耳穴埋针干预超重或肥胖2型糖尿病患者的相关临床指标研究

发布时间：2018-08-22 10:29

【摘要】：目的:通过临床随机对照研究,观察不同耳穴埋针干预超重或肥胖2型糖尿病患者的临床疗效,为耳穴埋针在超重或肥胖的2型糖尿病患者中的临床应用提供参考和依据。方法:选择2016年6月-2017年1月就诊于江苏省中医院门诊及住院的超重或肥胖2型糖尿病患者90例,采用随机对照试验的研究方法,随机分为3组:对照组(常规对照组)、试验1组(常规耳穴组)、试验2组(辨证耳穴组),每组各30例。对照组在常规降糖治疗的同时,给予每周1次面对面健康教育,共4周;试验1组在对照组基础上进行耳穴埋针,选择耳穴胃、口、神门、三焦、内分泌;试验2组在试验1组的取穴基础上,增加辨证取穴点,胃肠实热证患者增加耳穴大肠、脾;肝胃郁热证患者增加耳穴肝、大肠;气滞痰阻证患者增加耳穴脾、肝;脾虚痰湿证患者增加耳穴脾、肾,有其他证候者随证加减。耳穴埋针1周2次,4周为1疗程,共干预4周。在干预前后测量患者的体重、腰围、体脂率及糖脂代谢指标,采用一般情况调查表、糖尿病症状分级量化表及糖尿病生存质量量表对研究对象进行评估,比较三种方法干预本病的疗效差异。数据采用SPSS20.0软件进行统计分析。结果:(1)糖尿病症状分级量化积分:组内比较,干预后,三组患者症状积分均较干预前降低,差异有统计学意义(P0.05)。组间比较,干预后三组症状积分比较,试验2组试验1组对照组,差异有统计学意义(P0.01);干预前后积分差值比较,试验2组试验1组对照组,差异有统计学意义(P0.01)。(2)肥胖指标:组内比较,试验1组和试验2组的体重、腰围、体质指数、体脂率均较干预前明显改善,差异有统计学意义(P0.01),而对照组各项减重指标较干预前相比差异无统计学意义(P0.05)。组间比较,干预后三组各项肥胖指标比较,差异无统计学意义(P0.05);干预前后指标差值比较,试验1组和试验2组的体重、腰围、体质指数及体脂率的差值均低于对照组,差异有统计学意义(P0.05),而试验1组与试验2组比较差异无统计学意义(P0.05)。(3)糖脂代谢指标:组内比较,干预后,三组患者的空腹血糖、餐后2h血糖、糖化血清蛋白、总胆固醇、甘油三酯及低密度脂蛋白6项糖脂代谢指标均较干预前明显改善,差异有统计学意义(P0.01)。组间比较,干预后三组比较,差异无统计学意义(P0.05)。(4)糖尿病生存质量得分:组内比较,干预后,三组患者的生存质量总分及各维度得分均较干预前降低,差异有统计学意义(P0.01)。组间比较,干预后三组比较,差异无统计学意义(P0.05);干预前后得分差值比较,试验2组试验1组对照组,差异有统计学意义(P0.01)。结论:(1)耳穴埋针能够有效改善超重或肥胖2型糖尿病患者的临床症状,降低其体重、腰围、体质指数和体脂率,提升患者的生活质量。(2)辨证耳穴埋针能够更好地改善患者的临床症状,提高患者的生活质量。
[Abstract]:Objective: to observe the clinical effect of different auricular acupoints embedding acupuncture on type 2 diabetes mellitus patients with overweight or obesity, and to provide reference and basis for clinical application of ear acupoint embedding acupuncture in patients with type 2 diabetes mellitus. Methods: from June 2016 to January 2017, 90 patients with type 2 diabetes mellitus were selected from outpatient and inpatient clinics of Jiangsu Provincial traditional Chinese Medicine Hospital. They were randomly divided into three groups: control group (routine control group), experimental group 1 (routine auricular point group) and experimental group 2 (syndrome differentiation auricular point group) with 30 cases in each group. The control group was given face to face health education once a week for 4 weeks while the control group was treated with oral, Shenmen, stomach, oral, Sanjiao, endocrine and acupuncture points on the basis of the control group. In group 2, on the basis of acupoints taken from experimental group 1, the points of syndrome differentiation were increased, and the large intestine and spleen were increased in patients with gastrointestinal heat syndrome, the liver and large intestine were increased in patients with stagnation of heat of liver and stomach, the spleen and liver were increased in patients with stagnation of qi and phlegm, and the patients with syndrome of stagnation of qi and phlegm increased the number of auricular points and liver. Spleen deficiency and phlegm dampness syndrome patients increased the ear point spleen, kidney, other syndromes with the syndrome plus or minus. The auricular acupoint embedding needle was given twice a week for 4 weeks as a course of treatment, and the intervention lasted for 4 weeks. The body weight, waist circumference, body fat rate and glucose and lipid metabolism were measured before and after intervention. The subjects were evaluated by general information questionnaire, diabetes symptom scale and diabetes quality of life scale. To compare the curative effect of three methods in treating this disease. The data were analyzed by SPSS20.0 software. Results: (1) quantitative score of diabetes symptom: compared with the control group, the symptom scores of the three groups were lower than those before intervention, the difference was statistically significant (P0.05). There was significant difference in symptom score between the three groups after intervention (P0.01), the difference between the two groups before and after intervention was significant (P0.01), the difference between the two groups before and after intervention was significant (P0.01), and the difference between the two groups before and after intervention was significant (P0.01). The difference was statistically significant (P0. 01). (2). The body weight, waist circumference, body mass index and body fat rate of group 1 and group 2 were significantly improved compared with those before intervention. The difference was statistically significant (P0.01), but the control group had no significant difference compared with before intervention (P0.05). There was no significant difference between the three groups after intervention (P0.05), and the difference in body weight, waist circumference, body mass index and body fat rate between group 1 and group 2 was lower than that of control group before and after intervention. The difference was statistically significant (P0.05), but there was no significant difference between group 1 and group 2 (P0.05). (3). After intervention, fasting blood glucose, 2 h postprandial blood glucose, glycosylated serum protein, total cholesterol in the three groups were compared. Triglyceride and low density lipoprotein (LDL) were significantly improved compared with those before intervention (P0.01). There was no significant difference between the three groups after intervention (P0.05). (4) score of diabetes mellitus quality of life: intragroup comparison, after intervention, the total score of quality of life and the scores of each dimension of the three groups were lower than those before intervention, the difference was statistically significant (P0.01). There was no significant difference between the three groups after intervention (P0.05); the difference between the scores before and after intervention was statistically significant (P0.01). Conclusion: (1) Auricular acupuncture can effectively improve the clinical symptoms and decrease the body weight, waist circumference, body mass index and body fat rate of patients with type 2 diabetes mellitus who are overweight or obese. Improve the quality of life of patients. (2) Auricular acupuncture can improve the clinical symptoms of patients, improve the quality of life of patients.
【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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