针刺联合大黄[庶虫]虫汤加味治疗糖尿病周围神经病变临床研究

Effect of acupuncture combined with modified Dahuang Zhechong decoction in patients with type 2 DPN

目的:研究针刺联合大黄[庶虫]虫汤加味对2型糖尿病周围神经病变(DPN)患者脂蛋白相关磷脂酶A2(Lp-PLA2)、视黄醇结合蛋白4(RBP4)的影响。方法:选取154例2型DPN患者,治疗手段不同分为对照组和研究组,各78例。检测两组患者治疗前、治疗2周后、4周后Lp-PLA2、RBP4水平及运动神经、感觉神经传导速度,评定患者中医证候评分、神经症状积分及治疗效果。结果:与治疗前相比,两组患者治疗两周后、4周后Lp-PLA2、RBP4水平、中医证候积分、神经症状积分均降低,运动神经传导速度、感觉神经传导速度均升高;与对照组治疗两周后、4周后相比,研究组治疗两周后、4周后Lp-PLA2、RBP4水平、中医证候积分、神经症状积分均降低,运动神经传导速度、感觉神经传导速度均升高(P<0.05);研究组治疗4周后总有效率高于对照组(P<0.05)。结论:针刺联合大黄[庶虫]虫汤加味可降低2型DPN患者Lp-PLA2、RBP4水平,减轻患者炎性反应。

Objective:To study the effects of acupuncture combined with rhubarb stinging decoction on lipoprotein-associated phospholipase A2(LP-PLA2)and retinol-binding protein 4(RBP4)in patients with type 2 diabetic peripheral neuropathy(DPN),respectively.Methods:154 patients with type 2 DPN.Treatment is divided into control group and study group,78 cases each.Detection of motor and sensory nerve conduction velocity before,after 2 weeks and 4 weeks Lp-PLA2,RBP4 treatment,to evaluate the score of TCM syndromes,the score of neurological symptoms and the therapeutic effect.Results:The Lp-PLA2,RBP4 level,TCM syndrome score and NS score were lower after 2 weeks and 4 weeks,and the motor nerve conduction velocity and sensory nerve conduction velocity were higher than those of control group after 2 weeks and 4 weeks.The Lp-PLA2,RBP4 level,TCM syndrome score and neurological symptom score were lower after 2 weeks(P<0.05),and the total effective rate of study group after 4 weeks was higher than that of control group after 4 weeks(P<0.05).Conclusion:Acupuncture combined with rhubarb stinging decoction can reduce the Lp-PLA2,RBP4 level and inflammatory response of type 2 DPN patients.