中医针灸联合西药甲钴胺治疗糖尿病周围神经病变的临床效果.pdf
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1、 糖尿病与并发症 糖尿病新世界 2023年8月糖尿病新世界 DIABETES NEW WORLD中医针灸联合西药甲钴胺治疗糖尿病周围神经病变的临床效果刘现锋淄博市张店区中医院中风康复科,山东淄博 255035摘要 目的 探讨针灸对糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)患者的治疗价值。方法 选取2019年1月2020年12月淄博市张店区中医院收治的100例DPN患者,根据治疗方法的不同分为对照组和观察组,各50例。对照组患者行西药甲钴胺片治疗,观察组患者行西药甲钴胺片+针灸治疗,分析比较两组患者治疗前后的应激反应指标、病情严重程度评分、神经电生
2、理指标及治疗有效率。结果 治疗后,两组超氧化物歧化酶、丙二醛水平均优于治疗前,且观察组超氧化物歧化酶、丙二醛水平均优于对照组,差异有统计学意义(P0.05)。治疗后,两组中医证候积分、多伦多临床评分系统评分均较治疗前降低,且观察组中医证候积分、多伦多临床评分系统评分较对照组更低,差异有统计学意义(P0.05)。治疗后,两组患者神经传导速度均优于治疗前,且观察组神经传导速度高于对照组,差异有统计学意义(P0.05)。观察组总有效率(94.00%)优于对照组(80.00%),差异有统计学意义(2=6.061,P0.05)。结论 针灸结合西药甲钴胺治疗DPN的治疗效果显著,值得在临床工作中进一步推广
3、。关键词 糖尿病周围神经病变;针灸;应激反应;神经传导速度中图分类号 R587.1 文献标识码 A 文章编号 1672-4062(2023)08(a)-0170-04Clinical Effect of Traditional Chinese Medicine Acupuncture and Moxibustion Combined with Western Medicine Mecobalamin in the Treatment of Diabetic Peripheral NeuropathyLIU XianfengDepartment of Stroke Rehabilitation,
4、Zhangdian District Hospital of Traditional Chinese Medicine,Zibo,Shandong Province,255035 ChinaAbstract Objective To explore the therapeutic value of acupuncture and moxibustion for patients with diabetic peripheral neuropathy(DPN).Methods 100 patients with DPN admitted to Zhangdian District Traditi
5、onal Chinese Medicine Hospital in Zibo City from January 2019 to December 2020 were selected and divided them into a control group and an observation group based on different treatment methods,with 50 patients in each group.The patients in the control group were treated with western medicine mecobal
6、amin tablets,and the patients in the observation group were treated with western medicine mecobalamin tablets+acupuncture and moxibustion.The stress response indicators,disease severity scores,neuroelectrophysiological indicators and treatment efficiency of the patients in the two groups before and
7、after treatment were analyzed and compared.Results After treatment,the levels of SOD and MDA in both groups were better than before treatment,and the levels of SOD and MDA in the observation group were better than those in the control group,the difference was statistically significant(P0.05).After t
8、reatment,the TCM syndrome score and TCSS score of both groups decreased compared to before treatment,and the observation group had lower TCM syndrome score and TCSS score compared to the control group,the difference was statistically significant(P0.05).After treatment,the nerve conduction velocity o
9、f both groups of patients was better than before treatment,and the nerve conduction velocity of the observation group was higher than that of the control group,the difference was staDOI:10.16658/ki.1672-4062.2023.15.170作者简介 刘现锋(1980-),男,硕士,副主任医师,研究方向为神经康复。170 糖尿病与并发症 糖尿病新世界 2023年8月DIABETES NEW WORLD
10、 糖尿病新世界tistically significant(P0.05).The total effective rate of the observation group(94.00%)was better than that of the control group(80.00%),the difference was statistically significant(2=6.061,P0.05),具有可比性。本研究已通过医院医学伦理委员会批准。1.2 纳入与排除标准纳入标准:患者均符合 临床神经病学3糖尿病周围神经病变中医临床诊疗指南(2016 年版)4中对应的诊断和辨证标准;自愿参与
11、并知情同意本项研究;临床资料完备;经多伦多临床评分系统(Toronto Clinical Scoring System,TCSS)5评分为轻度与中度;依从性好。排除标准:非糖尿病引起的周围神经病变;存在重要脏器(肝、肾等)功能障碍;妊娠或哺乳期女性。1.3 方法两组患者均通过控制饮食、增加运动量、口服降糖药、注射胰岛素,将患者的血糖水平维持在安全水平(空腹血糖7.0 mmol/L,糖化血红蛋白7.5%)。对 照 组 给 予 口 服 甲 钴 胺 片(国 药 准 字H20052325,规格:0.5 mg/片)治疗,1片/次,3次/d。观察组在对照组的基础上加用针灸治疗。取内关、气海、合谷、足三里、
12、三阴交、肺俞、血海、胰俞穴行针刺治疗,常规消毒后,取无菌毫针(0.35 mm40 mm,华佗牌)直接刺入穴位,得气后留针30 min,采用捻转、提插法行针,针刺处以感到酸麻肿胀感为度。针刺后再加用艾灸治疗,取足三里、行健、成山、台溪、三阴交、合谷、涌泉、曲池、太冲、卫中穴位施灸,2030 min/次,隔日 1次。两组治疗时间均为15 d。1.4 观察指标应激反应指标。采集患者治疗前后空腹静脉血,分离血清后,采用日立 7600全自动生化分析仪检测超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(malondialdehyde,MDA)水平。中医证候积分。主要症状包含 4
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- 中医 针灸 联合 西药 甲钴胺 治疗 糖尿病 周围神经 病变 临床 效果