针刺联合前列腺素E1治疗2型糖尿病下肢动脉粥样硬化病变临床观察  

Clinical Observation of Acupuncture Combined with Prostaglandin E1 in Treating Lower-extremity Atherosclerosis in Type 2 Diabetes

作　　者：马国良[1] 陆军[1] 黄兴民[1] 朱建芳[1] 徐大伟[2] MA Guo-liang;LU Jun;HUANG Xing-min;ZHU Jian-fang;XU Da-wei(Rugao People’s Hospital,Rugao 226500,China;Nantong First People’s Hospital,Nantong 226000,China)

机构地区：[1]如皋市人民医院,如皋226500 [2]南通市第一人民医院,南通226000

出　　处：《上海针灸杂志》2020年第2期167-172,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：江苏省卫生计生委医学科研课题面上项目(H201754)

摘　　要：目的观察针刺联合前列腺素E1治疗2型糖尿病下肢动脉粥样硬化病变气阴两虚证的效果以及对患者血清脂肪细胞型脂肪酸结合蛋白(AFABP)和白细胞介素(IL)-17水平的影响。方法选取如皋市人民医院收治2型糖尿病下肢动脉粥样硬化性病变患者90例,按随机数字表法随机分为观察组和对照组,每组45例。两组均给予常规西医治疗,对照组给予前列腺素E1静脉滴注,观察组在对照组基础上予针刺治疗。治疗2个月后,比较两组血糖水平、踝肱指数(ABI)、气阴两虚证评分、疗效、胫前动脉的收缩期峰速、血管搏动指数、阻力指数以及血清AFABP和IL-17水平。结果观察组治疗后血糖水平、糖化血红蛋白(HbA1C)、气阴两虚证评分显著低于对照组,ABI明显高于对照组(P<0.01);观察组总有效率(93.3%)明显高于对照组(75.6%)(P<0.05);观察组患者胫前动脉的收缩期峰速、阻力指数明显低于对照组,血管搏动指数显著高于对照组(P<0.01);观察组血清AFABP和IL-17水平明显低于对照组(P<0.01)。结论针刺联合前列腺素E1能够降低2型糖尿病下肢动脉粥样硬化病变气阴两虚证患者的血糖水平,改善中医证候,增加下肢血流量,提高临床疗效,且可下调血清AFABP和IL-17水平。Objective To observe the efficacy of acupuncture combined with prostaglandin E1(PGE1)in treating lower-extremity atherosclerosis in type 2 diabetes with syndrome diagnosed as dual deficiency of qi and yin,and its effects on serum levels of adipocyte-type fatty acid binding protein(AFABP)and interleukin(IL)-17.Method Ninety patients with type 2 diabetes complicated with lower-extremity atherosclerosis were recruited from Rugao People’s Hospital and randomly divided into an observation group and a control group by the random number table method,with 45 cases in each group.Both groups were given conventional Western medicine treatment.The control group was given intravenous drip of PGE1,and the observation group received acupuncture treatment in addition to the intervention given to the control group.After 2-month treatment,the blood glucose level,ankle-brachial index(ABI),score of dual deficiency of qi and yin syndrome,efficacy,peak systolic velocity,pulsatility index,and resistance index of the anterior tibial artery,and the serum levels of AFABP and IL-17 of the two groups were compared.Result The blood glucose level,HbA1C and the score of dual deficiency of qi and yin syndrome were significantly lower and the ABI was significantly higher in the observation group than in the control group after treatment(P<0.01).The total effective rate in the observation group(93.3%)was markedly higher than that in the control group(75.6%)(P<0.05).The peak systolic velocity and resistance index of the anterior tibial artery were significantly lower and the pulsatility index was markedly higher in the observation group than in the control group(P<0.01).The serum levels of AFABP and IL-17 in the observation group were significantly lower than those in the control group(P<0.01).Conclusion In treatment of lower-extremity atherosclerosis in type 2 diabetes with syndrome diagnosed as dual deficiency of qi and yin,acupuncture combined with PGE1 can reduce the blood glucose level,improve the traditional Chinese medicine symptoms,incre

关 键 词：针刺疗法 针药并用 糖尿病血管病变 下肢动脉粥样硬化 气阴两虚证 血糖 踝肱指数 胫前动脉收缩期峰速 血管搏动指数 阻力指数 脂肪细胞型脂肪酸结合蛋白 白细胞介素-17 

分 类 号：R246.1[医药卫生—针灸推拿学]