针刺联合生理性缺血训练治疗糖尿病下肢动脉硬化闭塞症  

Acupuncture Combined with Physiological Ischemia Training in Treatment of Diabetic Lower Extremity Arteriosclerosis Obliterans

作　　者：魏桂梅[1] 任锟[2] 赵璐[1] 张珂珂 万红[3] 燕树勋[3] WEI Guimei;REN Kun;ZHAO Lu;ZHANG Keke;WAN Hong;YAN Shuxun(The Third Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou Henan China 450008;The Second Affiliated Hospital of Henan University of Chinese Medicine/Henan Province Hospital of TCM,Zhengzhou Henan China 450002;The First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou Henan China 450000)

机构地区：[1]河南中医药大学第三附属医院,河南郑州450008 [2]河南中医药大学第二附属医院/河南省中医院,河南郑州450002 [3]河南中医药大学第一附属附院,河南郑州450000

出　　处：《中医学报》2022年第4期857-862,共6页Acta Chinese Medicine

基　　金：河南省中医药科学研究专项课题项目(20-21ZY2227)。

摘　　要：目的:观察针刺联合生理性缺血训练治疗糖尿病下肢动脉硬化闭塞症的临床疗效。方法:将52例糖尿病下肢动脉硬化闭塞症患者按照就诊顺序随机分为观察组(26例)与对照组(26例)。对照组给予针刺治疗,观察组给予针刺+生理性缺血训练。比较两组患者治疗前后的踝肱指数(ankle-brachial index, ABI),动脉硬化指数(atherosclerosis index, AI),空腹血糖(fasting blood-glucose, FPG)、糖化血红蛋白(glycosylated hemoglobin, HbA1c)、总胆固醇(total cholesterol, TC)、三酰甘油(triacylglycerol, TG)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol, HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein cholesterin, LDL-C)、纤维蛋白原(fibrinogen, FIB)水平,下肢血管超声检查及两组患者临床疗效。结果:观察组有效率为96.15%,明显优于对照组(76.92%),差异有统计学意义(P <0.05)。治疗后,两组患者FPG、HbA1c、TC、TG、LDL-C和FIB水平均显著低于治疗前,HDL-C明显高于治疗前(P<0.05);观察组FPG、HbA1c、TC、TG、LDL-C和FIB水平显著低于同期对照组,HDL-C显著高于同期对照组(P<0.05)。治疗后,两组患者ABI显著高于治疗前,AI显著低于治疗前(P<0.05);观察组ABI显著高于同期对照组,AI显著低于同期对照组(P<0.05)。治疗后,两组患者胫后动脉和足背动脉血管内径、血流量和收缩期峰值流速均明显高于治疗前(P<0.05),且观察组明显高于同期对照组(P<0.05)。结论:针刺联合生理性缺血训练治疗糖尿病下肢动脉硬化闭塞症的临床疗效确切,可有效改善临床症状,调节脂糖代谢紊乱,促进血液循环、改善疾病预后。Objective: To observe the clinical effect of acupuncture combined with physiological ischemia training in the treatment of diabetic lower extremity arteriosclerosis obliterans.Methods: 52 patients with diabetic lower extremity arteriosclerosis obliterans were randomly divided into observation group(26 cases) and control group(26 cases) according to the order of treatment.The control group was given acupuncture, while the observation group was given acupuncture plus physiological ischemia training.The level of the ankle-brachial index(ABI),atherosclerosis index(AI),fasting blood-glucose(FPG),glycosylated hemoglobin(HbA1 c),total cholesterol(TC),triacylglycerol(TG),high density lipoprotein cholesterol,(HDL-C),low density lipoprotein cholesterol,(LDL-C),and the level of fibrinogen(FIB) were compared between the two groups before and after treatment.Ultrasound was used to examine the lower extremity blood vessels and clinical efficacy of two groups of patients.Results: The effective rate of the observation group was 96.15%,which was significantly better than that of the control group, and the difference was statistically significant(P<0.05).After treatment, the levels of FPG,HbA1 c, TC, TG, LDL-C,and FIB in the two groups were significantly lower than before treatment, and HDL-C was significantly higher than before treatment(P<0.05).The levels of FPG,HbA1 c, TC, TG, LDL-C,and FIB in the observation group were significantly lower than those in the control group, and DL-C was significantly higher than that in the control group(P<0.05).After treatment, the ABI scores of the two groups of patients were significantly higher than those before treatment, and the AI scores were significantly lower than those before treatment(P<0.05).The ABI scores of the observation group were significantly higher than those of the control group at the same period, and the AI scores were significantly lower than those of the control group at the same period(P<0.05).After treatment, the inner diameter, blood flow, and peak systolic flow veloc

关 键 词：糖尿病下肢动脉硬化闭塞症 针刺 生理性缺血训练 踝肱指数 动脉硬化指数 血糖 血脂 

分 类 号：R259.872[医药卫生—中西医结合]