目的 观察针刺联合点刺放血治疗2型糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的临床疗效.方法 将 68 例DPN患者随机分为观察组和对照组,每组 34 例.两组均予基础治疗,对照组予常规针刺治疗,观察组在对照组的基础上予点刺放血治疗.观察两组治疗前后多伦多临床评分系统(Toronto clinical scoring system,TCSS)评分、腓总神经和胫神经的感觉神经传导速度(sensory nerve conduction velocity,SCV)及运动神经传导速度(motor nerve conduction velocity,MCV)、生存质量测定量表简表(World Health Organization quality of life brief version scale,WHOQOL-BREF)评分、血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)和白细胞介素-6(interleukin-6,IL-6)水平的变化,并比较两组临床疗效及不良反应.结果 治疗后,两组TCSS各项评分及总分均较治疗前降低(P＜0.01),且观察组低于对照组(P＜0.05).随访时,两组TCSS各项评分及总分均较治疗后降低(P＜0.05),且观察组低于对照组(P＜0.05).治疗后,两组腓总神经、胫神经MCV和SCV较治疗前升高(P＜0.01),且观察组高于对照组(P＜0.05).治疗后,两组WHOQOL-BREF评分较治疗前升高(P＜0.01),且观察组高于对照组(P＜0.05).治疗后,两组血清TNF-α和IL-6水平较治疗前降低(P＜0.01),且观察组低于对照组(P＜0.05).观察组总有效率为 88.2%,高于对照组的 73.5%,差异有统计学意义(P＜0.05).两组不良反应发生率比较,差异无统计学意义(P＞0.05).结论 在基础治疗基础上,针刺联合点刺放血治疗 2 型糖尿病周围神经病变能有效地改善患者临床症状,提高神经传导速度,改善生存质量,机制可能与下调炎性因子水平有关.
Therapeutic observation of acupuncture plus point-pricking blood-letting for peripheral neuropathy in type 2 diabetes mellitus
Objective To observe the clinical efficacy of acupuncture plus point-pricking blood-letting in treating peripheral neuropathy in type 2 diabetes mellitus(DPN).Method Sixty-eight DPN patients were randomized into an observation group and a control group,each consisting of 34 cases.Both groups were offered basic treatments.In addition,the control group was given conventional acupuncture treatment,and the observation group was given point-pricking blood-letting and the same acupuncture treatment.Before and after the treatment,the two groups were observed for changes in the Toronto clinical scoring system(TCSS)score,sensory nerve conduction velocity(SCV)and motor nerve conduction velocity(MCV)of the common peroneal and tibial nerves,the score of World Health Organization quality of life brief version scale(WHOQOL-BREF),and the serum levels of tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6).The clinical efficacy and adverse reactions were also compared.Result After the treatment,the TCSS component and total scores dropped in both groups(P＜0.01)and were lower in the observation group than in the control group(P＜0.05).At the follow-up,the TCSS component and total scores were lower than those after the treatment in each group(P＜0.05)and were lower in the observation group than in the control group(P＜0.05).The MCV and SCV of the common peroneal and tibial nerves increased in both groups after the treatment(P＜0.01)and were higher in the observation group than in the control group(P＜0.05).After the treatment,both groups achieved an increase in the WHOQOL-BREF score(P＜0.01),and the observation group was higher than the control group(P＜0.05).After the treatment,the serum levels of TNF-α and IL-6 decreased in both groups(P＜0.01),and the observation group was lower than the control group(P＜0.05).The total effective rate was 88.2% in the observation group,significantly higher than 73.5% in the control group(P＜0.05).There was no significant difference in the adverse reaction rate between the two groups(P＞0.05).Conclusion Based on the basic intervention,acupuncture plus point-pricking blood-letting can effectively improve the clinical symptoms,increase nerve conduction velocities,and improve the quality of life in treating DPN;down-regulating inflammatory factor levels may play a role in the mechanism.
万方数据
维普
