针灸温阳疗法治疗糖尿病周围神经病变患者32例临床观察

Acupuncture Treatment with Warming-yang Method for the Patients of Diabetic Peripheral Neuropathy :A Report of 32 Cases

目的观察针灸温阳疗法治疗糖尿病周围神经病变(DPN)阳虚寒凝血瘀证患者的临床疗效。方法收集DPN患者64例随机分为治疗组及对照组各32例,对照组在基础治疗上静脉滴注参附注射液及口服甲钴胺片;治疗组在对照组基础上加用针刺肢端的五输穴及艾灸疗法,治疗12周后检测空腹血糖(FBG)、餐后2小时血糖(P2hPG)、糖化血红蛋白(HbA1c)、双侧腓总神经、正中神经的运动传导速度(MCV)及评价中医证候疗效。结果两组患者治疗后FBG、P2hPG及HbA1c较治疗前都有不同程度下降(P<0.05或P<0.01),在降低P2hPG及HbA1c方面治疗组优于对照组(P<0.05或P<0.01);两组患者治疗后正中神经、腓总神经MCV均较治疗前有差异统计学意义(P<0.05或P<0.01),且治疗组改善优于对照组(P<0.05)。治疗组中医证候疗效总有效率为96.88%,对照组为87.50%,治疗组优于对照组(P<0.05)。结论针灸温阳疗法在纠正DPN阳虚寒凝血瘀证患者糖代谢紊乱及改善临床症状、电生理方面疗效肯定。

Objective To observe the effect of acupuncture and moxibustion with warming-yang method on the patients of diabetic peripheral neuropathy（DPN） with yang deficiency cold stagnation blood stasis syndrome in TCM.Methods Sixty-four DPN patients were randomized into treatment group and control group with 32 cases in each.The control group was given the basic treatment,Shenfu Injection [Injection containing Hongshen（Radix Ginseng Rubra） and Fuzi（Radix Aconiti praeparata）] for intravenous drip,and methylcobalamine for oral taking,while the treatment group was additionally treated with acupuncture at Five-shu points located at the distal part of limbs and moxibustion.The treatment lasted 12 weeks,then the fasting blood-glucose（FBG）,postprandial 2h blood glucose（P2hBG）,glycosylated hemoglobin（HbA1c）,and the movement conduction velocity（MCV） of common peroneal nerve and median nerve of both sides were detected and the therapeutic effect for TCM syndromes was evaluated.Results After treatment,FBG,P2hBG and HbA1c in both groups were decreased to different degrees（P0.05 or P0.01）,and the decrease of P2hBG and HbA1c in the treatment group was more significant than in the control group（P0.05 or P0.01）.The MCV of the median nerve and common peroneal nerve in the two groups was significantly different from that of before treatment（P0.05 or P0.01）,and the improvement in the treatment group was more significant than in the control group（P0.05）.The total effective rate of the TCM syndromes in the treatment group was 96.88%,better than 87.50% in the control group（P0.05）.Conclusion The warming-yang method of acupuncture and moxibustion therapy is effective in correcting the disturbance of carbohydrate metabolism and improving the clinical symptoms and electrical physiological condition of the DPN patients with yang deficiency cold stagnation blood stasis syndrome in TCM.