泻胃补脾法针刺治疗2型糖尿病的临床研究

发布时间：2018-06-30 04:38

本文选题：泻胃补脾 + 针刺　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的:观察泻胃补脾针法治疗对2型糖尿病患者相关指标的影响,探讨泻胃补脾针法治疗2型糖尿病的机制。方法:采用随机数表法,随机分配针刺组与对照组各30名患者。两组患者均进行饮食控制及坚持运动,并保持原有的药物治疗方案不变,本研究期间不更换药物或调整药物用量。针刺组在原有治疗基础上加入针刺:主穴中脘、内庭、足三里、脾俞、太白、三阴交。其中足三里、内庭、中脘使用泻法针刺,操作为针刺得气后运用捻转泻法和提插泻法各6次。太白、三阴交、脾俞使用补法针刺,操作为针刺得气后,行捻转补法和提插补法各6次。治疗过程中,脾俞穴针刺后不留针,余穴留针30min,隔日1次,每周3次。本研究时间为1月。观察治疗1月前后两组患者症状、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、空腹C肽(FC-P)、胰岛素抵抗指数[Homa-IR(C-P)]、胰岛β细胞功能指数[Homa-islet(C-P)]及总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、瘦素(LEP)、抵抗素(Resistin)、类胰升糖素肽-1(GLP-1)等指标。结果:1、症状积分及疗效:干预前两组患者症状积分无统计学差异(P0.05),针刺组干预后症状积分较干预前降低(P0.05),较对照组降低显著(P0.05);针刺干预后患者总有效率较对照组高,差异显著(P0.05)。2、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、空腹C肽(FC-P):干预前两组患者FBG、HbA1c、FC-P无统计学差异(P0.05);针刺组干预后FBG、HbA1c、FC-P较干预前降低(P0.05),较对照组降低显著(P0.05)。3、胰岛素抵抗指数[Homa-IR(C-P)]、胰岛β细胞功能指数[Homa-islet(C-P)]:干预前两组患者Homa-IR(C-P)、Homa-islet(C-P)均无统计学差异(P0.05);针刺组干预后Homa-IR(C-P)较干预前降低(P0.05),较对照组降低显著(P0.05);针刺组干预后Homa-islet(C-P)较干预前升高(P0.05),较对照组降低无显著差异(P0.05)。4、血脂:干预前两组患者甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)均无统计学差异(P0.05);针刺组干预后TG、TC、LDL-C较干预前降低(P0.05),较对照组降低显著(P0.05);HDL-C较干预前升高(P0.05)较对照组升高显著(P0.05)。5、瘦素(LEP)、抵抗素(Resistin):干预前两组患者LEP、Resistin无统计学差异(P0.05);针刺组干预后LEP、Resistin较干预前降低(P0.05),较对照组降低显著(P0.05)。6、类胰升糖素肽-1(GLP-1):干预前两组患者GLP-1无统计学差异(P0.05);针刺组干预后GLP-1较干预前升高(P0.05),较对照组升高显著(P0.05)。结论:泻胃补脾法针刺治疗2型糖尿病可显著改善患者症状、降低患者FBG、HbA1c、FC-P、TG、TC、LDL-C、LEP、Resistin、Homa-IR(C-P),显著升高 HDL-C、GLP-1;具有升高Homa-islet(C-P)的趋势。泻胃补脾法针刺可有效降低患者血糖,调节血脂,改善胰岛素抵抗,增强胰岛β细胞功能,治疗2型糖尿病具有良好的疗效。
[Abstract]:Objective: to observe the effect of purging stomach and reinforcing spleen acupuncture therapy on the related indexes of type 2 diabetes mellitus and to explore the mechanism of purging stomach and reinforcing spleen acupuncture method to treat type 2 diabetes mellitus. Methods: 30 patients in acupuncture group and 30 patients in control group were randomly assigned by random number table method. The patients in both groups were given diet control and exercise, and the original drug treatment regimen was not changed or drug dosage was adjusted during the study period. Acupuncture group added acupuncture on the basis of the original treatment: main points in epigastric, chamber, Zusanli, Peshu, Taibai, Sanyinjiao. Among them, Zusanli, Inner Court and Middle epigastric were treated by purging acupuncture, and the operation was performed 6 times each by twirling and purging after acupuncture. Taibai, Sanyinjiao, spleen Yu use complement method acupuncture, the operation is acupuncture qi, twirling complement method and lifting interpolation method 6 times each. In the course of treatment, there was no needle retention at Peshu point after acupuncture, but 30 mins at the remaining point, once every other day, 3 times a week. The time of this study is January. The symptoms of the two groups were observed before and after one month of treatment. Fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), fasting insulin (fins), fasting C-peptide (FC-P), insulin resistance index (Homa-IR (C-P), islet 尾 cell function index (Homa-islet (C-P) and total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholagglutination (HDL-C) Alcohol (HDL-C), leptin (LEP), resistin (resistin), glucagon-like peptide-1 (GLP-1) and so on. Results: there was no significant difference in symptom score between the two groups before intervention (P0.05), but the symptom score in acupuncture group was lower than that before intervention (P0.05), which was significantly lower than that in control group (P0.05), the total effective rate of patients after acupuncture intervention was higher than that of control group. The difference was significant (P0.05), fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), fasting C-peptide (FC-P): there was no significant difference between the two groups before intervention (P0.05); after acupuncture intervention, FBGG HbA1cFC-P was lower than that before intervention (P0.05), significantly lower than that of control group (P0.05), insulin resistance index [Homa-IR (C-P)], islet (P 0.05). 尾 cell function index [Homa-islet (C-P)]: there was no significant difference in Homa-IR (C-P) Homa-islet (C-P) between the two groups before and after intervention (P0.05); after acupuncture intervention, Homa-IR (C-P) was lower than that before intervention (P0.05) and significantly lower than that in control group (P0.05); after acupuncture intervention, Homa-islet (C-P) was higher than that before intervention (P0.05), but not significantly lower than that in control group (P0.05). Difference (P0.05) .4Blood lipid: before intervention, there was no statistical difference in triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) between the two groups before intervention (P0.05); Low HDL-C (P0.05) increased significantly (P0.05) compared with control group (P0.05), leptin (LEP), resistin (resistin): there was no significant difference between the two groups before intervention (P0.05); after acupuncture intervention, LEP resistin was lower than that before intervention (P0.05), compared with control group (P0.05), glucagon was significantly decreased (P0.05). Peptide 1 (GLP-1): there was no significant difference in GLP-1 between the two groups before intervention (P0.05); GLP-1 in acupuncture group was higher than that before intervention (P0.05), and significantly higher than that in control group (P0.05). Conclusion: acupuncture with the method of reducing stomach and invigorating spleen can significantly improve the symptoms of type 2 diabetes mellitus, and decrease the level of FBGG HbA1c FC-PnP in patients with FBGG, decrease the level of TBGG TGV, LDL-C, LEP, and increase the level of HDL-Cn GLP-1, and have the tendency of increasing Homa-islet (C-P) in patients with type 2 diabetes mellitus. Acupuncture with the method of purging stomach and reinforcing spleen can effectively reduce blood sugar, regulate blood lipid, improve insulin resistance, enhance the function of islet 尾 cells, and have a good curative effect on type 2 diabetes mellitus.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.1

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