穴位按摩治疗血瘀不畅型糖尿病周围神经病变的临床观察

Clinical observation on acupoint massage for the treatment of blood stasis impediment type diabetic peripheral neuropathy

目的:观察穴位按摩对糖尿病周围神经病变(DPN)患者临床症状、神经传导速度的影响。方法:选取2022年1-6月新疆维吾尔自治区中医医院就诊的血瘀不畅型DPN患者120例。根据入院顺序,选用随机数表法分为3组:对照组、甲钴胺组、穴位按摩组,每组40例。3组均给予常规基础治疗,对照组不予其他处理;甲钴胺组另予口服甲钴胺片,每次0.5 mg,每天3次;穴位按摩组另予桥弓、内关、血海、委中、承山、足三里、三阴交、太溪、太冲、内庭10个穴位按摩,每个穴位按摩约3 min,持续按摩约为20 min,每周5次;均持续2周。分析各组患者治疗前后临床症状积分、胫神经和腓浅神经的感觉神经传导速度(SCV)、多伦多临床评分系统(TCSS)评分的变化。结果:治疗后,各组临床症状积分、TCSS评分较治疗前均显著降低(P<0.05);甲钴胺组、穴位按摩组效果较对照组更好(P<0.05);且穴位按摩组与甲钴胺组效果一样。各组间、组内胫神经、腓浅神经SCV均较治疗前变化不明显。结论:穴位按摩组能够更好地降低临床症状积分、TCSS评分,其效果与甲钴胺组相当。

Objective:To observe the effects of acupoint massage on clinical symptoms and nerve conduction velocity in patients with diabetic peripheral neuropathy(DPN).Methods:A total of 120 patients with blood stasis impediment type DPN admitted to Xinjiang Uygur Autonomous Region Hospital of Traditional Chinese Medicine during the period of January-June 2022 were selected.According to the order of admission,the random number table method was chosen to divide them into three groups:the control group,the methylcobalamin group,and the acupressure group,with 40 cases in each group.On the basis of conventional basic treatment,no other treatment was given to the control group;the methylcobalamin group was given oral methylcobalamin tablets,O.5 mg each time,three times a day;the acupressure group was given 10 acupoint massages,such as Qiaogong,Neiguan(PC6),Xuehai(SP10),Weizhong(BL40),Chengshan(BL57),Zusanli(ST36),Sanyinjiao(SP6),Taixi(KI3),Taichong(LR3),Neiting(ST44),with each acupoint being massaged for about 3 minutes,and the continuous massage lasting for about 20 minutes,five times a week for 2 weeks.The changes in clinical symptom scores,sensory nerve conduction velocity(SCV)of tibial nerves and superficial peroneal nerves,TCSS scores before and after treatment in each group were analysised.Results:After treatment,the clinical symptom scores and TCSS scores of each group were significantly reduced than that before the treatment(P<0.05),the effects of the methylcobalamin group and the acupressure group was better thant that ocntrol group(P<0.05),and the acupressure group was able to achieve the same effect as that of the methylcobalamin group.The SCV of tibial nerve and superficial peroneal nerve did not change significantly between and within groups compared with that before treatment.Conclusion:The acupressure group is able to reduce the clinical symptom score and TCSS score,and its clinical ffect is comparable to that of the methylcobalamin group.