运动联合穴位按摩治疗糖尿病合并下肢动脉硬化闭塞症的效果

Effect of exercise combined with acupoint massage in the treatment of the diabetes mellitus with lower limb arteriosclerosis obliterans

目的 :探讨运动联合穴位按摩治疗社区糖尿病合并下肢动脉硬化闭塞症患者的效果。方法 :选择伴有下肢动脉硬化闭塞症的糖尿病患者150例,随机分为社区管理组和运动干预组各75例。社区管理组进行常规糖尿病管理,运动干预组在社区管理基础上进行运动联合穴位按摩干预。分别比较两组在干预前和干预9、18个月后的跛行距离、动脉硬化指数(AI)、踝肱指数(ABI)、血管多普勒超声表现。结果 :干预9个月时,运动干预组患者的跛行距离大于干预前和社区管理组(P<0.05);AI小于干预前(4.82±1.61比5.28±1.30,P<0.05)。干预18个月时,运动干预组患者的跛行距离为(697±199)m,ABI为0.87±0.19,均大于社区管理组的(635±241)m和0.78±0.22(P<0.05);AI、腘动脉内膜中层厚度均小于社区管理组(P<0.05)。干预前后社区管理组的跛行距离、ABI、内膜中层厚度比较差异均无统计学意义(P>0.05)。结论 :对于糖尿病合并下肢动脉硬化闭塞患者应在常规社区管理基础上联合运动和穴位按摩进行干预,对患者症状改善和病情控制有积极意义。

Objective： To investigate the effect of exercise combined with acupoint massage in the treatment of the diabetes mellitus with lower limb arteriosclerosis obliterans. Methods： One hundred and fifty cases of diabetes mellitus with lower limb arteriosclerosis obliterans were selected and randomly divided into a community management group and an exercise intervention group with 75 cases each. The community management group received the conventional diabetic management, while the exercise intervention group received the exercise combined with acupoint massage on the base of the community management. The claudication distance, atherogenic index（AI）, ankle brachial index（ABI）and expression of vascular Doppler ultrasound were compared on admission, after 9 and 18 months of intervention. Results： After intervention for 9 months, the claudication distance of the exercise intervention group was longer than those before intervention and the community management group（P〈0.05）, AI was lower than that before intervention（4.82±1.61 vs 5.28±1.30, P〈0.05）. After intervention for 18 months, claudication distance and ABI of the exercise intervention group were（697±199）m and 0.87±0.19, while those were（635±241）m and 0.78±0.22 in the community management group（P〈0.05）. AI and popliteal artery intima-media thickness of the exercise intervention group were less than those of the community management group（P〈0.05）. Claudication distance, ABI and intima-media thickness of the community management group were compared before and after the intervention and there were no significant differences（P〈0.05）. Conclusion： The diabetic patients with lower limb arteriosclerosis obliterans should be intervened by exercise combined with acupoint massage based on the conventional community management, which has positive significance to the improvement of the symptoms and the control of the disease.