宁波江东社区糖尿病并发冻结肩患者针灸治疗情况的横断面研究

发布时间：2018-08-14 20:05

【摘要】：目的通过对宁波市江东区社区居民中2型糖尿病并发冻结肩患者的问卷调查,初步了解2型糖尿病并发冻结肩的疾病特征和针灸治疗情况,进而分析针灸治疗2型糖尿病并发冻结肩的临床现状和疗效影响因素,以期为提高针灸临床疗效和拓宽针灸适应症提供客观依据。方法采用普查的方法,以宁波市江东区6个社区1971名2型糖尿病伴发冻结肩患者为研究对象。对所有研究对象进行问卷调查,采集一般情况、体格检查、空腹血糖、糖化血红蛋白、总胆固醇、甘油三酯、患病情况及冻结肩治疗情况等指标,分析2型糖尿病并发冻结肩患者的针灸治疗率,描述不同针灸疗法治疗此类肩痛的分布情况及疗效。最后运用Spearman相关系数分析得出糖尿病病程、糖化血红蛋白水平与该类肩痛针灸治疗疗效的相关性。结果(1)本研究共调查了宁波市江东区6个社区,13996名2型糖尿病患者,其中同时伴发冻结肩的有1971名,2型糖尿病并发冻结肩在2型糖尿病患者中的患病率为14.1%。宁波市江东区2型糖尿病伴发冻结肩人群中,男性患病率高于女性(1:0.9);以45-54周岁年龄段患者居多。(2)经调查,冻结肩可在2型糖尿病的任何一个时间段发生。其中糖尿病病程在5年内及20年以上伴发冻结肩的患者相对较少,分别占18.8%及4.4%。2型糖尿病伴发冻结肩患者调查时(一周内)的空腹血糖为6.41±1.32mmol/L、糖化血红蛋白为6.56±1.08%、总胆固醇为5.24±0.71mmol/L、甘油三酯为2.0±1.52mmol/L,均高出正常水平值。(3)调查1971名2型糖尿病伴发冻结肩患者近3个月内的治疗情况,以针灸疗法治疗2型糖尿病伴发冻结肩为最多。(4)922名接受针灸疗法的2型糖尿病伴发冻结肩患者,采用的各种针灸疗法中以温针法、单纯灸法最为常用。(5)针灸治疗2型糖尿病患者冻结肩的有效率为83.3%。不同针灸疗法间有效率各异,其中毫针刺法的有效率为77.2%、艾条灸法的有效率为84.5%、温针灸法的有效率为87.1%、电针疗法的有效率为82.1%、火针疗法的有效率为66.7%、穴位注射疗法的有效率为78.8%、针刀疗法的有效率为67.2%。(6)糖尿病病程为6-10年的冻结肩患者针灸治疗有效率最高(88.4%)。糖尿病病程时间与针灸疗效呈一定负相关(R2=0.028,P=0.00),即糖尿病病程越短,针灸治疗疗效越佳。(7)糖化血红蛋白正常组针灸治疗有效率(95.7%)高于比糖化血红蛋白偏高组(76.4%)。糖化血红蛋白值与针灸疗效呈一定负相关(R2=0.111,P=0.00),即糖化血红蛋白值越低,针灸治疗疗效越佳。结论2型糖尿病并发冻结肩患者中男性多于女性;糖尿病病程、血糖水平与该类冻结肩针灸治疗的疗效存在负相关。在治疗糖尿病伴发的冻结肩时应该积极治疗及控制糖尿病病情。
[Abstract]:Objective to investigate the disease characteristics and acupuncture treatment of type 2 diabetes mellitus complicated with frozen shoulder by questionnaire survey in Jiangdong District residents of Ningbo City. The clinical status and influencing factors of acupuncture and moxibustion in treating type 2 diabetes mellitus complicated with frozen shoulder were analyzed in order to provide an objective basis for improving the clinical efficacy of acupuncture and moxibustion and widening the indication of acupuncture and moxibustion. Methods 1971 patients with type 2 diabetes with frozen shoulder in 6 communities of Jiangdong District of Ningbo City were studied by general survey. All the subjects were investigated by questionnaire, general condition, physical examination, fasting blood glucose, glycosylated hemoglobin, total cholesterol, triglyceride, illness and frozen shoulder treatment, and so on. To analyze the rate of acupuncture and moxibustion in patients with type 2 diabetes mellitus complicated with frozen shoulder, and to describe the distribution and curative effect of different acupuncture and moxibustion therapy for this kind of shoulder pain. Finally, the correlation between the course of diabetes, the level of glycosylated hemoglobin and the curative effect of acupuncture and moxibustion for shoulder pain was obtained by Spearman correlation coefficient analysis. Results (1) A total of 13996 patients with type 2 diabetes were investigated in 6 communities of Jiangdong District, Ningbo City. Among them, 1971 patients with type 2 diabetes mellitus complicated with frozen shoulder were found to have a prevalence rate of 14.1in type 2 diabetes mellitus. The prevalence rate of type 2 diabetes with frozen shoulder in Jiangdong District of Ningbo City was higher in men than in women (1: 0.9), and was mostly in patients aged 45-54 years. (2) the frozen shoulder could occur in any time of type 2 diabetes mellitus. Among them, the number of patients with diabetes with frozen shoulder within 5 years and more than 20 years was relatively few. The fasting blood glucose, glycosylated hemoglobin, total cholesterol, triglyceride and triglyceride were 6.41 卤1.32 mmol / L, 6.56 卤1.08, 5.24 卤0.71 mmol / L and 2.0 卤1.52 mmol / L, respectively. (3) 1971 patients with type 2 diabetes mellitus were investigated. Treatment of patients with frozen shoulder in the past 3 months, (4) 922 patients with type 2 diabetes mellitus accompanied with frozen shoulder were treated by acupuncture and moxibustion therapy, and all kinds of acupuncture and moxibustion methods were used to warm up the shoulder. Simple moxibustion is the most commonly used method. (5) the effective rate of acupuncture and moxibustion on frozen shoulder of type 2 diabetes mellitus is 83.3%. The effective rate varies among different acupuncture and moxibustion treatments, The effective rate of filiform acupuncture is 77.2, the effective rate of moxa moxibustion is 84.5, the effective rate of warming acupuncture is 87.1, the effective rate of electroacupuncture is 82.1, the effective rate of fire acupuncture is 66.7, the effective rate of acupoint injection is 78.8, the effective rate of acupuncture is 87.1, the effective rate of acupuncture is 78.8, the effective rate of acupuncture is 87.1, the effective rate of acupuncture is 82.1, the effective rate of fire acupuncture is 66.7, the effective rate of acupoint injection is 78.8, and the effective rate of acupuncture is 87.1. The effective rate was 67.2%. (6) the effective rate of acupuncture and moxibustion was the highest (88.4%) in frozen shoulder patients whose diabetes course was 6-10 years. The duration of diabetes was negatively correlated with the effect of acupuncture and moxibustion (R2 / 0.028), that is, the shorter the course of diabetes was, the better the therapeutic effect of acupuncture was. (7) the effective rate of acupuncture and moxibustion in the normal hemoglobin glycosylated group (95.7%) was higher than that in the higher glycosylated hemoglobin group (76.4%). The value of glycosylated hemoglobin was negatively correlated with the curative effect of acupuncture and moxibustion (R _ 2: 0.111 P ~ (0.00), that is, the lower the value of glycosylated hemoglobin, the better the curative effect of acupuncture and moxibustion. Conclusion there are more males than females in patients with type 2 diabetes mellitus complicated with frozen shoulder, and there is a negative correlation between the course of diabetes and the therapeutic effect of acupuncture and moxibustion on frozen shoulder of type 2 diabetes mellitus. In the treatment of diabetes associated with frozen shoulder should be actively treated and control the diabetic condition.
【学位授予单位】：浙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246

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