电子灸治疗糖尿病周围神经病变的临床研究
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摘要
目的观察电子灸治疗肝肾亏虚型糖尿病周围神经病变的临床疗效。方法将90例肝肾亏虚型糖尿病周围神经病变患者随机分为治疗组44例和对照组46例。治疗组采用温热电针艾绒隔热穴位治疗,对照组采用中药熏洗足部治疗。两组均治疗10次为1个疗程,共治疗3个疗程。观察两组治疗前后全血黏度、血脂、空腹血糖水平、糖化血红蛋白水平及密歇根神经筛查量表(MNSI)评分的变化情况。结果两组治疗前后全血黏度各项指标、血脂各项指标、空腹血糖水平及糖化血红蛋白水平差值比较,差异均无统计学意义(P>0.05)。两组治疗后MNSI评分组内及组间比较,差异均具有统计学意义(P<0.01);两组治疗前后MNSI评分差值比较,差异具有统计学意义(P<0.01)。结论电子灸是一种治疗糖尿病周围神经病变的有效方法。
Objective To observe the clinical efficacy of electronic moxibustion in treating diabetic peripheral neuropathy due to liver-kidney deficiency. Method Ninety patients with diabetic peripheral neuropathy due to liver-kidney deficiency were randomized into a treatment group of 44 cases and a control group of 46 cases. The treatment group was intervened by acupoint therapy by warm electronic moxibustion, while the control group was intervened by foot bath with Chinese medication. For both groups, 10 treatment sessions were taken as a course of treatment, for 3 courses in total. Before and after the treatment, the whole blood viscosity, blood lipids, fasting blood glucose(FBG), glycosylated hemoglobin(GHb) and Michigan Neuropathy Screening Instrument(MNSI) were evaluated in the two groups. Result The whole blood viscosity indexes, blood lipids levels, FBG level and GHb level didn't show significant differences after the treatment in the two groups(P>0.05). The intra-group and inter-group comparisons of MNSI score showed significant differences after the treatment(P<0.01); there was a between-group difference in the change of MNSI score after the treatment(P<0.01). Conclusion Electronic moxibustion is an effective approach in treating diabetic peripheral neuropathy.
Objective To observe the clinical efficacy of electronic moxibustion in treating diabetic peripheral neuropathy due to liver-kidney deficiency. Method Ninety patients with diabetic peripheral neuropathy due to liver-kidney deficiency were randomized into a treatment group of 44 cases and a control group of 46 cases. The treatment group was intervened by acupoint therapy by warm electronic moxibustion, while the control group was intervened by foot bath with Chinese medication. For both groups, 10 treatment sessions were taken as a course of treatment, for 3 courses in total. Before and after the treatment, the whole blood viscosity, blood lipids, fasting blood glucose(FBG), glycosylated hemoglobin(GHb) and Michigan Neuropathy Screening Instrument(MNSI) were evaluated in the two groups. Result The whole blood viscosity indexes, blood lipids levels, FBG level and GHb level didn't show significant differences after the treatment in the two groups(P>0.05). The intra-group and inter-group comparisons of MNSI score showed significant differences after the treatment(P<0.01); there was a between-group difference in the change of MNSI score after the treatment(P<0.01). Conclusion Electronic moxibustion is an effective approach in treating diabetic peripheral neuropathy.
引文
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[16]Nishizawa Y,Wada R,Baba M,et al.Neuropathy induced by exogenously administered advanced glycation end-products in rats[J].J Diabetes Investig,2010,1(1-2):40-49.
[17]邓青峰,曾蕊珠.中药封包疗法治疗糖尿病周围神经病变的临床观察[J].云南中医中药杂志,2017,38(10):34-35.
[18]严传亮.中西医结合治疗糖尿病周围神经病变的疗效分析[J].实用中西医结合临床,2015,15(6):60,67.
[19]杨婉花,张碧瑶,黄菁菁.糖尿病周围神经病变的中医辨证和治疗进展[J].世界中医药,2015,10(9):1448-1452.
[20]张子震,楚江静,王敏.腕踝针配合刺络拔罐治疗糖尿病周围神经病变临床观察[J].上海针灸杂志,2017,36(12):1443-1446.
[21]王栋才.针灸辅助治疗糖尿病周围神经病变对神经功能恢复及预后的影响[J].上海针灸杂志,2017,36(12):1439-1442.
[2]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:201,203.
[3]吴耀持,陆嘉惠,张敏.上海市基层中医药适宜技术操作指南[M].上海:上海科学技术出版社,2015:307-308.
[4]Bongaerts BW,Rathmann W,Heier M,et al.Older subjects with diabetes and prediabetes are frequently unaware of having distal sensorimotor polyneuropathy:the KORA F4 study[J].Diabetes Care,2013,36(5):1141-1146.
[5]Liu F,Bao Y,Hu RD,et al.Screening and prevalence of peripheral neuropathy in type 2 diabetic outpatients:a randomized multicentre survey in 12 city hospitals of China[J].Diabetes Metab Res Rev,2010,26(6):481-489.
[6]贾伟平,沈琴,包玉倩,等.糖尿病周围神经病变的检测方法及其诊断价值的评估[J].中华医学杂志,2006,86(38):2707-2710.
[7]Bril V.Treatments for diabetic neuropathy[J].J Peripher Nerv Syst,2012,17(Suppl 2):22-27.
[8]Mc Kay GJ,Paterson EN,Maxwell AP,et al.Retinal microvascular parameters are not associated with reduced renal function in a study of individuals with type 2diabetes[J].Sci Rep,2018,8(1):3931.
[9]Zeng X,Tang Y,Hu K,et al.Three-week topical treatment with placenta-derived mesenchymal stem cells hydrogel in a patient with diabetic foot ulcer:A case report[J].Medicine(Baltimore),2017,96(51):e9212.
[10]AI-Nasser B.Early involvement of spinal cord in diabetic peripheral neuropathy may influence patient outcome after neuraxial anesthesia[J].J Anesth,2012,26(6):951-952.
[11]Monastiriotis C,Papanas N,Veletza S,et al.APOE gene polymorphisms and diabetic peripheral neuropathy[J].Arch Med Sci,2012,8(4):583-588.
[12]Tabatabaei-Malazy O,Mohajeri-Tehrani M,Madani S,et al.The prevalence of diabetic peripheral neuropathy and related factors[J].Iran J Public Health,2011,40(3):55-62.
[13]El Boghdady NA,Badr GA.Evaluation of oxidative stress markers and vascular risk factors in patients with diabetic peripheral neuropathy[J].Cell Biochem Funct,2012,30(4):328-334.
[14]Rucker JL,Jernigan SD,Mc Dowd JM,et al.Adults with diabetic peripheral neuropathy exhibit impairments in multitasking and other executive functions[J].J Neurol Phys Ther,2014,38(2):104-110.
[15]Handsaker JC,Brown SJ,Bowling FL,et al.Contributory factors to unsteadiness during walking up and down stairs in patients with diabetic peripheral neuropathy[J].Diabetes Care,2014,37(11):3047-3053.
[16]Nishizawa Y,Wada R,Baba M,et al.Neuropathy induced by exogenously administered advanced glycation end-products in rats[J].J Diabetes Investig,2010,1(1-2):40-49.
[17]邓青峰,曾蕊珠.中药封包疗法治疗糖尿病周围神经病变的临床观察[J].云南中医中药杂志,2017,38(10):34-35.
[18]严传亮.中西医结合治疗糖尿病周围神经病变的疗效分析[J].实用中西医结合临床,2015,15(6):60,67.
[19]杨婉花,张碧瑶,黄菁菁.糖尿病周围神经病变的中医辨证和治疗进展[J].世界中医药,2015,10(9):1448-1452.
[20]张子震,楚江静,王敏.腕踝针配合刺络拔罐治疗糖尿病周围神经病变临床观察[J].上海针灸杂志,2017,36(12):1443-1446.
[21]王栋才.针灸辅助治疗糖尿病周围神经病变对神经功能恢复及预后的影响[J].上海针灸杂志,2017,36(12):1439-1442.