加减消痹汤配合针刺对糖尿病周围神经病变炎症因子和血液流变学指标的影响研究  

Study on Effect of Modified Xiaobi Decoction(加减消痹汤)Combined with Acupuncture on Inflammatory Factors and Hemorheological Indexes in Patients with Diabetic Peripheral Neuropathy

作　　者：刘畅 邱新萍 马万千 LIU Chang;QIU Xinping;MA Wanqian(Beijing Traditional Chinese Medicine Hospital,Shunyi Hospital,Beijing 101300,China)

机构地区：[1]北京中医医院顺义医院,北京101300

出　　处：《中华中医药学刊》2021年第12期117-120,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家中医药管理局马万千全国基层名老中医药专家传承工作室(国中医药人教教育便函[2017]325)。

摘　　要：目的探讨加减消痹汤配合针刺对糖尿病周围神经病变患者炎症因子和血液流变学指标的影响。方法以2018年1月—2019年12月医院收治的糖尿病周围神经病变患者95例为研究对象,依据治疗方法的不同分为研究组(49例)和对照组(46例),对照组给予糖尿病常规干预,包括饮食和运动,在此基础上加腺苷钴胺注射液治疗。研究组在对照组治疗的基础上,口服加减消痹汤配合针刺治疗。两组持续治疗8周。比较两组治疗前后临床证候积分和治疗疗效,比较两组治疗前后血糖指标(FPG、2 hPG、HbA1c)、肌电图指标、炎症因子指标(NO、IL-1β及IL-18)、血液流变学指标(全血黏度高切、全血黏度低切、血浆黏度、纤维蛋白原和血细胞比容)。结果研究组治疗总有效率高于对照组(P<0.05);研究组治疗后中医证候评分低于对照组(P<0.05);研究组治疗后FPG、2 hPG、HbA1c低于对照组(P<0.05);研究组治疗后右腓神经和正中神经的感觉神经传导速度(SNCV)和运动神经传导速度(MNCV)较对照组明显增快(P<0.05);两组治疗后血清NO水平较治疗前升高,IL-1β及IL-18水平较治疗前降低,且观察组改善幅度优于对照组(P<0.05);研究组治疗后血液流变学指标低于对照组(P<0.05)。结论加减消痹汤配合针刺能明显的降低糖尿病周围神经病变患者的中医证候评分,改善血糖水平,改善神经传导速度和血液流变学指标,降低炎症反应,提高治疗效果,联用临床价值高于单独西药治疗。Objective To investigate the effects of Modified Xiaobi Decoction(加减消痹汤)combined with acupuncture on inflammatory factors and hemorheological indexes in patients with diabetic peripheral neuropathy.Methods A total of 95 patients with diabetic peripheral neuropathy admitted to our hospital from January 2018 to December 2019 were divided into study group(49 cases)and control group(46 cases)according to different treatment methods.The control group was given routine intervention for diabetes,including diet and exercise,on the basis of which Adenosine Cobalamine Injection was added.On the basis of the treatment in the control group,the study group was given Modified Xiaobi Decoction orally combined with acupuncture treatment.Both groups were treated for 8 weeks.Clinical symptom scores and therapeutic efficacy were compared between the two groups before and after treatment.Blood glucose indexes(FPG,2 hPG,HbA1 c),EMG indexes,inflammatory factors indexes(NO,IL-1βand IL-18),blood rheology indexes(high whole blood viscosity,low whole blood viscosity,plasma viscosity,fibrinogen and hematocyte volume)were compared between the two groups before and after treatment.Results The total effective rate of the study group was higher than that of the control group(P<0.05).The scores of TCM symptoms in the study group were lower than those in the control group(P<0.05).After treatment,FPG,2 hPG and HbA1 c in the study group were lower than those in the control group(P<0.05).The sensory nerve conduction velocity(SNCV)and motor nerve conduction velocity(MNCV)of the right peroneal nerve and median nerve in the study group were significantly higher than those in the control group(P<0.05).After treatment,serum NO level was increased,and levels of IL-1βand IL-18 were decreased in both groups,and the improvement of the observation group was better than that of the control group(P<0.05).The blood rheological index was lower than that of the control group after treatment(P<0.05)Conclusion Modified Xiaobi Decoction with the acupunct

关 键 词：加减消痹汤 针刺 糖尿病周围神经病变 炎症因子 血液流变学 

分 类 号：R259.872[医药卫生—中西医结合] R245.3[医药卫生—中医内科学]