辨病、辨证配穴针刺治疗糖尿病周围神经病变临床研究  

Treatment of diabetes peripheral neuropathy with acupuncture based on disease differentiation and syndrome differentiation acupoint selection

作　　者：崔杰[1] 谈力欣[2] CUI Jie;TAN Lixin(Department of Traditional Chinese Medicine for Diabetes,Shijiazhuang Second Hospital,Shijiazhuang,Hebei 050051;Department of Diabetes Rehabilitation,Shijiazhuang Second Hospital,Shijiazhuang,Hebei 050051)

机构地区：[1]河北省石家庄市第二医院糖尿病中医科,河北石家庄050051 [2]河北省石家庄市第二医院糖尿病康复科,河北石家庄050051

出　　处：《河北中医》2023年第7期1160-1163,1168,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：河北省中医药管理局2019年度中医药类科研计划课题(编号:2019417)。

摘　　要：目的观察辨病、辨证配穴针刺治疗糖尿病周围神经病变的临床疗效。方法将120例糖尿病周围神经病变患者按照随机数字表法分为2组,对照组60例予甲钴胺片治疗,治疗组60例予辨病、辨证配穴针刺治疗。比较2组治疗前后空腹血糖(FPG)、糖化白蛋白(GA)、血糖水平标准差(SDBG)、餐后血糖波动幅度(PPGE)、最大血糖波动幅度(LAGE)、平均血糖波动幅度(MAGE)以及双侧正中神经、腓肠神经电流感觉阈值(CPT值),统计比较2组临床疗效。结果治疗组总有效率85.00%(51/60),对照组总有效率66.67%(40/60),治疗组总有效率高于对照组(P<0.05)。治疗后,2组SDBG、PPGE、LAGE、MAGE均较本组治疗前降低(P<0.05),且治疗组低于对照组(P<0.05)。治疗后2组FPG及GA与本组治疗前比较差异均无统计学意义(P>0.05),且组间比较差异亦均无统计学意义(P>0.05)。治疗后,2组左侧、右侧正中神经和腓肠神经在2000、250、5 Hz电流刺激下的CPT值均较本组治疗前降低(P<0.05),且治疗组均低于对照组(P<0.05)。结论辨病、辨证配穴针刺治疗糖尿病周围神经病变能改善患者血糖波动及正中神经、腓肠神经感觉障碍。Objective To observe the clinical efficacy of acupuncture on patients with diabetes peripheral neuropathy based on disease differentiation and syndrome differentiation acupoint selection.Methods A total of 120 patients with diabetic peripheral neuropathy were randomly assigned into control group(n=60)and treatment group(n=60).Mecobalamin tablets and acupuncture treatment based on disease differentiation and syndrome differentiation acupoint selection were given to the control group and the treatment group respectively.The key observation was fasting plasma glucose(FPG),glycated albumin(GA),standard deviation of blood glucose(SDBG),postprandial glucose excursion(PPGE),largest amplitude of glycemic excursion(LAGE),mean amplitude of glycemic excursions(MAGE),current perception threshold(CPT value)of bilateral median and sural nerve.The clinical efficacy of the two groups was counted.Results After treatment,the total effective rate in the treatment group was higher than that in the control group(85.00%[51/60]vs 66.67%[40/60],P<0.05).SDBG,PPGE,LAGE and MAGE in the two groups were decreased than those before treatment(P<0.05),and which were significant pronounced in the treatment group than in the control group(P<0.05).There was no significant difference in FPG and GA between before treatment and after treatment in the both groups(P>0.05),and there was no significant difference in inter-group FPG and GA after treatment(P>0.05).After treatment,when the current was 2000,250,5 Hz,the CPT values of bilateral median and sural nerve in the both groups were lower than those before treatment(P<0.05),and the CPT values in the treatment group were significantly lower than those in the control group(P<0.05).Conclusion For diabetes peripheral neuropathy,acupuncture based on disease differentiation and syndrome differentiation acupoint selection can improve blood glucose fluctuations and sensory disorders of median and sural nerve.

关 键 词：糖尿病神经病变 针刺疗法 

分 类 号：R587.250.5[医药卫生—内分泌] R245.31[医药卫生—内科学]