针灸干预治疗糖尿病周围神经病的临床疗效

王思瑶 李甜 徐华 张慎 宋燕文 杨臻 杨莉 黄奏琴

[摘要]目的觀察针灸干预治疗糖尿病周围神经病的临床疗效。方法选取2018年9月至2020年9月上海市浦东新区中医医院收治的60例轻、中度糖尿病周围神经病变患者作为研究对象，根据随机分组原则分为治疗组和对照组，每组各30例。对照组采用内科糖尿病周围神经病常规治疗，治疗组在内科糖尿病周围神经病常规治疗上增加针灸疗法。于治疗前、治疗2周后、治疗4周后比较两组受试者疼痛、麻木等临床症状评分的改善情况。结果治疗2周后，治疗组临床症状评分低于对照组，且治疗组与对照组治疗后的临床症状评分均低于本组治疗前，差异有统计学意义（P <0.05）;治疗4周后，治疗组临床症状评分低于对照组，且治疗组与对照组治疗后的临床症状评分均低于本组治疗前及治疗2周后，差异有统计学意义（ P <0.05）。结论在内科糖尿病周围神经病常规治疗基础上增加针灸疗法可有效提升疗效，改善患者临床症状。

[关键词]糖尿病周围神经病变;针灸干预;针药并用;糖尿病并发症

[中图分类号] R246.1  [文献标识码] A   [文章编号]2095-0616（2021）23-0101-04

Observation on clinical efficacy of acupuncture intervention in the treatment of diabetic peripheral neuropathy

WANG  Siyao    LI  Tian    XU  Hua    ZHANG  Shen    SONG  Yanwen    YANG  Zhen YANG  Li    HUANG  Zouqin

Pudong New Area Hospital ofTraditional Chinese Medicine in Shanghai， Shanghai 201299， China

[Abstract] Objective To observe the clinical efficacy of acupuncture intervention in the treatment of diabetic peripheral neuropathy （DPN）. Methods A total of 60 patients with mild and moderate DPN admitted to Pudong New Area Hospital of Traditional Chinese Medicine in shanghai from September 2018 to September 2020 were selected as the research objects， and they were randomly divided into the treatment group and the control group， with 30 cases in each group. The control group was treated with conventional medical treatment of DPN， while the treatment group was treated with acupuncture on the basis of conventional medical treatment of DPN. The improvements in scores of clinical symptom such as pain and numbness before treatment， 2 weeks after treatment and 4 weeks after treatment were compared between the two groups. Results After two weeks oftreatment， the scores ofclinical symptoms in the treatment group were lower than those in the control group， and the scores ofclinical symptoms in the treatment group and the control group after treatment were lower than those before treatment， with statistically significant differences （P <0.05）. After 4 weeks of treatment， the scores of clinical symptoms in the treatment group were lower than those in the control group， and the scores of clinical symptoms in the treatment group and the control group after treatment were lower than those before treatment and after 2 weeks of treatment， with statistically significant differences （P <0.05）. Conclusion The acupuncture therapy combined with conventional diagnosis and treatment of DPN in internal medicine can effectively improve the curative effect and improve the clinical symptoms ofpatients.

[Key words] Diabetic peripheral neuropathy; Acupuncture intervention; Combination of acupuncture and medicine; Complications of diabetes

糖尿病周围神经病（diabetic peripheral neuropathy， DPN）是指在排除其他原因的情况下，糖尿病患者出现与周围神经功能障碍相关的症状和（或）体征[1]，是糖尿病最常見的慢性并发症之一[2]。临床表现为肢体远端的麻木、疼痛，甚至可形成坏疽，是导致足部溃疡和截肢的常见原因，严重影响患者生活质量[3]。由于 DPN 发病机制尚不明确，目前其治疗多以缓解症状为主。西医多采用药物、微创介入、神经阻滞等治疗方法，疗效欠佳[4]。祖国医学多采用中药口服、针灸、熏洗等治疗方法，其中针灸疗法以其安全有效、无副作用等优势得到临床的认可，但在 DPN 的临床治疗中，针灸疗法的应用并不广泛，其疗效优势没有得到充分发挥。……