针灸阳明经腧穴治疗糖尿病下肢周围神经病变疗效观察
发布时间：2019-02-28 21:28
【摘要】：目的：观察针灸阳明经腧穴对糖尿病下肢周围神经病变的临床疗效,初步讨论其作用机理,以评估该方法在糖尿病周围神经病变治疗中的临床优势与应用价值,为糖尿病引起的下肢周围神经病变提供有效的、进一步的治疗途径。方法：本次课题全部病例来自于黑龙江中医药大学附属第一医院选取符合诊断标准及纳入标准的糖尿病周围神经病变患者60例,采用随机分组法,将全部病例分为治疗组(即针刺阳明经腧穴配合温和灸)30例,对照组(即常规针刺)30例,两组的基础治疗方案相同：监控血糖；两组均需控制日常饮食并通过降糖药或注射胰岛素降糖,使空腹血糖控制在8mmol/L,餐后血糖在11.1mmol/L以下并维持稳定1星期；口服弥可保片一一成人一次1片(0.5mg),一日3次。治疗组施以基础治疗,并行针刺阳明经腧穴(主经穴：足三里、上巨虚、丰隆、下巨虚、解溪、内庭,依据辩证分型加穴：气虚血瘀加三阴交、气海、血海,阴虚血瘀加肝俞、肾俞、三阴交,痰瘀阻络加脾俞、胃俞、三焦俞、三阴交,肝肾亏虚加肝俞、肾俞、太溪)加用温和灸治疗,观察治疗4个疗程。对照组施以基础治疗,并行常规针刺,取穴参照新世纪第二版教材《针灸学》取穴。近年来有很多研究报道多伦多临床神经病变评分系统(TCSS),并将其作为D PN有效的筛查和疗效评价工具广泛应用于临床。本课题应用TCSS评分、神经传导速度测定(NCV)评估,并运用统计学处理软件,比较两组TCSS分值、神经传导速度的变化,以及临床疗效。结果：1.治疗前后两组糖尿病下肢周围神经病变患者的TCSS评分、神经传导速度均有变化,改善了患者临床症状,经统计学软件分析,结果为：治疗后治疗组、对照组组内比较(P0.01)；且组间比较存在显著性差异(P0.05),具有统计学意义。2.治疗前后两组糖尿病下肢周围神经病变患者的总有效率比较,治疗组优于对照组(P0.05)。结论：1.针灸阳明经腧穴对糖尿病下肢周围神经病变患者的神经传导速度、临床症状和体征均有改善。2.针灸阳明经腧穴是治疗和改善糖尿病下肢周围神经病变的有效方法之一。
[Abstract]:Objective: to observe the clinical effect of acupuncture and moxibustion on diabetic peripheral neuropathy of lower extremities, and discuss its mechanism, so as to evaluate the clinical advantage and application value of this method in the treatment of diabetic peripheral neuropathy. To provide an effective and further treatment for peripheral neuropathy of lower extremities caused by diabetes. Methods: 60 patients with diabetic peripheral neuropathy were selected from the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine and randomly divided into groups. All cases were divided into treatment group (acupuncture Yangming acupoints combined with mild moxibustion) 30 cases, control group (that is, routine acupuncture) 30 cases, the two groups of basic treatment plan is the same: monitoring blood sugar; Both groups were required to control their daily diet and control fasting blood glucose at 8 mmol / L through hypoglycemic drugs or insulin injection. Postprandial blood glucose was below 11.1mmol/L and remained stable for 1 week. Take Mecobao tablets one by one adult 1 tablet (0.5mg), 3 times a day. The treatment group was treated with basic treatment and acupunctured at acupoints of Yangming Meridian (main meridian points: Zusanli, Shangjuxu, Fenglong, Xijuxu, Jiexi, inner atria, plus acupoints according to dialectical classification: Qi deficiency, blood stasis plus Sanyinjiao, Qi sea, blood sea, yin deficiency and blood stasis plus Gan Shu, Shenshu, Sanyinjiao, phlegm stasis blocking collaterals plus spleen, Weishu, Sanjiaoshu, Sanyinjiao, deficiency of liver and kidney plus Gansu, Shenshu, Taixi) were treated with mild moxibustion and observed for 4 courses of treatment. The control group was treated with basic treatment and routine acupuncture, and the acupoints were selected according to the second edition of the new century textbook of Acupuncture and moxibustion. In recent years, Toronto Clinical Neuropathy scoring system (TCSS),) has been widely used as an effective screening and therapeutic evaluation tool for D-PN. In this study, TCSS score, nerve conduction velocity (NCV) were used to evaluate (NCV), and statistical software was used to compare the changes of TCSS score, nerve conduction velocity (NCV) and clinical curative effect between the two groups. Results: 1. Before and after treatment, the TCSS score and nerve conduction velocity of the two groups of diabetic peripheral neuropathy of lower extremities were changed, which improved the clinical symptoms of the patients. The results were as follows: the treatment group after treatment, the clinical symptoms of the patients were improved by statistical software analysis. Comparison in the control group (P0.01); There was a significant difference between the two groups (P0.05), with statistical significance. 2. The total effective rate of diabetic peripheral neuropathy before and after treatment was better in the treatment group than in the control group (P0.05). Conclusion: 1. Acupuncture and moxibustion on acupoints of Yangming Meridian can improve nerve conduction velocity, clinical symptoms and signs of diabetic patients with peripheral neuropathy of lower limb. 2. Acupuncture and moxibustion Yangming Meridian acupoints is one of the effective methods to treat and improve peripheral neuropathy of diabetic lower limbs.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.1
本文编号：2432184
[Abstract]:Objective: to observe the clinical effect of acupuncture and moxibustion on diabetic peripheral neuropathy of lower extremities, and discuss its mechanism, so as to evaluate the clinical advantage and application value of this method in the treatment of diabetic peripheral neuropathy. To provide an effective and further treatment for peripheral neuropathy of lower extremities caused by diabetes. Methods: 60 patients with diabetic peripheral neuropathy were selected from the first affiliated Hospital of Heilongjiang University of traditional Chinese Medicine and randomly divided into groups. All cases were divided into treatment group (acupuncture Yangming acupoints combined with mild moxibustion) 30 cases, control group (that is, routine acupuncture) 30 cases, the two groups of basic treatment plan is the same: monitoring blood sugar; Both groups were required to control their daily diet and control fasting blood glucose at 8 mmol / L through hypoglycemic drugs or insulin injection. Postprandial blood glucose was below 11.1mmol/L and remained stable for 1 week. Take Mecobao tablets one by one adult 1 tablet (0.5mg), 3 times a day. The treatment group was treated with basic treatment and acupunctured at acupoints of Yangming Meridian (main meridian points: Zusanli, Shangjuxu, Fenglong, Xijuxu, Jiexi, inner atria, plus acupoints according to dialectical classification: Qi deficiency, blood stasis plus Sanyinjiao, Qi sea, blood sea, yin deficiency and blood stasis plus Gan Shu, Shenshu, Sanyinjiao, phlegm stasis blocking collaterals plus spleen, Weishu, Sanjiaoshu, Sanyinjiao, deficiency of liver and kidney plus Gansu, Shenshu, Taixi) were treated with mild moxibustion and observed for 4 courses of treatment. The control group was treated with basic treatment and routine acupuncture, and the acupoints were selected according to the second edition of the new century textbook of Acupuncture and moxibustion. In recent years, Toronto Clinical Neuropathy scoring system (TCSS),) has been widely used as an effective screening and therapeutic evaluation tool for D-PN. In this study, TCSS score, nerve conduction velocity (NCV) were used to evaluate (NCV), and statistical software was used to compare the changes of TCSS score, nerve conduction velocity (NCV) and clinical curative effect between the two groups. Results: 1. Before and after treatment, the TCSS score and nerve conduction velocity of the two groups of diabetic peripheral neuropathy of lower extremities were changed, which improved the clinical symptoms of the patients. The results were as follows: the treatment group after treatment, the clinical symptoms of the patients were improved by statistical software analysis. Comparison in the control group (P0.01); There was a significant difference between the two groups (P0.05), with statistical significance. 2. The total effective rate of diabetic peripheral neuropathy before and after treatment was better in the treatment group than in the control group (P0.05). Conclusion: 1. Acupuncture and moxibustion on acupoints of Yangming Meridian can improve nerve conduction velocity, clinical symptoms and signs of diabetic patients with peripheral neuropathy of lower limb. 2. Acupuncture and moxibustion Yangming Meridian acupoints is one of the effective methods to treat and improve peripheral neuropathy of diabetic lower limbs.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.1
【参考文献】
相关期刊论文 前10条
1 杨会蓉;黎元惠;;化湿活血汤联合西药治疗2型糖尿病下肢周围神经病变随机平行对照研究[J];实用中医内科杂志;2016年03期
2 张磊;王国豪;王馨曼;孟繁洁;;中药熏洗对比西药治疗糖尿病周围神经病变的系统评价[J];华西医学;2016年03期
3 武静美;郑荣斌;胡栋;;中医火针配合硫辛酸治疗糖尿病周围神经病变的80例临床研究[J];白求恩医学杂志;2016年01期
4 郎宁;余洁;文俊;;加味黄芪桂枝五物汤治疗糖尿病周围神经病变82例临床观察[J];中国实用神经疾病杂志;2015年20期
5 李崖雪;闫建华;王丰;金弘;张秦宏;李晓陵;;针刺六经原穴(阴经输穴)治疗糖尿病周围神经病变患者的临床疗效观察[J];中医药学报;2015年05期
6 周卓宁;刘鹏;庞健丽;姜俊玲;莫钧婷;;消渴通痹方治疗气阴两虚夹瘀证糖尿病周围神经病变的临床观察[J];中医药导报;2015年19期
7 钟柳娜;;栗德林教授治疗糖尿病周围神经病变经验[J];环球中医药;2015年06期
8 李子华;邱忠朋;吕荼;;周围神经松解术治疗糖尿病性周围神经病变的临床应用[J];中国实用神经疾病杂志;2015年04期
9 梁永林;李娟;贾育新;张文龙;;贾斌主任医师治疗糖尿病周围神经病变经验[J];时珍国医国药;2015年02期
10 孙娜;崔建美;刘慧娟;高秀娟;齐峰;;针刺预防及治疗对糖尿病大鼠血糖血脂的影响[J];中国老年学杂志;2015年01期
相关博士学位论文 前1条
1 陆永康;针刺对胰岛素抵抗大鼠氧化应激的影响[D];广州中医药大学;2015年
，本文编号：2432184
本文链接：https://www.wllwen.com/zhongyixuelunwen/2432184.html
最近更新
教材专著
