RESUMO
Objective: To study the effects of acupuncture combined with the formula of Yi Qi Yang Yin and blood activating (A-YBF) on blood glucose levels and renal function in patients with early diabetic nephropathy. Methods: 96 patients with early diabetic nephropathy treated in our hospital from April 2021 to April 2022 were included in the study and divided into the control group (conventional medical treatment) and the study group (A-YBF), with 48 cases in each group. The efficacy and adverse effects were recorded by comparing the Chinese medicine symptom points, blood glucose level, renal function, and inflammatory factor level between the two groups before and after the treatment. Results: The clinical efficacy of the study group was significantly higher than that of the control group (P < .05). Before treatment, no difference was found between the primary and secondary symptom scores of the two groups (P > .05); after treatment, the primary and secondary symptom scores of the study group were lower than those of the control group (P < .05). Before treatment, there was no difference in fasting blood glucose (FPG) and 2h postprandial glucose (2hPG) levels; 24h urine protein quantification, cystatin C (Cys-C), urinary albumin excretion rate (UAER), and estimated glomerular filtration rate (eGFR) levels; and growth differentiation factor-15 (GDF-15), interleukin-1ß (IL-1ß), interleukin-17 (IL-17), and serum amyloid A (SAA) levels between the two groups (P > .05). After treatment, FPG and 2hPG levels; 24h urine protein quantification, Cys-C and UAER levels; and GDF-15, IL-1ß, IL-17, and SAA levels were lower in the study group than in the control group, while eGFR levels were higher than those in the control group (P < .05). Conclusion: A-YBF can effectively reduce blood glucose levels and improve renal function in patients with early diabetic nephropathy and can be promoted in clinical application.
RESUMO
Diabetes is a chronic disease and has huge pressure on patients and the medical system, especially for patients with diabetic complications, for example, diabetic nephropathy. Diabetic nephropathy is a diabetic complication associated with damage to the kidney. To improve the quality of life of patients with diabetes, it is necessary to understand the factors that are associated with diabetic nephropathy. The objective of the study was to find the prevalence of diabetic nephropathy in newly diagnosed patients with diabetes and to develop the association between clinicopathological parameters and diabetic nephropathy. In a case-control study, demographics, anthropometric, and clinicopathological parameters of a total of 305 newly diagnosed patients with diabetes (the fasting blood glucose ≥ 7.0 mM/L and/or glycosylated hemoglobin ≥ 6.5 mM/L) in Hebei province were included in the analysis. If the urine albumin to creatinine ratio was ≥ 30 (microalbuminuria) then patients were considered diabetic nephropathy. Among enrolled patients, 206 (68%) were males and 99 (32%) were females and they were 46 to 71 years old. Demographic variables and health-related behaviors were the same among patients with diabetes either with nephropathy (case group, n = 135) or patients without nephropathy (control group, n = 170, P > .05 for all). The prevalence of diabetic nephropathy was 44%. Female to male ratio was 1:1.7 in the case group. Patients with diabetic nephropathy had higher body weight (P < .0001), waist circumference (P = .0006), and body mass index (P = .0002) than those of patients without nephropathy. Abnormal urinary globulin (P = .041, odd ratio (OR): 1.1231) was associated with diabetic nephropathy. Aspartate transaminase (P = .0651, OR: 0.8541), alkaline phosphatase (P = .0661, OR: 0.8122), hypertension (P = .0821, OR: 0.8214), and blood urea nitrogen (P = .0842, OR: 0.9411) were not significantly associated with diabetic neuropathy. However, they are near the statistical cutoff value. The prevalence of diabetic nephropathy in newly diagnosed diabetic patients of Hebei province is higher than those of the other provinces. Urinary globulin excretion had a weak association with the presence of nephropathy defined by urinary albumin excretion in patients with diabetes. The presence of other diabetic complications is also an essential parameter for diabetic nephropathy. Males are more susceptible to diabetic nephropathy than females if diabetic (Evidence Level: V; Technical Efficacy: Stage 3).