穴位注射治疗脾虚痰湿型糖尿病周围神经病变的疗效观察  

Observations on the efficacy of acupuncture point injection for diabetic peripheral neuropathy of spleen deficiency and phlegm dampness type

作　　者：朱瑜艾 张永健[1] 曹亮[1] 朱晓亮 ZHU Yuai;ZHANG Yongjian;CAO Liang;ZHU Xiaoliang(Qinhuangdao Hospital of Chinese Medicine,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市中医医院,秦皇岛066000

出　　处：《上海针灸杂志》2023年第9期910-916,共7页Shanghai Journal of Acupuncture and Moxibustion

基　　金：河北省医学科学研究计划(20220623)。

摘　　要：目的观察穴位注射治疗脾虚痰湿型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随机分为研究组和对照组,每组60例。对照组给予西医基础对症治疗,研究组在西医基础对症治疗同时给予穴位注射灯盏细辛注射液治疗。观察两组治疗前后血Toll样受体2(Toll-like receptors 2,TLR2)、高迁移率族蛋白B1(high mobility group protein B1,HMGB1)、可溶性血管细胞黏附分子-1(soluble vascular cell adhesion molecule-1,sVCAM-1)、γ-谷氨酰转肽酶(γ-glutamyl transpeptidase,γ-GGT)、脂氧素A4(lipoxin A4,LXA4)、超氧化物歧化酶(superoxide dismutase,SOD)、活性氧(reactive oxygen species,ROS)、同型半胱氨酸(homocysteine,Hcy)、血友病因子(von willebrand factor,vWF)、血管内皮生长因子(vascular endothelial growth factor,VEGF)、γ-氨基丁酸(γ-aminobutyric acid,γ-GABA)、神经生长因子(nerve growth factor,NGF)和胰岛素样生长因子-1(insulin-like growth factor 1,IGF-1)含量,检测腓神经及正中神经的运动神经传导速度(motor nerve conduction velocity,MCV)和感觉神经传导速度(sensory nerve conduction velocity,SCV),并比较两组临床疗效。结果研究组血HMGB1、TLR2、sVCAM-1、ROS、γ-GGT、vWF、Hcy含量较对照组降低(P<0.05);研究组血SOD、LXA4、γ-GABA、VEGF、IGF-1、NGF含量较对照组升高(P<0.05);研究组正中神经及腓总神经SCV和MCV较对照组升高(P<0.05);研究组总有效率高于对照组(P<0.05)。结论在西医基础对症治疗的基础上,穴位注射治疗脾虚痰湿型糖尿病周围神经病变疗效明显,可抑制机体炎症,改善氧化应激反应,减少血管内皮功能损伤,提升γ-GABA、NGF、IGF-1含量,改善神经传导速度。Objective To observe the clinical efficacy of acupuncture point injection for diabetic peripheral neuropathy of spleen deficiency and phlegm dampness type.Method One hundred and twenty patients with diabetic peripheral neuropathy were randomized to study and control groups,with 60 cases in each group.The control group received basic symptomatic treatment of Western medicine and the study group,acupuncture point injection of Dengzhanxixin injection in addition.Blood toll-like receptors 2(TLR2),high mobility group protein B1(HMGB1),soluble vascular cell adhesion molecule-1(sVCAM-1),γ-glutamyl transpeptidase(γ-GGT),lipoxin A4(LXA4),superoxide dismutase(SOD),reactive oxygen species(ROS),homocysteine(Hcy),von willebrand factor(vWF),vascular endothelial growth factor(VEGF),γ-aminobutyric acid(γ-GABA),nerve growth factor(NGF)and insulin-like growth factor 1(IGF-1)contents were measured in the two groups before and after treatment.Peroneal nerve and median nerve motor nerve conduction velocity(MCV)and sensory nerve conduction velocity(SCV)were determined.The clinical therapeutic effects were compared between the two groups.Result Blood HMGB1,TLR2,sVCAM-1,ROS,γ-GGT,vWF and Hcy contents were lower in the study group than in the control group(P<0.05).Blood SOD,LXA4,γ-GABA,VEGF,IGF-1 and NGF contents were higher in the study group than in the control group(P<0.05).Peroneal nerve and median nerve MCV and SCV were higher in the study group than in the control group(P<0.05).The total efficacy rate was higher in the study group than in the control group(P<0.05).Conclusion On the basis of basic symptomatic treatment of Western medicine,acupuncture point injection has a marked therapeutic effect in treating diabetic peripheral neuropathy of spleen deficiency and phlegm dampness type.It can inhibit bodily inflammation,reduce oxidative stress response,decrease the impairment of vascular endothelial function,increase γ-GABA,NGF and IGF-1 contents and improve nerve conduction velocity.

关 键 词：水针 糖尿病 糖尿病并发症 脾虚痰湿 周围神经系统疾病 氧化应激 神经传导速度 

分 类 号：R246.1[医药卫生—针灸推拿学]