温针灸联合益气滋阴方治疗糖尿病周围神经病变及对患者氧化应激水平及神经电生理的影响

Effect of warming needle moxibustion combined with Yiqi Ziyin decoction on oxidative stress level and nerve electrophysiology in patients with diabetic peripheral neuropathy

目的:探究温针灸联合益气滋阴方对糖尿病周围神经病变(DPN)患者氧化应激水平及神经电生理的影响,为DPN患者的诊疗提供指导依据。方法:60例DPN患者为研究对象,按照随机数字表法,将60例患者分成观察组和对照组各30例。对照组在常规降糖基础上给予依帕司他片口服治疗,观察组在对照组的基础上,给予温针灸和益气滋阴方治疗。比较两组治疗前后的多伦多临床评分系统(TCSS)和患者下肢神经的传导速度(SCV和MCV),血清超氧化物歧化酶(SOD)和丙二醛(MDA)等氧化应激指标,并观察两组肌电图疗效。采用随机行走模型评价两组患者治疗后氧化应激水平和神经电生理的改善情况。结果:治疗前,两组患者TCSS评分、MCV、SCV、SOD、MDA水平比较,差异均无统计学意义(P>0.05),治疗后均显著改善(P<0.05);治疗后,观察组患者TCSS评分、空腹血糖(FBG)、餐后2 h血糖(2hPG)、总胆固醇(CHOL)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、MDA水平显著降低,高密度脂蛋白(HDL-C)、运动神经传导速度(MCV)、感觉神经传导速度(SCV)、治疗有效率、SOD水平均显著上升(P<0.05)。随机行走模型结果显示:对照组每正向行走1步,SOD、MDA、MCV、SCV综合改善率分别为11.2%、15.3%、10.5%、14.3%,观察组每正向行走1步,SOD、MDA、MCV、SCV综合改善率分别为17.3%、26.5%、16.1%、25.6%,观察组较对照组改善明显。结论:温针灸联合益气滋阴方可有效治疗DPN,尤其是对于神经传导、氧化应激方面具有明显的改善作用。

Objective:Explore the effects of warming acupuncture and moxibustion combined with Yiqi Ziyin decoction on oxidative stress levels and neuroelectrophysiology in patients with diabetic peripheral neuropathy(DPN),and provide guidance for the diagnosis and treatment of patients with DPN.Methods:The 60 patients with DPN were prospectively selected as the research objects.According to the random number table method,60 patients were divided into observation group(n=30)and control group(n=30).The control group was given oral metformin hydrochloride treatment,and the observation group was given warm needle moxibustion and Yiqi Ziyin decoction on the basis of the control group.Compare the toronto clinical scoring system and the lower limb nerve conduction velocity,serum superoxide dismutase and malondialdehyde and other oxidative stress indicators of the two groups before and after treatment,and observe EMG curative effect in the two groups.The random walking model was used to evaluate the oxidative stress level and neuro-electrophysiological improvement of the two groups of patients after treatment.Results:Before treatment,the comparison of TCSS scores,MCV,SCV,SOD,and MDA levels between the two groups of patients was not statistically significant(P>0.05),and they were significantly improved after treatment(P<0.05);after treatment,the observation group patients’TCSS scores,fasting blood glucose,2 h postprandial blood glucose,total cholesterol,triglycerides,low-density lipoprotein,and MDA levels were significantly reduced,and high-density lipoprotein motor nerve conduction velocity,sensory nerve conduction velocity,treatment effective rate,and SOD level increased significantly(P<0.05).The results of the random walking model showed that the comprehensive improvement rates of SOD,MDA,MCV,and SCV were 11.2%,15.3%,10.5%,and 14.3%for each forward step in the control group.For each forward step in the observation group,SOD,MDA,the comprehensive improvement rates of MCV and SCV were 17.3%,26.5%,16.1%,25.6%,respectively.The observation group improved significantly compared with the control group.Conclusion:Warming needle moxibustion combined with Yiqi Ziyin decoction can effectively treat DPN,especially for nerve conduction and oxidative stress.This method is worthy of clinical reference.