Clinical Study on Warming Moxibustion at Points Combined with Jianpi Yishen Prescription for Patients with Spleen- Kidney Yang Deficiency Syndrome Undergoing Continuous Ambulatory Peritoneal Dialysis
Abstract: Objective: To observe the effect of warming moxibustion at points combined with Jianpi Yishen Prescription on glomerular filtration rate (eGFR), residual renal function (RRF) and microinflammation status in patients with spleen- kidney yang deficiency syndrome undergoing continuous ambulatory peritoneal dialysis (CAPD). Methods: A total of 106 cases of patients with chronic kidney disease undergoing CAPD were selected and divided into two groups according to the random number table method, with 53 cases in each group. Both groups were given symptomatic support treatment and oral administration of Jianpi Yishen Prescription based on CAPD, and the observation group was additionally treated with warming moxibustion for 30 minutes at three points, namely Zhongwan (RN 12), Shenque (RN 8),and Guanyuan (RN 4). Both groups were treated for six months. The clinical effects were compared between the two groups;traditional Chinese medicine (TCM) syndrome scores,GFR,RRF,and microinflammation status before and after treatment were compared between the two groups. Results:The total effective rate was 89.13% in the observation group,higher than that of 72.34% in the control group (P< 0.05). Before treatment,there was no significant difference being found in the comparison of the scores of TCM syndromes including fear of cold and cold limbs,soreness and weakness in waist and knees,fatigue and lack of strength,shortage of qi and unwilling to talk,and torpid intake between the two groups (P> 0.05). After treatment,the above TCM syndrome scores in the two groups were decreased (P<0.05),and the scores in the observation group were lower than those in the control group (P<0.05). Before treatment,there was no significant difference being found in the comparison of urea excretion ratio (Kt/V) and total creatinine clearance rate (TCCr) between the two groups (P>0.05). After treatment, Kt/V and TCCr in the control group were significantly decreased (P<0.05),and there was no significant change in Kt/ V and TCCr in the observation group (P>0.05);Kt/V and TCCr in the observation group were higher than those in the control group (P<0.05). Before treatment,there was no significant difference being found in the comparison of 24- hour urine volume, eGFR and RRF between the two groups (P>0.05). After treatment,there was no significant change in 24-hour urine volume,eGFR,and RRF in the observation group and 24-hour urine volume in the control group (P>0.05),eGFR and RRF in the control group were decreased (P<0.05);after treatment,eGFR and RRF in the observation group were higher than those in the control group (P<0.05). Before treatment, there was no significant difference being found in the comparison of the levels of C- reactive protein (CRP),interleukin- 6 (IL- 6),and tumor necrosis factor- α (TNF-α) in serum between the two groups (P>0.05). After treatment,the levels of CRP,IL-6,and TNF-α in serum in the two groups were decreased (P<0.05),and the above levels in the observation group were lower than those in the control group (P<0.05). Conclusion:Jianpi Yishen Prescription combined with for CAPD patients with spleen- kidney yang deficiency syndrome can promote symptom relief, enhance curative effect,help to enhance dialysis adequacy,reduce kidney function damage,and improve microinflammation status of the body.