推拿按脊治疗2型糖尿病近期疗效分析

Short-term curative effect of traditional massage on type 2 diabetes mellitus

目的:观察推拿按脊疗法对2型糖尿病患者空腹血糖、糖耐量的影响。方法:选择2000-03/2003-03于青岛大学医学院附属医院门诊就诊的2型糖尿病患者38例,均符合卫生部发布的消渴病疗效判断标准和美国糖尿病学会糖尿病诊断标准。空腹血糖8.2～21.0mmol/L,男19例,女19例,平均年龄45.6岁,平均病程2年零6个月,均伴有不同程度的背痛。随机数字表法分为治疗组和对照组,每组19例。排除合并其他脏器严重疾病、年龄>70岁或体质弱不适合推拿疗法治疗者。治疗组口服复方降糖灵1周后停止口服药,给予推拿按脊点穴手法治疗,治疗30d。对照组用口服降糖灵药物治疗,每次1～2片,3次/d,治疗30d。仿照陆一农腰背痛指数研究报告,以临床症状的程度设置指数如:口渴、乏力程度、肥胖或体质量减轻、背痛的程度、脊柱的活动度、空腹血糖的表现设定1∶2∶3∶4∶5指数对比,治疗前后进行统计评估并测定空腹血糖、餐后2h血糖、胰岛素释放。参照1979年全国糖尿病会议的标准统计疗效。显效:治疗后症状基本消失,空腹血糖降到正常。有效:治疗后症状明显减轻,空腹血糖降至7.3mmol以下。改善:治疗后症状较治疗前减轻,空腹血糖降至8.1mmol以下。无效:治疗后症状较治疗前无明显变化,空腹血糖持续8.1mmol上下。结果:38例患者均进入结果分析。①治疗后治疗组显效13例,有效3例,改善2例,无效1例,有效率94.7%,对照组显效1例,有效6例,改善4例,无效8例,有效率42.1%。两组间有效率比较差异显著(P<0.01)。②治疗组治疗前后胰岛素释放差异显著[平均胰岛素释放:(29.0±8.0),(26.0±8.0)IU/L,P<0.01,治疗后糖耐量各时间点指标均明显低于治疗前[空腹:(8.1±1.1),(5.6±1.1)mmol/L;餐后2h:(9.8±1.1),(6.1±10.1)mmol/L,P均<0.05,对照组治疗后的糖耐量时间点指标均明显低于治疗前[空腹:(8.2±1.2),(6.1±1.0)mmol/L;餐后2h:(11.6±1.3),(8.5±1.2)mmol/L,P<0.05],两组治疗后糖代谢变化,差异显著(P<0.01)。③治疗组治疗后症状指数为57.0±0.0,对照组治疗后症状指数为83.7±0.0,两组比较差异显著(P<0.01)。结论:推拿按脊治疗2型糖尿病效果显著,近期治疗效果明显优于口服降糖灵。

AIM： To investigate the effect of traditional massage on fasting blood glucose and sugar tolerance of patients with type 2 diabetes mellitns. METHODS： Thirty-eight patients with type 2 diabetes mellitus were selected from the Outpatient Clinic of the Hospital Affiliated to the Medical College of Qingdao University between March 2000 and March 2003, and all enrolled subjects were in accordance with the diagnostic standard for diabetes carried out by the Ministry of Public Health as well as the diagnostic criteria of diabetes published by American Diabetes Association. including 19 males and 19 females with the average age of 45.6 years as well as an average course of disease of 2.6 years with the fasting plasma glucose ranged from 8.2 to 21.0 mmol/L, accompanied by the backache of different degree. The patients were randomly divided into treatment group and control group with 19 cases in each group. Patients with other serious diseases in organs or older than 70 years as well as those who were too weak to accept massage therapy were excluded. Patients in the treatment group orally took compound Jiangtangling for one week and then received traditional massage therapy for 30 days. Patients in the control group orally took Jiangtangling for 30 days three times a day with 1-2 tablets each time, The indexes were designed as follows by imitating Lu＇s report on lumbodorsal pain indexes according to the clinical symptoms： thirsty, debilitation, obesity or losing of body mass, backache, range of spinal motion as well as the fasting blood sugar, which were designed as 1：2：3：4：5. The fasting blood sugar, the blood sugar at 2 hours after meal and the insulin releasing were determined and statistically analyzed according to the standard statistical curative effect designed in 1997 on State Diabetes Meeting. Effective： Most of the symptoms disappeared after the treatment with the fasting blood glucose decreased to the normal level. Efficacy： The symptoms were significantly ameliorated after the treatment, and the fasting blood glucose decreased below 7.3 mmol. Improved： The symptoms were ameliorated much after the treatment than that before the treatment, and the fasting blood sugar decreased below 8.1 mmol. Invalid： There were no significant difference in the symptoms before and after the treatment, and the fasting blood sugar was about 8.1 mmol. RESULTS： A total of 38 patients were involved in the analysis of results. ①There were 13 patients with efficacy, 3 patients with validity, 2 patients being improved and one patient without efficacy in the treatment group after the treatment, and the efficient rate was 94.7%, while those in the control group were 1, 6, 4 and 8 respectively with the efficient rate of 42.1%. There were significant differences between the two groups （P 〈 0.01）. ② The insulin release in the treatment group was significantly different before and after the treatment [Average insulin release was （29.0±8.0）, （26.0±8.0） IU/L, P 〈 0.01）, and the indexes of sugar tolerances at each time point after the treatment were remarkably lower than those before the treatment [fasting blood sugar. （8.1 ±1.1 ）, （5.6±1.1） mmol/L;the blood sugar at 2 hours after the meal： （9.8±1.1）, （6.1±10.1） mmol/L, P all. 〈 0.05, while those in the control group after the treatment were markedly lower than those before the treatment [fasting blood sugar： （8.2 ±1.2）, （6.1±1.0） mmol/L;the blood sugar at 2 hours after the meal： （ 11.6± 1.3 ）, （8.5± 1.2） mmol/L,P 〈 0.05）. ③ The symptom index in the treatment group after the treatment was 57.0±0.0, while it was 83.7±0.0 in the control group, and there were significant differences between the two groups （P 〈 0.01）. CONCLUSION： Traditional massage has great efficacy on type 2 diabetes mellitus, and its short-term efficacy is significantly superior to that of Jiangtangting.