扬刺法为主治疗糖尿病周围神经病变的临床疗效观察
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摘要
目的:比较扬刺法与常规针刺法的临床疗效差异,为糖尿病周围神经病变的针刺治疗提供依据。方法:将40例患者随机分为扬刺组(21例)和常规组(19例)。两组均给予相同基础用药,针刺穴位取膈俞、胃脘下俞、肝俞、脾俞、肾俞、足三里、太溪、阿是穴,常规组采用普通针刺治疗,扬刺组在常规组治疗的基础上,配合局部扬刺法治疗。观察两组患者治疗前后糖尿病周围神经病变积分、神经传导速度的变化,并评定两组疗效。结果:两组均能促进糖尿病周围神经功能恢复,扬刺组痊愈率为85.7%(18/21),优于常规组的63.2%(12/19,P <0.05);治疗后,扬刺组与常规组正中神经和腓总神经各自SNCV及MNCV均较治疗前提高(P <0.05)。两组间正中神经SNCV及MNCV比较,扬刺组优于常规组(P <0.05);两组间腓总神经SNCV比较,扬刺组优于常规组(P <0.05),两组间腓总神经MNCV比较,差异无统计学意义(P> 0.05)。结论:扬刺组与常规组治疗糖尿病周围神经病变皆有良好的临床疗效,扬刺组在改善糖尿病患者感觉障碍、肌力减弱等临床体征方面,及提高患者的神经传导性和临床疗效方面,优于常规针刺组。
Objective: To compare the effect of the Yang-needling( 扬 刺 法) and conventional acupuncture on diabetic peripheral neuropathy, and provide the basis for treating diabetic peripheral neuropathy by acupuncture. Methods: 40 patients were randomly divided into the Yang-needling group(n=21) and conventional group(n=19). Two groups were given the same basic medication; acupuncture points were Geshu( 膈俞), Weiwanxiashu( 胃脘下俞), Ganshu( 肝俞), Pishu( 脾俞), Shenshu( 肾俞), Zusanli( 足三里), Taixi( 太溪), Ashixue(阿是穴). The conventional group was given conventional acupuncture; the Yang-needling group was treated by the Yang-needling. The changes of diabetic peripheral neuropathy and nerve conduction velocity were observed before and after treatment in two groups; and the curative effect was evaluated. Results: The methods in groups can promote the recovery of diabetic peripheral nerve function. The total efficiency in the Yang-needling group was 85.7%, which was better than 63.2% in the conventional group, P<0.05. The SNCV and MNCV of median nerve and common peroneal nerve in groups were significantly higher than before treatment. After treatment, the SNCV and MNCV of median nerve in the Yang-needling group were higher than the conventional group; the SNCV of common peroneal nerve in the Yang-needling group was higher than the conventional group; there was no statistically significant difference of the MNCV of common peroneal nerve between groups(P>0.05). Conclusion: The methods in the Yang-needling group and conventional group on diabetic peripheral neuropathy showed good efficacy. The Yang-needling can improve sensory disturbances, weakness and other clinical signs, and improve nerve conduction and clinical efficacy, is better than conventional acupuncture.
Objective: To compare the effect of the Yang-needling( 扬 刺 法) and conventional acupuncture on diabetic peripheral neuropathy, and provide the basis for treating diabetic peripheral neuropathy by acupuncture. Methods: 40 patients were randomly divided into the Yang-needling group(n=21) and conventional group(n=19). Two groups were given the same basic medication; acupuncture points were Geshu( 膈俞), Weiwanxiashu( 胃脘下俞), Ganshu( 肝俞), Pishu( 脾俞), Shenshu( 肾俞), Zusanli( 足三里), Taixi( 太溪), Ashixue(阿是穴). The conventional group was given conventional acupuncture; the Yang-needling group was treated by the Yang-needling. The changes of diabetic peripheral neuropathy and nerve conduction velocity were observed before and after treatment in two groups; and the curative effect was evaluated. Results: The methods in groups can promote the recovery of diabetic peripheral nerve function. The total efficiency in the Yang-needling group was 85.7%, which was better than 63.2% in the conventional group, P<0.05. The SNCV and MNCV of median nerve and common peroneal nerve in groups were significantly higher than before treatment. After treatment, the SNCV and MNCV of median nerve in the Yang-needling group were higher than the conventional group; the SNCV of common peroneal nerve in the Yang-needling group was higher than the conventional group; there was no statistically significant difference of the MNCV of common peroneal nerve between groups(P>0.05). Conclusion: The methods in the Yang-needling group and conventional group on diabetic peripheral neuropathy showed good efficacy. The Yang-needling can improve sensory disturbances, weakness and other clinical signs, and improve nerve conduction and clinical efficacy, is better than conventional acupuncture.
引文
[1]刘彦辰.经方贴敷治疗糖尿病周围神经病变的临床疗效研究[D].广州:广州中医药大学,2013.
[2]Leinninger GM, Vincent AM, Feldman EL. The role of growth factor indiabetic peripheral neuropathy[J]. Peripher Nerv Syst,2004,9(1):26.
[3]中华医学会糖尿病学分会.中国2型糖尿防病治指南[J].中国糖尿病杂志,2014,22(8):2-42.
[4]中华人民共和国卫生部.中药新药临床研究指导原则(第一辑)[S].1993:34-36.
[5]吴名,张蒙,王瑞珉,等.针灸治疗糖尿病周围神经病变临床研究[J].中医学报,2015,30(6):810-812.
[6]Kashyap AS, AnandKP,KashyapS, etal.Peripheralneuropathy[J].Lancet,2004,364(9446):1664.
[7]Flynn MD,Tooke JE.Diabetic neuropathy and the microcirculalion[J].Diabet Med,1995,12(12):298.
[8]钱宝珊,黄淑玲.滋阴消痹方治疗糖尿病周围神经病变临床观察[J].世界中西医结合杂志,2017,12(1):122-125.
[9]白清.黄芪桂枝五汤对糖尿病周围神经病变的疗效及神经传导速度的影响[J].中成药,2015,37(5):962-964.
[10]陈瑞萍,陈冬梅.从肝论治糖尿病周围神经病变[J].中国医疗前沿,2010,5(12):9-14.
[11]路玫,李昆珊,王佳丽.针刺治疗糖尿病患者肢体远端对称性多发性周围神经病变:随机对照研究[J].中国针灸,2015,5(36):484.
[12]李军,金艳蓉,薛耀明.针灸治疗对糖尿病周围神经病变的影响——兼析随机对照临床研究的系统评价[J].世界科学技术——中医药现代化,2015,17(4):819-826.
[13]陈建中.针刺配合体穴贴压治疗糖尿病周围神经病变的疗效观察[D].北京:北京中医药大学,2013.
[2]Leinninger GM, Vincent AM, Feldman EL. The role of growth factor indiabetic peripheral neuropathy[J]. Peripher Nerv Syst,2004,9(1):26.
[3]中华医学会糖尿病学分会.中国2型糖尿防病治指南[J].中国糖尿病杂志,2014,22(8):2-42.
[4]中华人民共和国卫生部.中药新药临床研究指导原则(第一辑)[S].1993:34-36.
[5]吴名,张蒙,王瑞珉,等.针灸治疗糖尿病周围神经病变临床研究[J].中医学报,2015,30(6):810-812.
[6]Kashyap AS, AnandKP,KashyapS, etal.Peripheralneuropathy[J].Lancet,2004,364(9446):1664.
[7]Flynn MD,Tooke JE.Diabetic neuropathy and the microcirculalion[J].Diabet Med,1995,12(12):298.
[8]钱宝珊,黄淑玲.滋阴消痹方治疗糖尿病周围神经病变临床观察[J].世界中西医结合杂志,2017,12(1):122-125.
[9]白清.黄芪桂枝五汤对糖尿病周围神经病变的疗效及神经传导速度的影响[J].中成药,2015,37(5):962-964.
[10]陈瑞萍,陈冬梅.从肝论治糖尿病周围神经病变[J].中国医疗前沿,2010,5(12):9-14.
[11]路玫,李昆珊,王佳丽.针刺治疗糖尿病患者肢体远端对称性多发性周围神经病变:随机对照研究[J].中国针灸,2015,5(36):484.
[12]李军,金艳蓉,薛耀明.针灸治疗对糖尿病周围神经病变的影响——兼析随机对照临床研究的系统评价[J].世界科学技术——中医药现代化,2015,17(4):819-826.
[13]陈建中.针刺配合体穴贴压治疗糖尿病周围神经病变的疗效观察[D].北京:北京中医药大学,2013.