摘要
目的 探讨糖尿病周围神经病变(DPN)使用益气养阴针法联合超短波治疗的临床疗效.方法 前瞻性选取2022年1月至2024年1月泰州市人民医院收治的100例DPN患者作为研究对象.按照随机数字表法将患者分为两组,每组各50例.对照组予以超短波治疗,观察组予以益气养阴针法联合超短波,两组均治疗4周.对比两组的疗效差异.治疗前、治疗4周后,评定并比较两组患者的中医证候积分、密歇根糖尿病神经病变评分(MDNS);治疗前、治疗4周后,检测并比较两组患者的血液流变学[全血黏度、血浆黏度、红细胞沉降率(ESR)]和炎症因子[白细胞介素(IL)-6、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)]水平.观察两组患者治疗期间的不良反应.结果 观察组总有效率为91.49％,显著高于对照组(75.00％),差异有统计学意义(P＜0.05).治疗4周后,两组患者的中医证候积分、MDNS均较治疗前降低,且观察组的中医证候积分、MDNS分别为(7.45±1.72)、(5.37±0.91)分,均低于对照组[(9.21±1.68)、(6.89±1.21)分],差异均有统计学意义(P＜0.05).治疗4周后,两组的全血黏度、血浆黏度、ESR水平均较治疗前降低,且观察组的全血黏度、血浆黏度、ESR水平分别为(6.17±0.72)mPa/s、(1.76±0.52)mPa/s、(15.14±2.34)mm/h,均低于对照组[(6.89±0.84)mPa/s、(2.09±0.64)mPa/s、(17.58±2.91)mm/h],差异均有统计学意义(P＜0.05).治疗4周后,两组的血清IL-6、TNF-α和CRP水平均较治疗前显著降低,且观察组的血清IL-6、TNF-α 和 CRP 水平分别为(8.43±3.12)μg/mL、(2.46±0.48)ng/L、(4.69±2.72)mg/L,均低于对照组[(9.48±2.75)μg/mL、(3.54±0.51)ng/L、(5.45±2.94)mg/L],差异均有统计学意义(P＜0.05).治疗期间,两组患者均未见明显不良反应.结论 益气养阴针法联合超短波治疗DPN气阴两虚证可提高疗效,其机制可能与改善血液流变学、减轻炎症反应有关.
Abstract
Objective To investigate the efficacy of Yiqi Yangyin acupuncture combined with ultrashort wave in the treatment of diabetic peripheral neuropathy(DPN)with the syndrome of deficiency of both Qi and Yin.Methods A total of 100 patients with DPN admitted to Taizhou People s Hospital from January 2022 to January 2024 were prospectively selected as the study subjects.The patients were divided into two groups according to the random number table method,50 cases in each group.The control group was treated with ultrashort wave,and the observa-tion group was treated with Yiqi Yangyin acupuncture combined with ultrashort wave.Both groups were treated for 4 weeks.The difference of two groups's curative effect was compared.Before treatment and after 4 weeks of treatment,the TCM syndrome scores and Michigan diabetic neuropathy score(MDNS)of the two groups were evaluated and compared.Before treatment and after 4 weeks of treatment,the levels of hemorheology[whole blood viscosity,plasma viscosity,erythrocyte sedimentation rate(ESR)]and inflammatory factors[interleukin(IL)-6,tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)]were detected and compared between the two groups.The adverse reactions of the two groups dur-ing treatment were observed.Results The total effective rate of the observation group was 91.49％,which was significantly higher than that of the control group(75.00％),the difference was statistically significant(P＜0.05).After 4 weeks of treatment,the TCM syndrome scores and MDNS of the two groups were lower than those before treatment,and the TCM syndrome scores and MDNS of the observation group were(7.45±1.72)and(5.37±0.91)points,respectively,which were lower than those of the control group[(9.21±1.68),(6.89±1.21)points],the differences were statistically significant(P＜0.05).After 4 weeks of treatment,the whole blood viscosity,plasma viscosity and ESR levels of the two groups were lower than those before treatment,and the whole blood viscosity,plasma viscosity and ESR levels of the observation group were(6.17±0.72)mPa/s,(1.76±0.52)mPa/s,(15.14±2.34)mm/h,respectively,which were lower than those of the control group[(6.89±0.84)mPa/s,(2.09±0.64)mPa/s,(17.58±2.91)mm/h],the differences were statistically significant(P＜0.05).After 4 weeks of treatment,the levels of serum IL-6,TNF-α and CRP in the two groups were significantly lower than those before treatment,and the levels of serum IL-6,TNF-α and CRP in the observation group were(8.43±3.12)μg/mL,(2.46±0.48)ng/L,(4.69±2.72)mg/L,respective-ly,which were lower than those in the control group[(9.48±2.75)μg/mL,3.54±0.51)ng/L,(5.45±2.94)mg/L],the differences were statistically significant(P＜0.05).During the treatment,there were no obvious adverse reactions in the two groups.Conclusion Yiqi Yangyin acupuncture combined with ultrashort wave in the treatment of DPN with the syndrome of deficiency of both Qi and Yin can improve the curative effect,and its mechanism may be related to improving hemorheology and reducing inflammation.
维普
万方数据