杵针治疗脾肾亏虚型血透患者肌少症症状的随机对照研究

A Randomized Controlled Trial on the Effect of Chuzhen Therapy in Improving Sarcopenia Symptoms in Hemodialysis Patients with Spleen-Kidney Deficiency Pattern

摘要: 目的：探讨杵针疗法对脾肾亏虚型维持性血液透析(MHD)患者肌少症症状的改善作用。方法：采用随机对照研究设计，将40例患者分为对照组(常规治疗 + 左卡尼汀)和观察组(常规治疗 + 左卡尼汀 + 杵针干预)，治疗8周后比较两组中医证候积分、体能指标(SPPB、Berg)、握力、步行速度及肌少症相关指标(ASMI、MSTN、IGF-1)。结果：观察组中医证候总有效率为63.2%，显著高于对照组的21.1% (P < 0.01)；治疗后观察组握力显著提升(P < 0.01)，Berg平衡评分改善(P < 0.05)，两组间SPPB、步行速度及ASMI、MSTN、IGF-1无统计学差异(P > 0.05)。安全性指标未见异常。结论：杵针疗法可有效改善脾肾亏虚型MHD患者肌少症相关症状及肢体功能，且安全性良好，为中西医结合干预肌少症提供了新思路。

Abstract: Objective: To investigate the effects of Chu-needle therapy on improving sarcopenia symptoms in maintenance hemodialysis (MHD) patients with spleen-kidney deficiency pattern. Methods: A randomized controlled trial was conducted, dividing 38 patients into a control group (routine treatment + L-carnitine) and an observation group (routine treatment + L-carnitine + Chu-needle intervention). After 8 weeks of treatment, comparisons were made between the two groups regarding TCM syndrome scores, physical performance indicators (SPPB, Berg Balance Scale), grip strength, walking speed, and sarcopenia-related biomarkers (ASMI, MSTN, IGF-1). Results: The total effective rate of TCM syndrome improvement in the observation group was 63.2%, significantly higher than 21.1% in the control group (P < 0.01). Post-treatment grip strength significantly increased (P < 0.01) and Berg Balance Scale scores improved (P < 0.05) in the observation group. However, no significant differences were observed between groups in SPPB, walking speed, ASMI, MSTN, or IGF-1 levels (P > 0.05). Safety indicators showed no abnormalities. Conclusion: Chu-needle therapy effectively improves sarcopenia-related symptoms and limb function in MHD patients with spleen-kidney deficiency pattern, demonstrating good safety and providing a novel integrated approach for sarcopenia management.