益气温阳活血通络验方联合针刺治疗气虚血瘀型2型糖尿病周围神经病变的疗效及对氧化应激的影响  

Efficacy of Yiqi Wenyang Huoxue Tongluo Prescription Combined with Acupuncture on Type 2 Diabetic Peripheral Neuropathy of Qi Deficiency and Blood Stasis and Its Effect on Oxidative Stress

作　　者：林惠京[1] 刘艺芬 詹国良 LIN Hui-jing;LIU Yi-fen;ZHAN Guo-liang(Department of Endocrinology,Huizhou Hospital of Traditional Chinese Medicine,Huizhou Guangdong 516008)

机构地区：[1]惠州市中医医院内分泌科,广东惠州516008

出　　处：《世界中西医结合杂志》2022年第2期354-358,363,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：广东省中医药局科研项目(20181260)。

摘　　要：目的探讨针药结合治疗气虚血瘀型2型糖尿病周围神经病变(Diabetic peripheral neuropathy,DPN)的疗效,并观察其对机体氧化应激的影响。方法选取2018年7月—2020年5月期间惠州市中医医院内分泌科收治的气虚血瘀型2型DPN患者165例,按随机数字表法分为针刺组、中药组和针药组,每组各55例。所有患者均给予常规治疗,包括改善代谢,营养神经、抗氧化应激等。针刺组同时给予针刺原穴治疗,隔日1次。中药组同时给予益气温阳活血通络验方治疗,1剂/d。针药组同时给予针刺与中药验方结合治疗。3组患者均连续治疗8周。观察比较3组患者临床疗效,观察比较3组患者治疗前后中医证候积分、周围神经传导速度、氧化应激指标和不良反应情况。结果治疗后针药组总有效率为94.34%(50/53)均高于针刺组74.07%(40/54)和中药组81.13%(43/53),差异有统计学意义(P<0.05)。治疗后3组患者各项中医证候积分均较治疗前降低,差异有统计学意义(P<0.05),且多食易饥、神疲乏力、少气懒言、手足不温、肌肤甲错5项症候积分,中药组和针药组均较针刺组降低,差异有统计学意义(P<0.05)。肢体麻木或疼痛单项症候积分,针药组均较针刺组和中药组降低,差异有统计学意义(P<0.05)。治疗后3组患者周围神经MNCV正中神经、胫后神经、腓总神经和SNCV正中神经、胫后神经、腓总神经均较治疗前升高,差异有统计学意义(P<0.05);且针刺、针药组均高于中药组,针药组均高于针刺组,差异均有统计学意义(P<0.05)。治疗后3组患者血清SOD、TAOC水平均较治疗前升高,血清MDA水平均较治疗前降低,差异有统计学意义(P<0.05);且针药组血清SOD、TAOC水平均较针刺组和中药组升高,针药组血清MDA水平较针刺组和中药组降低,差异均有统计学意义(P<0.05)。3组患者不良反应比较,差异无统计学意义(P>0.05)。结论益气温阳活血通络验方联合针刺治Objective To investigate the efficacy of acupuncture and medicine in the treatment of type 2 diabetic peripheral neuropathy(DPN)with qi deficiency and blood stasis,and to observe its effect on oxidative stress.Methods Total of 165 DPN patients with Qi deficiency and blood stasis type who were admitted to the Endocrinology Department of Huizhou Hospital of Traditional Chinese Medicine from July 2018 to May 2020 were selected and divided into the acupuncture group(55),the Chinese medicine group(55)and the acupuncture and medicine group(55)according to the random number table.All patients were given conventional treatment,including improving metabolism,nutritional nerves,and anti-oxidative stress.The acupuncture group was given acupuncture at the original points every other day.The Chinese medicine group was given the treatment of Yiqi Wenyang Huoxue Tongluo prescription in our hospital,1 dose per day.And the acupuncture and medicine group were given acupuncture and Chinese medicine combined treatment.All groups were treated continuously for 8 weeks.After treatment,the clinical efficacy,the TCM syndrome scores,peripheral nerve conductionvelocity,the oxidative stress indicators,and adverse reactions of each group were compared.Results After treatment,the total effective rate of the acupuncture and medicine group(94.34%)(50/53)was higher than the acupuncture group 74.07%(40/54)and the Chinese medicine group 81.13%(43/53)(P<0.05).There was no statistical difference between the acupuncture group and the Chinese medicine group(P>0.05).After treatment,the scores of all TCM syndromes in each group were lower than before treatment,and the scores of the Duoshi Yiji,Shenpifali,Shaoqi lanyan,Shouzu Buwen in the Chinese medicine group and the acupuncture and medicine group were lowerthan those in the acupuncture group,the scores of limb numbness or pain in the acupuncture and medicine group were lower than those in the acupuncture group and the Chinese medicine group(P<0.05).After treatment,the motor nerve conduction velocity(M

关 键 词：2型糖尿病 糖尿病周围神经病变 气虚血瘀 益气温阳活血通络 针刺 氧化应激 

分 类 号：R245.31[医药卫生—针灸推拿学] R781.64[医药卫生—中医临床基础]