从治未病角度分析耳针预防糖尿病的优势
|
摘要
中医自古以来就有治未病的思想,针灸用于预防疾病也有着悠久的历史,称为逆针灸。糖尿病前期是糖尿病发展的高危阶段,此类人群也是糖尿病预防的主要目标人群,中医在《黄帝内经》时代已认识到这一阶段,并提出"脾瘅"一词。目前主要预防方法包括生活方式干预及药物干预。这些方法都有各种不足之处,使得糖尿病增长远超预期。用耳针预防糖尿病,具有疗效确切、简便易推广、安全性高、无疼痛、经济成本低,可与其他手段联合等优势,应用前景良好。耳针在糖尿病预防方面的研究和经验抑或为中医治未病开辟一条崭新途径。
Since ancient times, traditional Chinese medicine has the idea of preventive treatment of disease. Acupuncture and moxibustion has a long history of preventing diseases, called inverse acupuncture and moxibustion. Pre-diabetes is a highrisk stage of the development of diabetes mellitus and the main target population of diabetes prevention. In the era of Huangdi Neijing, traditional Chinese medicine has recognized this stage and put forward the word ‘spleen and macula'. At present, the main prevention methods include lifestyle intervention and drug intervention. These methods have various shortcomings, making the growth of diabetes far exceed expectations. Prevention of diabetes mellitus by ear acupuncture has the advantages of definite curative effect, easy popularization, high safety, no pain, very low economic cost and can be combined with other means. It has a good prospect. The research and experience of ear acupuncture in the prevention of diabetes mellitus may open up a new way for the preventive treatment of disease in traditional Chinese medicine.
Since ancient times, traditional Chinese medicine has the idea of preventive treatment of disease. Acupuncture and moxibustion has a long history of preventing diseases, called inverse acupuncture and moxibustion. Pre-diabetes is a highrisk stage of the development of diabetes mellitus and the main target population of diabetes prevention. In the era of Huangdi Neijing, traditional Chinese medicine has recognized this stage and put forward the word ‘spleen and macula'. At present, the main prevention methods include lifestyle intervention and drug intervention. These methods have various shortcomings, making the growth of diabetes far exceed expectations. Prevention of diabetes mellitus by ear acupuncture has the advantages of definite curative effect, easy popularization, high safety, no pain, very low economic cost and can be combined with other means. It has a good prospect. The research and experience of ear acupuncture in the prevention of diabetes mellitus may open up a new way for the preventive treatment of disease in traditional Chinese medicine.
引文
[1]Alberti K,Zimmet P Z,Consultation W H O.Definition,diagnosisand classification of diabetes mellitus and its complications part 1:Diagnosis and classification of diabetes mellitus-Provisional reportof a WHO consultation.Diabetic Medicine,1998,15(7):539-553
[2]World Health Organization.Global report on diabetes.Geneva:WHOPress,2016
[3]King H,Aubert R E,Herman W H.Global burden of diabetes,1995-2025:Prevalence,numerical estimates,and projections.DiabetesCare,1998,21(9):1414-1431
[4]全国糖尿病研究协作组调查研究组.全国14个省市30万人口中糖尿病调查报告.中华内科杂志,1981,20(11):678-683
[5]Wang L,Gao P,Zhang M,et al.Prevalence and Ethnic Pattern ofDiabetes and Prediabetes in China in 2013.JAMA,2017,317(24):2515-2523
[6]International Diabetes Federation.IDF Diabetes Atlas.7th edition.Brussels,Belgium:International Diabetes Federation,2015
[7]Tabak A G,Herder C,Rathmann W,et al.Prediabetes:A high-riskstate for diabetes development.Lancet,2012,379(9833):2279-2290
[8]Nathan D M,Davidson M B,Defronzo R A,et al.Impaired fastingglucose and impaired glucose tolerance:implications for care.Diabetes Care,2007,30(3):753-759
[9]Gerstein H C,Santaguida P,Raina P,et al.Annual incidenceand relative risk of diabetes in people with various categoriesof dysglycemia:A systematic overview and meta-analysis ofprospective studies.Diabetes Research and Clinical Practice,2007,78(3):305-312
[10]Organization W H,Federation I D.Definition and diagnosis ofdiabetes mellitus and intermediate hyperglycaemia:Report of aWHO/IDF consultation.Geneva:WHO Press,2006
[11]American Diabetes Association.2.Classification and diagnosis ofdiabetes.Diabetes Care,2017,40(Suppl 1):S11-S24
[12]Xu Y,Wang L M,He J,et al.Prevalence and control of diabetesin Chinese adults.Journal of the American Medical Association,2013,310(9):948-958
[13]Menke A,Casagrande S,Geiss L,et al.Prevalence of and Trendsin Diabetes Among Adults in the United States,1988-2012.Journal of the American Medical Association,2015,314(10):1021-1029
[14]Mainous A G 3rd,Tanner R J,Baker R,et al.Prevalence ofprediabetes in England from 2003 to 2011:Population-based,cross-sectional study.BMJ Open,2014,4(6):e005002
[15]Pan X R,Li G W,Hu Y H,et al.Effects of diet and exercise inpreventing NIDDM in people with impaired glucose tolerance:TheDa Qing IGT and diabetes study.Diabetes care,1997,20(4):537-544
[16]Li G,Zhang P,Wang J,et al.The long-term effect of lifestyleinterventions to prevent diabetes in the China Da QingDiabetes Prevention Study:A 20-year follow-up study.Lancet,2008,371(9626):1783-1789
[17]Tuomilehto J,Lindstrom J,Eriksson J G,et al.Prevention of type2 diabetes mellitus by changes in lifestyle among subjects withimpaired glucose tolerance.N Engl J Med,2001,344(18):1343-1350
[18]Lindstrom J,Ilanne-Parikka P,Peltonen M,et al.Sustained reductionin the incidence of type 2 diabetes by lifestyle intervention:Follow-up of the Finnish Diabetes Prevention Study.Lancet,2006,368(9548):1673-1679
[19]Lindstrom J,Peltonen M,Eriksson J G,et al.Improved lifestyleand decreased diabetes risk over 13 years:Long-term follow-up of the randomised finnish diabetes prevention study(DPS).Diabetologia,2013,56(2):284-293
[20]Knowler W C,Barrett-Connor E,Fowler S E,et al.Reduction inthe incidence of type 2 diabetes with lifestyle intervention ormetformin.N Engl J Med,2002,346(6):393-403
[21]Diabetes Prevention Program Research G,Knowler W C,FowlerS E,et al.10-year follow-up of diabetes incidence and weight lossin the Diabetes Prevention Program Outcomes Study.Lancet,2009,374(9702):1677-1686
[22]Long-term effects of lifestyle intervention or metformin on diabetesdevelopment and microvascular complications over 15-year follow-up:The Diabetes Prevention Program Outcomes Study.LancetDiabetes Endocrinol,2015,3(11):866-875
[23]Moutzouri E,Tsimihodimos V,Rizos E,et al.Prediabetes:to treat ornot to treat?.Eur J Pharmacol,2011,672(1-3):9-19
[24]Chiasson J L,Josse R G,Gomis R,et al.Acarbose for preventionof type 2 diabetes mellitus:The STOP-NIDDM randomised trial.Lancet,2002,359(9323):2072-2077
[25]Knowler W C,Hamman R F,Edelstein S L,et al.Prevention of type2 diabetes with troglitazone in the Diabetes Prevention Program.Diabetes,2005,54(4):1150-1156
[26]Ostergren J.Renin-angiotensin-system blockade in theprevention of diabetes.Diabetes Research and Clinical Practice,2007,76:S13-S21
[27]Heymsfield S B,Segal K R,Hauptman J,et al.Effects of weight losswith orlistat on glucose tolerance and progression to type 2 diabetesin obese adults.Arch Intern Med,2000,160(9):1321-1326
[28]Amer Diabet A.4.Prevention or Delay of Type 2 Diabetes.DiabetesCare,2016,39:S36-S38
[29]中国2型糖尿病防治指南(2013年版).中国糖尿病杂志,2014,22(8):2-42
[30]Fang Z,Zhao J,Shi G,et al.Shenzhu Tiaopi granule combinedwith lifestyle intervention therapy for impaired glucosetolerance:A randomized controlled trial.Complement Ther Med,2014,22(5):842-850
[31]Lian F,Li G,Chen X,et al.Chinese herbal medicine Tianqi reducesprogression from impaired glucose tolerance to diabetes:A double-blind,randomized,placebo-controlled,multicenter trial.J ClinEndocrinol Metab,2014,99(2):648-655
[32]Gao Y,Zhou H,Zhao H,et al.Clinical research of traditional Chinesemedical intervention on impaired glucose tolerance.Am J ChinMed,2013,41(1):21-32
[33]Pang B,Zhang Y,Liu J,et al.Prevention of type 2 diabetes with theChinese herbal medicine Tianqi Capsule:A systematic review andMeta-analysis.Diabetes Ther,2017,8(6):1227-1242
[34]Carlsson L M S,Peltonen M,Ahlin S,et al.Bariatric surgery andprevention of type 2 diabetes in swedish obese subjects.NewEngland Journal of Medicine,2012,367(8):695-704
[35]GarberAJ,HandelsmanY,EinhornD,etal.Diagnosisandmanagementofprediabetesinthecontinuumofhyperglycemia:when do the risks of diabetes begin?A consensusstatement from the American College of Endocrinology and theAmerican Association of Clinical Endocrinologists.Endocr Pract,2008,14(7):933-946
[36]秦小永.耳穴的起源与发展.辽宁中医药大学学报,2011,13(5):122-123
[37]王文炎,梁凤霞,宋爱群,等.针灸预防糖尿病前期的临床思路探讨.中华中医药杂志,2018,33(11):5012-5015
[38]He W,Wang X,Shi H,et al.Auricular acupuncture and vagalregulation.Evidence-Based Complementary and AlternativeMedicine,2012,doi:10.115/2012/786839
[39]Licht C M,Vreeburg S A,Van Reedt Dortland A K,et al.Increasedsympathetic and decreased parasympathetic activity ratherthan changes in hypothalamic-pituitary-adrenal axis activity isassociated with metabolic abnormalities.J Clin Endocrinol Metab,2010,95(5):2458-2466
[40]De Couck M,Mravec B,Gidron Y.You may need the vagus nerveto understand pathophysiology and to treat diseases.Clin Sci(Lond),2012,122(7):323-328
[41]Peuker E T,Filler T J.The nerve supply of the human auricle.Clinical Anatomy,2002,15(1):35-37
[42]Wang S X,Zhai X,Li S Y,et al.Transcutaneous vagus nervestimulation induces tidal melatonin secretion and has anantidiabetic effect in zucker fatty rats.Plos One,2015,10(4):12
[43]Chen Y.Magnets on ears helped diabetics.Am J Chin Med,2002,30(1):183-185
[44]郑真真,夏玉卿,朱兵,等.针刺耳迷走神经点降低高血糖即时效应的临床观察.中国针灸,2008,28(9):702
[45]Huang F,Dong J,Kong J,et al.Effect of transcutaneous auricularvagus nerve stimulation on impaired glucose tolerance:A pilotrandomized study.BMC Complement Altern Med,2014,14:203
[46]Li S Y,Zhai X,Rong P J,et al.Therapeutic effect of vagus nervestimulation on depressive-like behavior,hyperglycemia and insulinreceptor expression in zucker fatty rats.PloS One,2014,9(11):7
[47]Da Rocha Fernandes J,Ogurtsova K,Linnenkamp U,et al.IDFDiabetes Atlas estimates of 2014 global health expenditures ondiabetes.Diabetes Res Clin Pract,2016,117:48-54
[48]Firouzjaei A,Li G C,Wang N,et al.Comparative evaluation of thetherapeutic effect of metformin monotherapy with metforminand acupuncture combined therapy on weight loss and insulinsensitivity in diabetic patients.Nutr Diabetes,2016,6:e209
[49]Jing X,Ou C,Chen H,et al.Electroacupuncture reduces weightgain induced by rosiglitazone through PPARgamma and leptinreceptor in CNS.Evid Based Complement Alternat Med,2016,2016:8098561
[50]Belivani M,Dimitroula C,Katsiki N,et al.Acupuncture in thetreatment of obesity:A narrative review of the literature.AcupunctMed,2013,31(1):88-97
[2]World Health Organization.Global report on diabetes.Geneva:WHOPress,2016
[3]King H,Aubert R E,Herman W H.Global burden of diabetes,1995-2025:Prevalence,numerical estimates,and projections.DiabetesCare,1998,21(9):1414-1431
[4]全国糖尿病研究协作组调查研究组.全国14个省市30万人口中糖尿病调查报告.中华内科杂志,1981,20(11):678-683
[5]Wang L,Gao P,Zhang M,et al.Prevalence and Ethnic Pattern ofDiabetes and Prediabetes in China in 2013.JAMA,2017,317(24):2515-2523
[6]International Diabetes Federation.IDF Diabetes Atlas.7th edition.Brussels,Belgium:International Diabetes Federation,2015
[7]Tabak A G,Herder C,Rathmann W,et al.Prediabetes:A high-riskstate for diabetes development.Lancet,2012,379(9833):2279-2290
[8]Nathan D M,Davidson M B,Defronzo R A,et al.Impaired fastingglucose and impaired glucose tolerance:implications for care.Diabetes Care,2007,30(3):753-759
[9]Gerstein H C,Santaguida P,Raina P,et al.Annual incidenceand relative risk of diabetes in people with various categoriesof dysglycemia:A systematic overview and meta-analysis ofprospective studies.Diabetes Research and Clinical Practice,2007,78(3):305-312
[10]Organization W H,Federation I D.Definition and diagnosis ofdiabetes mellitus and intermediate hyperglycaemia:Report of aWHO/IDF consultation.Geneva:WHO Press,2006
[11]American Diabetes Association.2.Classification and diagnosis ofdiabetes.Diabetes Care,2017,40(Suppl 1):S11-S24
[12]Xu Y,Wang L M,He J,et al.Prevalence and control of diabetesin Chinese adults.Journal of the American Medical Association,2013,310(9):948-958
[13]Menke A,Casagrande S,Geiss L,et al.Prevalence of and Trendsin Diabetes Among Adults in the United States,1988-2012.Journal of the American Medical Association,2015,314(10):1021-1029
[14]Mainous A G 3rd,Tanner R J,Baker R,et al.Prevalence ofprediabetes in England from 2003 to 2011:Population-based,cross-sectional study.BMJ Open,2014,4(6):e005002
[15]Pan X R,Li G W,Hu Y H,et al.Effects of diet and exercise inpreventing NIDDM in people with impaired glucose tolerance:TheDa Qing IGT and diabetes study.Diabetes care,1997,20(4):537-544
[16]Li G,Zhang P,Wang J,et al.The long-term effect of lifestyleinterventions to prevent diabetes in the China Da QingDiabetes Prevention Study:A 20-year follow-up study.Lancet,2008,371(9626):1783-1789
[17]Tuomilehto J,Lindstrom J,Eriksson J G,et al.Prevention of type2 diabetes mellitus by changes in lifestyle among subjects withimpaired glucose tolerance.N Engl J Med,2001,344(18):1343-1350
[18]Lindstrom J,Ilanne-Parikka P,Peltonen M,et al.Sustained reductionin the incidence of type 2 diabetes by lifestyle intervention:Follow-up of the Finnish Diabetes Prevention Study.Lancet,2006,368(9548):1673-1679
[19]Lindstrom J,Peltonen M,Eriksson J G,et al.Improved lifestyleand decreased diabetes risk over 13 years:Long-term follow-up of the randomised finnish diabetes prevention study(DPS).Diabetologia,2013,56(2):284-293
[20]Knowler W C,Barrett-Connor E,Fowler S E,et al.Reduction inthe incidence of type 2 diabetes with lifestyle intervention ormetformin.N Engl J Med,2002,346(6):393-403
[21]Diabetes Prevention Program Research G,Knowler W C,FowlerS E,et al.10-year follow-up of diabetes incidence and weight lossin the Diabetes Prevention Program Outcomes Study.Lancet,2009,374(9702):1677-1686
[22]Long-term effects of lifestyle intervention or metformin on diabetesdevelopment and microvascular complications over 15-year follow-up:The Diabetes Prevention Program Outcomes Study.LancetDiabetes Endocrinol,2015,3(11):866-875
[23]Moutzouri E,Tsimihodimos V,Rizos E,et al.Prediabetes:to treat ornot to treat?.Eur J Pharmacol,2011,672(1-3):9-19
[24]Chiasson J L,Josse R G,Gomis R,et al.Acarbose for preventionof type 2 diabetes mellitus:The STOP-NIDDM randomised trial.Lancet,2002,359(9323):2072-2077
[25]Knowler W C,Hamman R F,Edelstein S L,et al.Prevention of type2 diabetes with troglitazone in the Diabetes Prevention Program.Diabetes,2005,54(4):1150-1156
[26]Ostergren J.Renin-angiotensin-system blockade in theprevention of diabetes.Diabetes Research and Clinical Practice,2007,76:S13-S21
[27]Heymsfield S B,Segal K R,Hauptman J,et al.Effects of weight losswith orlistat on glucose tolerance and progression to type 2 diabetesin obese adults.Arch Intern Med,2000,160(9):1321-1326
[28]Amer Diabet A.4.Prevention or Delay of Type 2 Diabetes.DiabetesCare,2016,39:S36-S38
[29]中国2型糖尿病防治指南(2013年版).中国糖尿病杂志,2014,22(8):2-42
[30]Fang Z,Zhao J,Shi G,et al.Shenzhu Tiaopi granule combinedwith lifestyle intervention therapy for impaired glucosetolerance:A randomized controlled trial.Complement Ther Med,2014,22(5):842-850
[31]Lian F,Li G,Chen X,et al.Chinese herbal medicine Tianqi reducesprogression from impaired glucose tolerance to diabetes:A double-blind,randomized,placebo-controlled,multicenter trial.J ClinEndocrinol Metab,2014,99(2):648-655
[32]Gao Y,Zhou H,Zhao H,et al.Clinical research of traditional Chinesemedical intervention on impaired glucose tolerance.Am J ChinMed,2013,41(1):21-32
[33]Pang B,Zhang Y,Liu J,et al.Prevention of type 2 diabetes with theChinese herbal medicine Tianqi Capsule:A systematic review andMeta-analysis.Diabetes Ther,2017,8(6):1227-1242
[34]Carlsson L M S,Peltonen M,Ahlin S,et al.Bariatric surgery andprevention of type 2 diabetes in swedish obese subjects.NewEngland Journal of Medicine,2012,367(8):695-704
[35]GarberAJ,HandelsmanY,EinhornD,etal.Diagnosisandmanagementofprediabetesinthecontinuumofhyperglycemia:when do the risks of diabetes begin?A consensusstatement from the American College of Endocrinology and theAmerican Association of Clinical Endocrinologists.Endocr Pract,2008,14(7):933-946
[36]秦小永.耳穴的起源与发展.辽宁中医药大学学报,2011,13(5):122-123
[37]王文炎,梁凤霞,宋爱群,等.针灸预防糖尿病前期的临床思路探讨.中华中医药杂志,2018,33(11):5012-5015
[38]He W,Wang X,Shi H,et al.Auricular acupuncture and vagalregulation.Evidence-Based Complementary and AlternativeMedicine,2012,doi:10.115/2012/786839
[39]Licht C M,Vreeburg S A,Van Reedt Dortland A K,et al.Increasedsympathetic and decreased parasympathetic activity ratherthan changes in hypothalamic-pituitary-adrenal axis activity isassociated with metabolic abnormalities.J Clin Endocrinol Metab,2010,95(5):2458-2466
[40]De Couck M,Mravec B,Gidron Y.You may need the vagus nerveto understand pathophysiology and to treat diseases.Clin Sci(Lond),2012,122(7):323-328
[41]Peuker E T,Filler T J.The nerve supply of the human auricle.Clinical Anatomy,2002,15(1):35-37
[42]Wang S X,Zhai X,Li S Y,et al.Transcutaneous vagus nervestimulation induces tidal melatonin secretion and has anantidiabetic effect in zucker fatty rats.Plos One,2015,10(4):12
[43]Chen Y.Magnets on ears helped diabetics.Am J Chin Med,2002,30(1):183-185
[44]郑真真,夏玉卿,朱兵,等.针刺耳迷走神经点降低高血糖即时效应的临床观察.中国针灸,2008,28(9):702
[45]Huang F,Dong J,Kong J,et al.Effect of transcutaneous auricularvagus nerve stimulation on impaired glucose tolerance:A pilotrandomized study.BMC Complement Altern Med,2014,14:203
[46]Li S Y,Zhai X,Rong P J,et al.Therapeutic effect of vagus nervestimulation on depressive-like behavior,hyperglycemia and insulinreceptor expression in zucker fatty rats.PloS One,2014,9(11):7
[47]Da Rocha Fernandes J,Ogurtsova K,Linnenkamp U,et al.IDFDiabetes Atlas estimates of 2014 global health expenditures ondiabetes.Diabetes Res Clin Pract,2016,117:48-54
[48]Firouzjaei A,Li G C,Wang N,et al.Comparative evaluation of thetherapeutic effect of metformin monotherapy with metforminand acupuncture combined therapy on weight loss and insulinsensitivity in diabetic patients.Nutr Diabetes,2016,6:e209
[49]Jing X,Ou C,Chen H,et al.Electroacupuncture reduces weightgain induced by rosiglitazone through PPARgamma and leptinreceptor in CNS.Evid Based Complement Alternat Med,2016,2016:8098561
[50]Belivani M,Dimitroula C,Katsiki N,et al.Acupuncture in thetreatment of obesity:A narrative review of the literature.AcupunctMed,2013,31(1):88-97