艾灸胰俞穴对2型糖尿病周围神经病变患者血糖波动及感觉神经传导速度的影响

Clinical efficacy of moxibustion at Yishu (EX-B3) on diabetic peripheral neuropathy of Qi deficiency and blood stasis syndrome and its influence on blood glucose fluctuation and sensory conduction velocity

目的 观察艾灸胰俞穴治疗糖尿病周围神经病变(DPN)气虚血瘀证患者的临床疗效及对患者血糖波动和感觉神经传导速度的影响。方法 将72例DPN气虚血瘀证患者按照随机数字表法分为2组。对照组36例予甲钴胺等常规治疗,治疗组36例在对照组基础上加艾灸胰俞穴治疗,2组均治疗4周后统计疗效。比较2组治疗前后空腹血糖、餐后2 h血糖、血糖水平标准差(SDBG)、餐后血糖波动幅度(PPGE)、最大血糖波动幅度(LAGE)水平变化,以及胫神经、腓肠神经的感觉神经传导速度,并进行安全性监测。结果 治疗组总有效率86.1%(31/36),对照组总有效率63.9%(23/36),治疗组总有效率高于对照组(P<0.05)。治疗后,2组空腹血糖、餐后2 h血糖水平均较本组治疗前无明显变化(P>0.05),且治疗后2组组间比较差异也无统计学意义(P>0.05)。治疗后,2组SDBG、PPGE、LAGE均较本组治疗前明显下降(P<0.05),且治疗组明显低于对照组(P<0.05)。与本组治疗前比较,2组治疗后腓肠神经和胫神经感觉神经传导速度均增快(P<0.05),且治疗组明显快于对照组(P<0.05)。治疗过程中2组患者均未出现不良反应,无病例脱落,治疗前后血常规、肝肾功能及凝血四项均未见异常变化。结论 艾灸胰俞穴可改善DPN气虚血瘀证患者血糖波动、临床症状、感觉神经传导速度,安全可靠。

Objective To observe the clinical efficacy of moxibustion at Yishu(EX-B3)on diabetic peripheral neuropathy(DPN)of Qi deficiency and blood stasis syndrome and its influence on blood glucose fluctuation and sensory conduction velocity(SCV).Methods A total of 72 DPN patients(Qi deficiency and blood stasis syndrome)were randomly assigned into the treatment group(n=36)and the control group(n=36).All patients were managed by mecobalamin,and those in the treatment group were additionally treated with moxibustion at Yishu(EX-B3).Treated for 4 weeks,the aim was to compare fasting plasma glucose(FPG),2 h postprandial glucose(2 hPG),standard deviation of blood glucose(SDBG),postprandial plasma glucose excursion(PPGE),largest amplitude of glycemic excursion(LAGE),SCV of tibial nerve and sural nerve.The curative effect and safety were assessed.Results The overall effective rate in the treatment group was better than that in the control group(86.1%[31/36]vs 63.9%[23/36],[P<0.05],respectively).There were no statistically significant differences in FPG and 2 hPG between groups before and after treatment(all P>0.05).After treatment,SDBG,PPGE,LAGE in groups were significantly decreased(P<0.05),which decreased notably in the treatment group compared with the control group(P<0.05).After treatment,the SCV of tibial nerve and sural nerve in groups was significantly increased(P<0.05),the increase in the treatment group was more common than the control group(P<0.05).There were no adverse reactions in both groups,and no cases dropped out.No abnormalities in blood routine,liver and kidney function,and coagulation four indices before and after treatment were found.Conclusion For DPN patients(Qi deficiency and blood stasis syndrome),moxibustion at Yishu(EX-B3)can improve blood glucose fluctuation,clinical symptoms,and SCV,and it is safe and reliable.