摘要
【目的】观察针刺治疗2型糖尿病肾病周围神经病变的临床疗效。【方法】将130例2型糖尿病肾病周围神经病变患者随机分为观察组和对照组,每组各65例,对照组在常规治疗方案的基础上,给予弥可保治疗,观察组在对照组治疗的基础上,给予针刺治疗。连续治疗4周。治疗1个月后,观察2组患者治疗前后糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2 h血糖(2hPG)的变化情况,以及24 h尿蛋白定量、血肌酐(Scr)和尿素氮(BUN)的情况。比较2组患者治疗前后多伦多糖尿病周围神经病变评分(TCSS)及中医证候积分的变化情况。并评价2组的安全性,治疗后随访6个月,比较2组患者的复发率。【结果】(1)治疗后,2组患者的HbA1c、FBG、2h PG水平均明显改善(P<0.05),且观察组在改善HbA1c、FBG、2hPG水平方面明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的24 h尿蛋白定量、Scr及BUN水平明显改善(P<0.05),且观察组在改善24 h尿蛋白定量、Scr及BUN水平方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者的TSCC评分及中医证候积分均明显改善(P<0.05),且观察组在改善TSCC评分及中医证候积分方面明显均优于对照组,差异有统计学意义(P<0.05)。(4)治疗后随访6个月,观察组复发率为9.23%(6/65),对照组为23.07%(15/65)。2组均无严重复发情况发生。观察组复发率明显低于对照组,差异有统计学意义(P<0.05)。(5)观察组与对照组的不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】针刺治疗2型糖尿病肾病周围神经病变,能有效改善患者的血糖状况,缓解患者的肾功能障碍,提升患者的周围神经功能,减轻临床症状,从而提高患者生活质量,疗效显著。
Objective To observe the clinical efficacy of acupuncture in treating peripheral neuropathy of type2 diabetic nephropathy. Methods A total of 130 patients with peripheral neuropathy in type 2 diabetic nephropathy were randomly divided into the observation group and the control group, with 65 patients in each group. The control group was given Methycobal treatment on top of the conventional treatment regimen,while the observation group was given acupuncture therapy on top of the control group. The treatment was continued for 4 weeks. After one month of treatment,the changes in glycated haemoglobin(HbA1c),fasting blood glucose(FBG)and 2-hour postprandial blood glucose(2hPG),as well as 24-hour urine protein quantification,blood creatinine(Scr)and urea nitrogen(BUN)were observed before and after treatment in the two groups. The changes in Toronto diabetic peripheral neuropathy score(TCSS)and traditional Chinese medicine(TCM)syndrome score were compared before and after treatment in the two groups. The safety of the two groups was also evaluated and the recurrence rate of the two groups was compared at a 6-month follow-up after treatment. Results(1)After treatment,the levels of HbA1c, FBG and 2hPG in two groups were significantly improved(P<0.05), and the observation group was significantly superior to the control group in improving the levels of HbA1c,FBG and 2hPG,the differences being statistically significant(P<0.05).(2)After treatment, both groups of patients with 24-hour urinary protein quantitative,Scr and BUN levels were significantly improved(P<0.05),and the observation group Scr and BUN levels were significantly superior to the control group in improving 24-hour urinary protein quantitative, the difference being statistically significant(P<0.05).(3)After treatment,TSCC score and TCM syndrome score of two groups were significantly improved(P<0.05), and the observation group was significantly superior to the control group in improving TSCC score and TCM syndrome score,the difference being statistically significant(P<0.05).(4)After 6 months of follow-up,the recurrence rate was 9.23%(6/65)in the observation group and 23.07%(15/65)in the control group. There was no serious recurrence occurred in both groups. The recurrence rate of the observation group was significantly lower than that of the control group, and the difference was statistically significant(P<0.05).(5)There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05). Conclusion Acupuncture treatment for peripheral neuropathy in type 2 diabetic nephropathy can effectively improve patients’ blood glucose status, relieve their renal dysfunction, enhance their peripheral nerve function and alleviate clinical symptoms, thereby improving their quality of life with remarkable efficacy.
作者
朱艺平
陈一平
赵艳英
牙侯军
苏仕豪
ZHU Yi-Ping;CHEN Yi-Ping;ZHAO Yan-Ying;YA Hou-Jun;SU Shi-Hao(Guangxi Zhuang Autonomous Region Ethnic Hospital,Nanning 530001 Guangxi,China)
出处
《广州中医药大学学报》
CAS
2023年第4期899-904,共6页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
广西壮族自治区中医药管理局科研资助项目(编号:GZZC2020515)
崇左市科技计划项目(编号:崇科20220633)。
关键词
针刺
2型糖尿病肾病
糖尿病周围神经病变
血糖
肾功能
临床观察
acupuncture
type 2 diabetic nephropathy
diabetic nephropathy
blood glucose
renal function
clinical observation
