龙胆泻肝汤联合穴位敷贴治疗老年糖尿病足伴失眠的随机对照研究  

A randomized controlled study of Longdan Xiegan decoction combined with acupoint application in the treatment of diabetes foot with insomnia in elderly patients

作　　者：董燕萍[1] 李福伦[2] 赵稼萤 Dong Yanping;Li Fulun;Zhao Jiaying(Department of Geriatrics,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai,200437,P.R.China;Departmentof Dermatology,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai,200437,P.R.China;Department of Internal Medicine,Traditional Chinese Medicine Hospital of Jiading District,Shanghai,201800,P.R.China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院老年科,上海200437 [2]上海中医药大学附属岳阳中西医结合医院皮肤科,上海200437 [3]上海市嘉定区中医医院内科,上海201800

出　　处：《老年医学与保健》2022年第3期616-621,共6页Geriatrics & Health Care

基　　金：上海市浦东新区卫生和计划生育委员会学科建设计划(PWZxq2017-16)。

摘　　要：目的观察龙胆泻肝汤加减联合穴位敷贴治疗肝火扰心型老年糖尿病足伴失眠患者的临床疗效及其对血清钙调蛋白的影响。方法纳入2018年1月—2020年12月上海中医药大学附属岳阳中西医结合医院老年科门诊及病房收治的肝火扰心型老年糖尿病足伴失眠患者90例,使用随机数字表分为联合组和对照组。2组均给予糖尿病饮食控制、口服或注射胰岛素控制血糖、改善循环、营养神经、抗血小板聚集、调脂治疗。根据情况给予抗感染治疗和创面治疗。按需给予安眠药物等基础治疗。在此基础上,联合组给予内服龙胆泻肝汤加减联合穴位敷贴治疗;对照组给予安慰剂治疗;共治疗8周。观察比较2组总有效率、匹兹堡睡眠质量指数(PSQI)、失眠严重指数量表(ISI)、爱泼沃斯嗜睡量表(ESS)、疲劳量表(FS-14)评分以及血清钙调蛋白(CaM)含量。结果治疗结束后,联合组总有效率为90.24%,高于对照组(P<0.05);联合组治疗后的PSQI评分、ISI评分、ESS评分和FS-14评分分别为(8.60±3.09)分、(11.34±3.75)分、(9.35±4.39)分和(5.39±1.48)分,均低于本组治疗前(P<0.05);而血清钙调蛋白含量为(49.35±4.39)ng/mL,高于本组治疗前(P<0.05)。与对照组相比差异有统计学意义(P<0.05)。结论龙胆泻肝汤加减联合穴位敷贴治疗糖尿病足伴肝火扰心型失眠,可改善患者的睡眠质量和日间生活质量,升高血清钙调蛋白含量,值得进一步研究。Objective To observe the clinical efficacy of modified Longdan Xiegan decoction combined with acupoint application in the treatment of elderly patients with diabetic foot complicated with the liver fire disturbing heart type insomnia and its effect on serum calmodulin.Methods A total of90elderly patients with diabetic foot complicated with the liver fire disturbing heart type insomnia who were admitted to the outpatient department and ward of Department of Geriatrics,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine from January2018to December2020were enrolled and divided into combined group and control group by random number table.Both groups were treated with diabetic diet control,oral or injectable insulin to control blood glucose,improve microcirculation,nourish nerves,anti-platelet aggregation,and lipid-lowering treatment.Anti-infective treatment and wound treatment were given according to the conditions.Basic treatments such as sleeping drugs were given as needed.On the basis of the above,the combined group was treated with modified Longdan Xiegan decoction combined with acupoint application and the control group was treated with placebo.The two groups were treated for8weeks.The total effective rate,Pittsburgh Sleep Quality Index(PSQI),insomnia severity index(ISI),Epworth Sleepiness Scale(ESS),Fatigue Scale(FS-14)and serum calmodulin(CaM)content were observed and compared between the two groups.Result After the treatment,the total effective rate of the combined group was90.24%,which was higher than that of the control group(P<0.05).The PSQI score,ISI score,ESS score and FS-14 score of the combined group after treatment were 8.60±3.09,11.34±3.75,9.35±4.39and5.39±1.48,respectively,which were all lower than those of the same group before treatment(P<0.05);and serum CaM content was(49.35±4.39)ng/mL,which was higher than that of the same group before treatment(P<0.05).Compared with the control group,the differences were

关 键 词：老年 龙胆泻肝汤 穴位敷贴 糖尿病足 失眠 肝火扰心证 

分 类 号：R259[医药卫生—中西医结合] R256.23[医药卫生—中医内科学]