEⅡscore and SOFA score of the two groups were significantly improved(P<0.05),and the improvement of APACHEⅡscore and SOFA score of the observation group was significantly superior to that of the control group,the differences being statistically significant(P<0.05).(2)After treatment,the levels of BUN and Scr in the two groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving the levels of BUN and Scr,the differences being statistically significant(P<0.05).(3)The total effective rate was 87.50(35/40)in the observation group and 75.00%(30/40)in the control group.The efficacy of observation group was slightly superior to that of control group,the difference being not statistically significant(P>0.05).(4)The hospital stay in the observation group was shorter than that in the control group,the difference being statistically signif

关 键 词：芪参解毒汤加减 针刺 脓毒症 急性肾损伤 肾功能 临床观察 

分 类 号：R246.9[医药卫生—针灸推拿学]