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中药熏洗结合针刺治疗糖尿病血管病变临床观察

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目的 观察中药熏洗结合针刺治疗糖尿病血管病变临床效果。方法 研究纳入合计151例糖尿病血管病变患者(2020年1月—2023年2月收治)进行分组研究,分组方法为随机数字表法,将患者分为观察组(76例)与对照组(75例),对照组患者采取西医常规治疗,观察组患者西医常规治疗结合中药熏洗及针刺治疗,各组数据观察:治疗效果、治疗前后患者血糖指标变化空腹血糖(Fasting blood glucose,FPG);餐后 2 h 血糖(2 hour postprandial plasma glucose,2hFPG);糖化血红蛋白(glycosylated hemoglobin,HbAlc)、中医证候积分(下肢麻木疼痛、疮面肉芽不新鲜、面色无华、心悸气短、神疲乏力等)变化、足背温度变化及踝/肱指数(ankle brachial index,ABI)变化、下肢动静脉彩超相关指标(血管内径、血管狭窄程度以及血流速度)变化、耐受疼痛最大行走距离变化及血液流变学指标(红细胞比容、血浆黏度值、全血高切黏度及全血低切黏度)变化、不良反应。结果 观察组与对照组治疗总有效率分别为96。05%、86。67%,前者更高,P<0。05;治疗前各组患者血糖指标(FPG、2hFPG、HbAlc)、中医证候积分(下肢麻木疼痛、疮面肉芽不新鲜、面色无华、心悸气短、神疲乏力等)、足背温度、ABI、下肢动静脉彩超相关指标(血管内径、血管狭窄程度以及血流速度)、耐受疼痛最大行走距离、血液流变学指标(红细胞比容、血浆黏度值、全血高切黏度及全血低切黏度)等比较,P>0。05,治疗后各组患者血糖指标(FPG、2hFPG、HbAlc)、中医证候积分(下肢麻木疼痛、疮面肉芽不新鲜、面色无华、心悸气短、神疲乏力等)、足背温度、ABI、下肢动静脉彩超相关指标(血管内径、血管狭窄程度以及血流速度)、耐受疼痛最大行走距离、血液流变学指标(红细胞比容、血浆黏度值、全血高切黏度及全血低切黏度)等指标均改善,观察组患者治疗后血糖指标(FPG、2hFPG、HbAlc)、中医证候积分(下肢麻木疼痛、疮面肉芽不新鲜、面色无华、心悸气短、神疲乏力等)、足背温度、ABI、下肢动静脉彩超相关指标(血管内径、血管狭窄程度以及血流速度)、耐受疼痛最大行走距离、血液流变学指标(红细胞比容、血浆黏度值、全血高切黏度及全血低切黏度)等指标均优于对照组,P<0。05;对照组与观察组不良反应率分别为2。66%、2。64%,均较低。结论 中药熏洗结合针刺治疗糖尿病血管病变效果显著,患者症状缓解,安全可靠,值得应用。
Clinical Observation of Fumigation with Traditional Chinese Medicine Combined with Acupuncture in Treatment of Diabetic Vascular Disease
Objective To observe the clinical effect of fumigation with traditional Chinese medicine combined with acupuncture in the treatment of diabetic vascular disease.Methods A total of 151 patients with diabetic vascular disease(admitted from Janu-ary 2020 to February 2023)were included in this study for grouping study.The grouping method was random number table meth-od,and the patients were divided into observation group(76 cases)and control group(75 cases).The control group received con-ventional Western medicine treatment,and the observation group received conventional Western medicine treatment combined with traditional Chinese medicine fumigation and acupuncture treatment.The treatment effect,the changes of fasting blood glucose(FPG),postprandial plasma glucose at 2 h(2 h FPG),glycosylated hemoglobin(HbAlc),traditional Chinese medicine symptom scores(numbness and pain of lower extremities,weak wound granulation,pale face,palpitation,shortness of breath),ankle brachi-al index(ABI)and indicators related to arteriovenous ultrasound of lower limbs(internal diameter of blood vessel,stenosis degree of blood vessel and blood flow velocity),the changes of maximum walking distance to tolerate pain,the changes of hemorheologi-cal indicators(hematocrit,plasma viscosity value,high and low tangential viscosity of whole blood)and adverse reactions of two groups were observed.Results The total effective rates of the observation group and the control group were 96.05%and 86.67%,respectively,and the former was higher(P<0.05).Before treatment,the levels of blood glucose indexes(FPG,2 h FPG,HbAlc),TCM symptom scores(numbness and pain of lower extremities,weak wound granulation,pale face,palpitation,shortness of breath),dorsalis temperature,ABI,indicators related to arteriovenous ultrasound of lower limbs(internal diameter of blood ves-sel,stenosis degree of blood vessel and blood flow velocity),the maximum walking distance to tolerate pain,the levels of hemo-rheological indicators(hematocrit,plasma viscosity value,high and low tangential viscosity of whole blood)had no significance(P>0.05).After treatment,the blood glucose indexes(FPG,2 h FPG,HbAlc),TCM symptom scores(numbness and pain of lower extremities,weak wound granulation,pale face,palpitation,shortness of breath),dorsalis temperature,ABI,indicators related to arteriovenous ultrasound of lower limbs(internal diameter of blood vessel,stenosis degree of blood vessel and blood flow veloci-ty),the maximum walking distance to tolerate pain,the levels of hemorheological indicators(hematocrit,plasma viscosity value,high and low tangential viscosity of whole blood)of the observation group were better than those of the control group(P<0.05).The adverse reaction rates of control group and observation group were 2.66%and 2.64%,respectively(P>0.05).Conclusion-Traditional Chinese medicine fumigation combined with acupuncture in the treatment of diabetic vascular lesions is significant.The symptoms of patients can be relieved,safe and reliable.It is worthy of application.

diabetic angiopathytraditional Chinese medicine fumigationacupuncturetherapeutic effectsymptoms of tradi-tional Chinese medicineadverse reaction

卢慧敏、樊炜静、柳国斌

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上海中医药大学附属曙光医院,上海 200021

糖尿病血管病变 中药熏洗 针刺 治疗效果 中医证候 不良反应

上海市"科技创新行动计划"医学创新研究专项上海市浦东新区卫生健康委卫生计生科研项目

21Y21920200PW2020E-4

2024

中华中医药学刊
中华中医药学会 ,辽宁中医药大学

中华中医药学刊

CSTPCD北大核心
影响因子:1.007
ISSN:1673-7717
年,卷(期):2024.42(6)
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