针刺荥输合穴治疗2型糖尿病周围神经病变疗效观察

Acupuncture at xing-spring point, shu-stream point and lower he-sea point for type-2 diabetic peripheral neuropathy

目的:观察针刺荥输合穴对2型糖尿病周围神经病变患者神经功能和临床症状的影响。方法:将60例2型糖尿病周围神经病变患者随机分为观察组和对照组,各30例。两组均予基础治疗,观察组加用针刺治疗,取穴内庭、陷谷、大都、太白、足三里等荥输穴及下合穴为主,隔日治疗1次,每周3次,共治疗4周。观察两组患者治疗前后中医症候积分、多伦多临床评分表(TCSS)评分、疼痛视觉模拟量表(VAS)评分及血清肿瘤坏死因子α(TNF-α)水平变化,并评定两组临床疗效。结果:治疗后两组中医症候积分、TCSS评分均较治疗前降低(P<0.05),观察组中医症候积分低于对照组(P<0.05)。治疗后观察组疼痛VAS评分降低(P<0.05),且观察组低于对照组(P<0.05)。两组血清TNF-α水平组内、组间比较差异均无统计学意义(P>0.05)。观察组总有效率为76.7%(23/30),高于对照组的33.3%(10/30,P<0.05)。结论:针刺荥输合穴能有效改善2型糖尿病周围神经病变患者神经功能和临床症状。

Objective To observe the effect of acupuncture at xing-spring point, shu-stream point and lower he-sea point on neurological function and clinical symptoms in patients with type-2 diabetic peripheral neuropathy. Methods Sixty patients with type-2 diabetic peripheral neuropathy were randomly divided into an observation group and a control group, 30 cases in each one. Both groups were treated with basic treatment, and the observation group was additionally treated with acupuncture at Neiting(ST 44), Xiangu(ST 43), Dadu(SP 2), Taibai(SP 3), Zusanli(ST 36), etc. once every other day, 3 times a week for 4 weeks. The changes of TCM symptom score, Toronto clinical assessment(TCSS) score, visual analogue scale(VAS) score of pain and serum tumor necrosis factor α(TNF-α) level were observed before and after treatment in the two groups, and the clinical effects of the two groups were evaluated. Results Compared before treatment, the TCM syndrome score and the TCSS score in the two groups were reduced after treatment(P<0.05), and the TCM syndrome score after treatment in the observation group was lower than that in the control group(P<0.05). After treatment, the VAS in the observation group was reduced(P<0.05), and the VAS score of pain in the observation group was lower than that in the control group(P<0.05). There was no significant difference in the level of serum TNF-α within and between the two groups(P>0.05). The total effective rate was 76.7%(23/30) in the observation group, which was superior to 33.3%(10/30) in the control group(P<0.05). Conclusion Acupuncture at xing-spring point, shu-stream point and lower he-sea point could effectively improve the neurological function and clinical symptoms in patients with type-2 diabetic peripheral neuropathy.