基于“气血交互于脉”探讨穴位敷贴在糖尿病周围神经病变中的应用

Investigation on the Application of Acupoint Application in Diabetes Peripheral Neuropathy Based on"Qi and Blood Interact With Pulse"

目的探讨基于“气血交互于脉”理论的穴位贴敷在糖尿病周围神经病变中的应用,为临床治疗糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)提供新的思路与方法。方法2020年11月—2022年4月通过查阅文献及古籍,对气血交互于脉理论进行概述。从气血交互于脉理论出发,结合现代医学对DPN的认识,探讨该理论指导下的穴位贴敷法在DPN治疗中的具体应用。纳入符合标准的126例气虚血瘀型DPN患者,进行为期4周的穴位贴敷干预,评价干预前后患者的血液流变学指标、多伦多临床神经病变评分。结果穴位敷贴4周后,患者的血液流变学的各项指标较穴位敷贴前有所降低,差异有统计学意义(P<0.05)。患者穴位敷贴4周后,多伦多临床神经病变评分(Toronto Clinical neuropathy score,TCSS)各项评分及总分较穴位敷贴前有所降低,干预前后差异比较差异有统计学意义(P<0.05)。结论基于“气血交互于脉”的当归补血方敷贴可有效促进血液循环,改善气虚血瘀型DPN患者的肢体症状,为穴位贴敷临床应用的行业标准制定提供参考。

Objective To explore the application of acupoint application based on the theory of“qi and blood interacting with pulse”in diabetic peripheral neuropathy,and bring new thoughts and methods for clinical therapy of diabetic peripheral neuropathy(DPN).Methods From November 2020 to April 2022,the theory of qi-blood interaction in pulse was summarized by consulting literature and ancient books.Starting from the theory of qi and blood interaction in the pulse,combined with the understanding of DPN in modern medicine,the specific application of acupoint application under the guidance of this theory in the treatment of DPN was discussed.A total of 126 patients with DPN of qi deficiency and blood stasis type who met the criteria were included in the study.A 4-week acupoint application intervention was conducted to evaluate the hemorheology indexes and Toronto clinical neuropathy score of the patients before and after the intervention.Results The indexes of hemorheology of patients after 4 weeks of acupoint application were lower than those before intervention,and the difference was statistically significant(P<0.05).The scores and total scores of Toronto Clinical neuropathy score(TCSS)after 4 weeks of acupoint application were lower than those before intervention,and the difference before and after intervention was statistically significant(P<0.05).Conclusion Acupoint application based on“qi and blood interaction in the pulse”can effectively improve the hemorheology and limb symptoms of DPN patients with qi deficiency and blood stasis,and provide reference for the formulation of industry standards for clinical application of acupoint application.