针灸治疗阴阳两虚型2型糖尿病疗效分析

Effect Analysis of Acupuncture and Moxibustion in Treating T2DM Patients with Dual Deficiency of Yin and Yang Syndrome

目的:观察针灸治疗阴阳两虚型2型糖尿病(T2DM)的临床疗效,分析影响疗效的因素。方法 :将108例阴阳两虚型T2DM患者采用针灸治疗3个月。观察患者治疗前后空腹血糖(FPG)、空腹瘦素(FLP)、空腹胰岛素(FINS)、胰岛素敏感性指数(ISI)、胰岛素抵抗指数(Homa-IR)、胰岛素分泌指数(Homa-β)及血脂和肥胖指标;并分析其疗效与证型、年龄、肥胖度、病程、性别及病因诱因的相关性。结果:1针灸治疗阴阳两虚型T2DM患者显著32例,有效50例,总有效率75.93%。2患者治疗后FLP、FPG、FINS、Homa-IR、TC、TG、LDL-C、体质量、肥胖度(A%)、BMI、F%均较治疗前明显下降(P<0.01),ISI、Homa-β、HDL-C明显升高(P<0.01)。3针灸治疗阴阳两虚型T2DM患者疗效和年龄、肥胖度及病程相关(P<0.01),年龄越小,肥胖度越低,病程越短者,疗效越好。结论:针灸治疗阴阳两虚型T2DM患者的疗效机制是通过对"脂肪-胰岛内分泌轴"的良性调整,使机体内分泌、糖以及脂质代谢恢复正常;针灸对阴阳两虚型T2DM患者的疗效与患者年龄、肥胖度和病程密切相关。

Objective：To observe the clinical effect of acupuncture in treating T2DM with dual deficiency of yin and yang syndrome and analyze the factors affecting the effect. Methods ：108 patients suffered from T2DM with dual deficiency of yin and yang syndrome were treated for 3 month with acupuncture. The fasting plasma glucose （FPG）, fasting leptin （FLP）, fasting insulin （FINS）, insulin sensitivity index （ ISI ）, homeostasis model assessment of insulin resistance（Homa-IR）,homeostasis model assessment-Beta（Homa-IR）,body fat and fat calculator were observed,and the relationship between the effect and the syndrome,age ,obesity degree （A%）, course of disease, gender, pathogenesis and inducement were analyzed. Results ： Among the 108 patients treated with acupuncture,in 32 patients achieved significant effect,in 50 patients it proved to be ef- fective,and the total effective rate was 75.93%. The FLP,FPG,FINS,Homa-IR,total cholesterol（TC）,triglyc eride （TG）, low density lipoprotein cholesterol （LDL-C）, high density lipoproteincholesterol （HDL-C）, weight,body mass index（BMI） and body fat percentage（F%） after treatment were significantly lower than before treatment （P〈0.01）,while the ISI,Homa-β,HDL-C was significantly higher（P〈0.01）. The effect was related to the patients＇ age,A% and the course of disease,the younger the age,the better the effect,the lower the A%,the better the effect and the shorter the course of disease,the better the effect. Conclusion：The mechanism of acupuncture treating T2DM is through positive adjustment of the fat-pancreatic endocrine axis,to reduce leptin resistance and insulin resistance,and induce the patient body＇s endocrine,glycometabolism and lipid metabolism return to normal. The clinical effect of acupuncture in treating T2DM of dual deficiency of yin and yang syndrome is closely related to the patients＇ age,A% and the course of disease.