针灸联合硫辛酸注射液及甲钻胺治疗糖尿病周围神经病变的临床效果

Clinical effect of acupuncture and moxibustion combined with thioctic acid injection and mecobalamin on diabetic peripheral neuropathy

目的探讨针灸联合硫辛酸注射液及甲钻胺治疗糖尿病周围神经病变的临床效果。方法选取解放军第二五一医院2011年5月至2016年5月收治的112例糖尿病周围神经病变患者,按照随机数字表法分为观察组和对照组,各56例。对照组在基础治疗方案上给予硫辛酸注射液及甲钴胺进行治疗;观察组在对照组基础上给予针灸治疗。比较2组疗效及治疗前后正中神经和腓总神经的运动神经传导速度(MNCV)和感觉神经传导速度(SNCV)。结果观察组治疗后总有效率明显高于对照组[94.6%(53/56)比71.4%(40/56)],差异有统计学意义(P<0.05)。2组治疗前正中神经和腓总神经的MNCV、SNCV比较,差异均无统计学意义(均P>0.05)。治疗后,2组正中神经和腓总神经的MNCV、SNCV均明显高于治疗前,且观察组改善差值均明显高于对照组[正中神经:(6.4±1.9)m/s比(2.8±0.6)m/s、(4.3±0.5)m/s比(1.3±0.4)m/s;腓总神经:(5.2±0.4)m/s比(1.1±0.6)m/s、(4.4±0.6)m/s比(1.3±0.5)m/s],差异均有统计学意义(均P<0.05)。结论针灸联合硫辛酸注射液及甲钻胺治疗糖尿病周围神经病变能改善患者症状、体征,提高神经传导速度,疗效明显优于只使用硫辛酸注射液及甲钴胺治疗。

Objective To investigate the clinical effect of acupuncture and moxibustion combined with thioctic acid injection and mecobalamin on diabetic peripheral neuropathy. Methods Totally 112 cases of diabetic peripheral neuropathy were enrolled from May 2011 to May 2016 at the 251st Hospital of the Chinese People′s Liberation Army. The patients were randomly divided into observation group and control group, with 56 cases in each group. The control group was treated with thioctic acid injection and mecobalamin; the observation group was treated with acupuncture and moxibustion combined with thioctic acid injection and mecobalamin. Motor nerve conduction velocity（MNCV） and sensory nerve conduction velocity（SNCV） of median nerve and common peroneal nerve were analyzed before and after treatment. Results Total effective rate in observation group was significantly higher than that in control group［94.6%（53/56） vs 71.4%（40/56）］（P＜0.05）. There were no significant differences of MNCV and SNCV of median nerve and common peroneal nerve between groups before treatment（P＞0.05）. After treatment, MNCV and SNCV of median nerve and common peroneal nerve were significantly higher than those before treatment; the differences in observation group were more significant than those in control group［median nerve：（6.4±1.9）m/s vs （2.8±0.6）m/s,（4.3±0.5）m/s vs （1.3±0.4）m/s； common peroneal nerve：（5.2±0.4）m/s vs （1.1±0.6）m/s,（4.4±0.6）m/s vs （1.3±0.5）m/s］（P＜0.05）. Conclusion Acupuncture and moxibustion combined with thioctic acid injection and mecobalamin treating diabetic peripheral neuropathy can effectively improve median nerve and common peroneal nerve conduction velocity.