针刺联合格列齐特与甲钴胺治疗糖尿病周围神经病变随机平行对照研究

Acupuncture combined with Gliclazide and Mecobalamin on Diabetic Peripheral Neuropathy Randomized Controlled Study

[目的]观察针刺联合格列齐特与甲钴胺治疗糖尿病周围神经病变疗效。[方法]使用随机平行对照方法,将86例住院患者按病志号抽签方法简单随机分为两组。对照组43例格列齐特80mg/次,2次/d,口服;甲钴胺0.5mg/次,1次/d,肌注。治疗组43例针刺,主穴：关元、肾俞、胃脘下俞、足三里、三阴交、曲池及合谷,辨证施针,上肢麻木感强烈加手三里、外关及尺泽等;下肢麻木感明显加足三里、太冲及阳陵泉等;患肢瘀血较重加膈俞、血海及阴陵泉等;痰浊较盛加丰隆及膻中等,局部消毒,0.35mm不锈钢毫针,平补平泻,插、捻、转手法,酸麻重胀为宜,留针20~30min/次,1次/d;西药治疗同对照组。连续治疗6d为1疗程。观测临床症状、空腹血糖值（FBG）、糖化血红蛋白（Hb Alc）、疼痛评分、不良反应。连续治疗5疗程,判定疗效。[结果]治疗组显效14例,有效21例,无效8例,总有效率84.40%。对照组显效9例,有效15例,无效9例,总有效率55.81%。治疗组疗效优于对照组（P〈0.01）。FBG、Hb A1c、疼痛评分改善治疗组优于对照组（P〈0.01）。[结论]针刺联合格列齐特与甲钴胺治疗糖尿病周围神经病变,疗效满意,无严重不良反应,值得推广。

[Objective]To observe the curative effect of acupuncture combined with peripheral neuropathy of gliclazide and Mecobalamin on diabetic. [Methods] 86 patients were randomly divided into two groups according to random parallel control method. The control group of 43 cases of glielazide 80mg/times, 2 times/d, oral Mecobalamin; 0.Smg/, l/d, intramuscular injection. Acupuncture treatment group （n=43）, the main point： Guanyuan, Shenshu, stomach Yu, Zusanli, Sanyinjiao, Quchi and Hegu, dialectical acupuncture, upper extremity numbness intense and hand in three, Waiguan and ehize etc.; lower extremity numbness is significantly Zusanli and Taichong and Yanglingquan; limb blood stasis heavier and Geshu, Xuehai, Yin Ling Quan and so on; phlegm is filled with abundant uplift and the smell of mutton and so on, local disinfection, 0.35 mm stainless steel needle, flat flat for diarrhea, plug, twist, turn technique, Suanma re inflation is appropriate, retaining needle 20 -30 minutes each time, 1 times/d; western medicine in the treatment of with the control group. Continuous treatment for 1 courses of 6D. Observation of clinical symptoms, fasting blood glucose （FBG）, glycosylated hemoglobin （HbAle）, pain score, adverse reactions. Continuous treatment for 5 courses of treatment, to determine efficacy. [Results]In the treatment group, 14 cases were markedly effective, 21 eases were effective, 8 cases were ineffective, the total effective rate was 84.40%. In the control group, 9 eases were markedly effective, 15 cases were effective, 9 cases were ineffective, the total effective rate was 55.81%. The curative effect of the treatment group was better than that of the control group （P〈0.01）. FBG, HbAlc, pain score improvement treatment group than the control group （P〈0.01）. [Conclusion]Acupuncture combined with Glipizide gliclazide tablets and Mecobalamin on diabetic peripheral neuropathy, and the results were satisfactory. No serious adverse reactions, worthy of promotion.