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目的:观察加味升降散联合针灸对肥胖相关性肾病(obesityrelatedglomerulopathy,ORG)患者胰岛素抵抗(insulinresistance,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20mg,替米沙坦片80mg,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(bodymassindex,BMI)、血肌酐(serumcreatinine,Scr)、血糖(glucose,Glu)、血总胆固醇(totalcholesterol,TC)、三酰甘油(triacylglycerol,TG)、高密度脂蛋白胆固醇(highdensitylipoproteincholesterol,HDLC)、低密度脂蛋白胆固醇(lowdensity lipoproteincholesterin,LDLC)、24小时尿蛋白、胰岛素(Insulin)及胰岛素抵抗指数(homeostasismodelassessmentinsulinresistanceindex,HOMAIR)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、LDLC、24小时尿蛋白、Insulin及HOMAIR,升高HDLC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、LDLC、24小时尿蛋白、Insulin及HOMAIR,升高HDLC,效果显著。
Objective: To observe the effect of Jiawei Shengjiang San combined with acupuncture on insulin resistance (IR) in obesity-related glomerular disease (ORG). Methods: A total of 127 patients who met the diagnostic criteria were randomly divided into treatment group and control group. The control group received atorvastatin calcium 20mg and telmisartan 80mg once daily, (BMI), serum creatinine (Scr), glucose (Glu), total cholesterol (TC), total cholesterol (total cholesterol) TG, HDL-C, LDL-C, 24-hour urinary protein, Insulin and insulin resistance index homeostasismodelassessment insulinre distanceindex, HOMA IR) changes. Results: The effective rate of the treatment group was 88.9%, the control group was 68.8%, the difference was statistically significant (P <0.05), compared with before treatment, the two groups in reducing BMI, TC, TG, LDL C , 24-hour urine protein, Insulin and HOMA-IR, elevated HDL C were improved compared with the control group, the treatment group improved more significantly (P <0.05). Conclusion: Modified Shengjiang Powder combined with acupuncture treatment of obesity-related renal disease patients can reduce BMI, TC, TG, LDL C, 24-hour urine protein, Insulin and HOMA IR, elevated HDL C, the effect is significant.