| ObjectiveBased on the guidance of the theory of " Open,Close and Pivot",opening-closing sixqi acupuncture combined with Shenqi decoction and Zhenwu decoction treated the patients with spleen-kidney-yang deficiency syndrome of stage 3-4 of chronic kidney disease.The therapeutic effect of this therapy on the patients’ TCM syndrome and laboratory indexes is observed,so as to evaluate the clinical efficacy of this theory and provide experimental basis for the application of the theory of opening and fushe in the clinical application of TCM.Methods74 patients who met the criteria were enrolled and randomly divided into experimental group and control group according to 37 cases in each group.On the basis of antihypertensive,lipid-regulating and glucose-lowering treatments,the control group was treated with Shenqi decoction and Zhenwu decoction,and the experimental group was treated with opening-closing six-qi acupuncture combined with Shenqi decoction and Zhenwu decoction.The course of treatment was 4 weeks for a total of 8 weeks.Vital signs,Serum creatinine(Scr),blood urea nitrogen(BUN),estimated glomerular filtration rate(eGFR),cystatin C(CysC),serum uric acid(UA),high-sensitivity C-reactive protein(hsCRP),Albumin/Creatinine Ratio(ACR)and other laboratory indicators were measured before and after treatment.The improvement of TCM clinical symptoms and changes of syndrome score were observed.A database was established,and SPSS was used for statistical analysis.Results①A total of 2 patients were dropped out,and 72 effective cases were finally included,36 cases in the experimental group and 36 cases in the control group.There were no significant differences in gender,age and CKD stage between the two groups before treatment,which were comparable.②TCM syndromes:the total TCM syndrome score of the experimental group was lower than that of the control group,and the difference was statistically significant(P<0.05).The effective rate of TCM syndrome improvement in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.01).There were significant differences in TCM symptom scores between the two groups after treatment(P<0.01).There were significant differences in symptom scores of shortness of breath and lazy speech,waist and knee soreness,and waist cold pain between the two groups(P<0.05).③Laboratory indicators:Within the groups:with the extension of time,Scr,BUN,CysC,and ACR in the two groups were significantly decreased(P<0.01),and eGFR was significantly increased(P<0.01).The UA of the two groups at 4 and 8 weeks of treatment were significantly different from those before treatment(P<0.01),and there was no significant difference between 8 weeks of treatment and 4 weeks of treatment(P>0.05).At 4 weeks of treatment,there was no significant difference in hs-CRP compared with before treatment(P>0.05),and at 8 weeks of treatment,there was significant difference in hs-CRP between the two groups compared with before treatment(P<0.01).Between the groups:after 4 weeks of treatment,the ACR of the experimental group was significantly different from that of the control group(P<0.01).After 8 weeks of treatment,there were significant differences in Scr,BUN,CysC,eGFR,hs-CRP and urine ACR between the experimental group and the control group(P<0.01).④Total clinical efficacy:After 8 weeks of treatment,the total effective rate of the experimental group was 91.67%,and that of the control group was 72.22%,the difference between the two groups was statistically significant(P<0.01).ConclusionThe combination therapy of acupuncture and Chinese medicine based on the theory of"Open,Close and Pivot" can effectively reduce Scr,BUN,CysC and ACR,improve eGFR and improve TCM symptoms in patients with CKD stage 3-4 spleen-kidney Yang deficiency,and the curative effect is better than simple oral Chinese medicine.The clinical application is safe and has no adverse reactions,which is worthy of further promotion. |
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