艾灸联合甲钴胺治疗糖尿病周围神经病变临床疗效观察及对患者血同型半胱氨酸的影响(英文)

Observation on clinical therapeutic efficacy of moxibustion combined with mecobalamin on diabetic perineuropathy and effects on patients' blood homocysteine

目的:观察艾灸联合甲钴胺对糖尿病周围神经病的疗效以及对糖尿病周围神经病变患者血同型半胱氨酸的影响。方法:将符合纳入标准的150例糖尿病周围神经病变患者采用随机数字表随机分为艾灸组、甲钴胺组、联合组,艾灸组取太溪、三阴交、足三里、合谷、曲池进行艾灸,隔日治疗1次,10次为一疗程,治疗3个疗程;甲钴胺组口服甲钴胺片500μg/次,每日3次,20 d为1个疗程,治疗3个疗程;联合组在口服甲钴胺片基础上进行艾灸治疗。观察3组治疗前后临床症状、神经传导速度以及血同型半胱氨酸(Hcy)的变化。结果:艾灸组总有效率为74.0%(37/50),甲钴胺组总有效率为82.0%(41/50),联合组总有效率为94.0%(47/50),联合组明显优于其它两组(P<0.01)。甲钴胺组及联合组治疗后较治疗前神经传导速度明显提高、血同型半胱氨酸水平下降(P<0.01),联合组与艾灸组及甲钴胺组比较,神经传导速度提高、血同型半胱氨酸水平下降(P<0.01)。结论:艾灸联合甲钴胺治疗糖尿病周围神经病变,不仅能改善患者的症状、提高患肢的神经传导速度,还能降低血Hcy水平,方法简单、经济、安全,值得在临床上推广。

Objective To observe the therapeutic efficacy of moxibustion combined with mecobalamin on diabetic perineuropathy and the effects on blood homocysteine in pa ents with diabe c perineuropathy. Methods One hundred and fifty patients with diabetic perineuropathy meeting with the inclusive criteria were randomized into a moxibus on group,a mecobalamin group and a therapeutic alliance group by using random digits table. Moxibustion was carried out on Tàixī（太溪 KI 3）,Sānyīnjiāo（三阴交 SP 6）,Zúsānl？（足三里 ST 36）,Hég？（合谷 LI 4） and Qūchí（曲池 LI 11） for the patients in the moxibustion group,the treatments were carried out once every other day,treatments for ten mes were considered as a treatment course,and totally three treatment courses were carried out. The pa ents in the mecobalamin group were orally administered with mecobalamin tablet 500 μg once,three times a day,20 days were considered as a treatment course,and totally three treatment courses were carried out. Moxibustion was carried out on the basis of oral administration with mecobalamin tablet in the therapeutic alliance group. The clinical symptoms,nerve conductive velocities and changes in blood homocysteine were observed before and after the treatments in the three groups. Results The total eff ec ve rate in the moxibus on group was 74.0%（37/50）,82.0%（41/50） in the mecobalamin group,94.0%（47/50） in the therapeutic alliance group,and the total effective rate in the therapeutic alliance group was significantly be er than the other two groups（P0.01）. The nerve conductive velocities in the mecobalamin group and the therapeutic alliance group after the treatments were significantly increased and the blood homocysteine level decreased in comparison to those before the treatments（P0.01）,while the nerve conductive velocity increased and the blood homocysteine level decreased in the therapeutic alliance group after the treatments in comparison to those in the other two groups（P0.01）. Conclusion Treatments on diabe c perineuropathy by therapeu c alliance of moxibustion and mecobalamin can not only improve symptoms of patients,increase nerve conduc ve velocity in aff ected limbs,but also decrease blood homocysteine level. The method is simple,economical and safe,and it deserves being generalized in clinical prac ces.