针刺加叩刺治疗阴虚夹瘀型2型糖尿病疗效观察  

Efficacy observation of acupuncture and tapping therapy in the treatment of type 2 diabetes of yin deficiency pattern combined with stasis in the patients

作　　者：汪一丹 刘志诚[1] 徐斌[1] 

机构地区：[1]南京中医药大学针药结合省部共建教育部重点实验室,江苏南京230046

出　　处：《中国针灸》2014年第8期731-735,共5页Chinese Acupuncture & Moxibustion

基　　金：国家自然科学基金资助项目:39770929;高等学校博士学科点专项科研基金资助项目:20040315008

摘　　要：目的:探讨针刺加叩刺治疗阴虚夹瘀型2型糖尿病患者的临床疗效及其作用机制。方法:将112例患者采用先针刺后叩刺的治疗方法,先取太溪、神门、太白、太渊、三阴交、足三里行提插捻转补法为主,太冲、合谷、血海、丰隆行平补平泻法,留针30min;起针后取膈俞、胰俞、肝俞、肾俞、脾俞梅花针叩刺,隔日治疗1次,治疗3个月。观察患者治疗前后脂肪-胰岛轴相关指标空腹血糖(FPG)、空腹瘦素(FLP)、空腹胰岛素(FINS)、胰岛素敏感性指数(ISI)、胰岛素抵抗指数(Homa-IR)、胰岛素分泌指数(Homa-β)以及肥胖和血脂等指标的变化。结果:治疗后总有效率为84.8%(95/112),且瘀证为主者疗效优于阴虚为主者[92.9%(52/56)vs 76.8%(43/56),P<0.05];治疗前患者FPG、FLP、FINS、Homa-IR、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、体质量、体质指数(BMI)、肥胖指标百分率(F%)、肥胖度(A)均明显高于正常组水平(均P<0.01);高密度脂蛋白胆固醇(HDL-C)、ISI低于正常组水平(均P<0.01)。治疗后FPG、FLP、FINS、Homa-IR、TC、TG、LDL-C、体质量、BMI、F%、A均较治疗前明显下降(均P<0.01),ISI、HDL-C明显升高(均P<0.01)。轻度肥胖者疗效均优于中度肥胖、重度肥胖者,年龄小者疗效优于年龄大者,男性患者疗效优于女性,但差异均无统计学意义(均P>0.05);病程10年以内者疗效优于病程10年以上者(P<0.01)。结论:针刺加叩刺治疗阴虚夹瘀型2型糖尿病疗效显著,其机制可能与良性调整患者糖、脂质代谢及脂肪-胰岛轴有关。ABSTRACT Objective To explore the clinical efficacy and mechanism of acupuncture and tapping therapy in the treatment of type 2 diabetes of yin deficiency pattern combined with stasis in the patients. Methods One hundred and twelve patients were treated with acupuncture, followed by tapping method. The reinforcing method with lift- ing, thrusting and rotating needle technique was used at Taixi （KI 3）, Shenmen （HT 7）, Taibai （SP 3）, Taiyuan （LU 9）, Sanyinjiao （SP 6） and Zusanli （ST 36） ; and the even-needling technique was used at Taichong （LR 3）, Hegu （LI 4）, Xuehai （SP 10） and Fenglong （ST 40）. The needles were remained for 30 min. After needle remov- al, the tapping method with plum-blossom needle was applied to Geshu （BL 17）, Yishu （EX-B 3）, Ganshu （BL 18）, Shenshu （BL 23） and Pishu （BL 20）, once every two days. The treatment of 3 months was required. The changes were observed before and after treatment in the relevant indices of fat-islet axis such as fasting plasma glu- cose （FPG）, fasting leptin （FLP）, fasting insulin （FINS）, insulin sensitivity index （ISI）, insulin resistance （Ho- ma IR）, insulin secretion index （Homa-l]） and the indices of obesity and blood lipids in the patients. Results Af- ter treatment, the total effective rate was 84.8% （95/112）, in which the efficacy on the stasis predominated syn- drome was better than that of yin deficiency predominated syndrome [92.9% （52/56） vs 76.8% （43/56）, P〈0.05]. Before treatment, FPG, FLP, FINS, Homa-IR, total cholesterol （TC）, trigtyceride （TG）, low-density lipoprotein cholesterol （LDL-C）, body mass, body mass index （BMI）, fat percentage （F%） and obesity degree in thepatients were higher obviously than those in the normal group （all P〈0.01） ; high-density lipoprotein cholesterol （HDL-C） and ISI were lower than those in the normal group （both P%0. 01）. After treatment, FPG, FLP, FINS, Homa-IR, TC, TG, LDL-C, body mass, BMI, F~

关 键 词：2型糖尿病 针刺疗法 叩刺 脂肪-胰岛轴 血脂 

分 类 号：R246.1[医药卫生—针灸推拿学]