【摘要】 目的：探讨早期糖尿病肾病患者应用当归四逆四妙方及针刺治疗的效果与安全性。方法：回顾性分析广州医科大学附属中医医院肾病风湿科、内分泌科2023年1月—2024年3月收治的112例早期糖尿病肾病患者的临床资料，根据患者治疗方法不同将其分为中医治疗组和常规治疗组，各56例。常规治疗组给予西医常规疗法，中医治疗组在常规治疗组基础上联合当归四逆四妙方及针刺治疗。比较两组患者的临床疗效，治疗期间血糖异常率，治疗前后中医证候总积分变化、尿白蛋白/肌酐比值(UACR)、内生肌酐清除率(Ccr)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)，不良反应发生情况。结果：中医治疗组的总有效率高于常规治疗组，治疗期间血糖异常率低于常规治疗组，差异均有统计学意义(P<0.05)。两组患者治疗前中医证候总积分、UACR及Ccr、IL-6、TNF-α比较，差异均无统计学意义(P>0.05)；两组治疗后各项指标均较治疗前改善，中医治疗组各项指标均优于常规治疗组，差异均有统计学意义(P<0.05)。中医治疗组、常规治疗组患者的不良反应率分别为1.79%、3.57%，差异无统计学意义(P>0.05)。结论：当归四逆四妙方联合针刺治疗早期糖尿病肾病临床效果良好，可改善患者症状及肾功能，降低机体炎症因子，不良反应少，治疗安全、可靠。更多还原

【Abstract】 Objective:To investigate the efficacy and safety of Danggui Sini Simiao Prescription and acupuncture in the treatment of early diabetic nephropathy patients.Method:The clinical data of 112 patients with early diabetes nephropathy admitted to the Department of Nephrology and Rheumatology and the Department of Endocrinology of the Affiliated Traditional Chinese Medicine Hospital,Guangzhou Medical University from January 2023 to March 2024 were retrospectively analyzed.According to the different treatment methods of patients,they were divided into the traditional Chinese medicine treatment group and the conventional treatment group,with 56 cases in each group.The conventional treatment group received western medicine conventional therapy,while the traditional Chinese medicine treatment group received a combination of Danggui Sini Simiao Prescription and acupuncture treatment on the basis of the conventional treatment group.The clinical efficacy,abnormal blood glucose rate during treatment,changes in total score of traditional Chinese medicine (TCM) syndromes before and after treatment,urinary albumin/creatinine ratio (UACR),endogenous creatinine clearance rate (Ccr),interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α),and incidence of adverse reactions between two groups of patients were compared.Result:The total effective rate of the traditional Chinese medicine treatment group was higher than that of the conventional treatment group,and the abnormal blood glucose rate during the treatment period was lower than that of the conventional treatment group,the differences were statistically significant (P<0.05).Before treatment,there were no statistically significant differences in the total score of TCM syndromes,UACR and Ccr,IL-6,and TNF-α between the two groups of patients (P>0.05);after treatment,all indicators in both groups improved compared with those before treatment,all indicators in the traditional Chinese medicine treatment group were better than those in the conventional treatment group,the differences were statistically significant (P<0.05).The adverse reaction rates of patients in the traditional Chinese medicine treatment group and the conventional treatment group were 1.79% and 3.57% respectively,the difference was not statistically significant (P>0.05).Conclusion:The combination of Danggui Sini Simiao Prescription with acupuncture in the treatment of early diabetic nephropathy has a good clinical effect,it can improve the symptoms and renal function of patients,reduce inflammatory factors in the body,has few adverse reactions,and is safe and reliable for treatment.更多还原