艾灸膈俞穴治疗早期糖尿病肢体动脉闭塞症临床研究

Moxibustion at Geshu(BL 17) for diabetic limb arterial obliteration at early stage

目的:比较艾灸膈俞穴与口服西洛他唑对早期糖尿病肢体动脉闭塞症的疗效差异及对血液流变学、下肢动脉内径的影响。方法:将70例早期糖尿病肢体动脉闭塞症患者随机分为观察组和对照组,每组35例。两组均在控制血糖、血脂等常规治疗基础上,对照组采用口服西洛他唑50 mg,每天2次;观察组采用艾灸膈俞穴,每天1次,两组均连续治疗2周为一疗程,共治疗4个疗程。观察并比较两组治疗前后症状总积分、血液流变学指标(全血低切、高切黏度,血浆黏度,红细胞压积,红细胞聚集指数)、下肢动脉内径(腘动脉、胫后动脉、足背动脉)的变化情况。结果:治疗后两组症状总积分、血液流变学各项指标及下肢各动脉内径均较治疗前改善(均P<0.05);治疗后,观察组症状总积分、血液流变学各项指标均较对照组改善明显(均P<0.05);对下肢各动脉内径的改善与对照组无差别(均P>0.05);治疗后观察组总有效率为91.4%(32/35),优于对照组的85.7%(30/35,P<0.05)。结论:艾灸膈俞穴治疗早期糖尿病肢体动脉闭塞症疗效优于口服西洛他唑,能有效改善临床症状及血流、血管状况,增加下肢血流量。

Objective To compare the efficacy differences between moxibustion at Geshu （BL 17） and oral administration of cilostazol on diabetic limb arterial obliteration （DLAO） at early stage as well as the impacts on hemorheology and arterial inner dimension of lower extremity. Methods Seventy patients of DLAO at early stage were randomly divided into an observation group and a control group, 35 cases m each one. The two groups were treated with regular treatment of blood glucose and blood lipid. The patients m the control group was treated with oral administration of cilostazol. 513 mg, twice a day; the patients in the observation group were treated with moxibustion at Geshu （BL 17）, once a day. The consecution treatment of two weeks constituted one session, and totally 4 sessions were given. The total syndrome score, hemorheology index （including low and high shear viscosity of blood, plasma viscosity, hematocrit and erythrocyte aggregauon index） and arterial inner dimension of lower extremity （including popliteal artery, posterior tibial artery and dorsalis pedis artery） were compared before and after treatment. Results Compared with those before treatment, the total syndrome score, hemorheology index and arterial inner dimension of lower extremity were significantly improved after treatment in the two groups （all P〈 0.05）. The total syndrome score, hemorheology index in the observation group were superior to those in the control group （all P〈 0.05）, but the improvement of arterial inner dimension of lower extremity was not significantly different between the two groups （P〉 0.05）. After treatment, the total effective rate was 91.4% （32/35） in the observation group, which was significantly superior to 85.7% （30/35） in the control group （P〈 0.05）. Conclusion Moxibustion at Geshu （BL 17） is superior to oral administration of cilostazol for DLAO at early stage, which could effectively improve the clinical symptoms, blood flow and blood vessel and increase the blood flow of lower limb.