2021 年第 6 期 第 16 卷

针灸结合常规西药治疗糖尿病周围神经病变的临床效益探讨

Clinical benefit of acupuncture and moxibustion combined with conventional western medicine in the treatment of diabetic peripheral neuropathy

作者：李桂云张雅琼刘攀云马红伟黄继良

英文作者：Li Guiyun Zhang Yaqiong Liu Panyun Ma Hongwei Huang Jiliang

单位：中国人民解放军陆军第八十一集团军医院内分泌科，河北省张家口市075000

英文单位：Department of Endocrinology the 81st Group Army Hospital of Land Force of the Chinese People′s Liberation Army Hebei Province Zhangjiakou 075000 China

关键词：糖尿病周围神经病变；针灸；硫辛酸注射液；甲钴胺；临床效益

英文关键词：Diabeticperipheralneuropathy;Acupunctureandmoxibustion;Thiocticacidinjection;

• 摘要：

• 目的 观察针灸结合常规西药治疗糖尿病周围神经病变（DPN）的临床效益。方法 选取2016年6月至2019年12月于中国人民解放军陆军第八十一集团军医院内分泌科住院的90例DPN患者，按照随机数字表法分为结合组和西药组，各45例。西药组应用硫辛酸注射液及甲钴胺注射液（或片）治疗，结合组在西药组基础上加以针灸治疗。本研究一般规定疗程18 d，如症状好转后，依据患者意愿，复查肌电图后，可提前办理出院。观察患者治疗总有效率、治疗前后正中神经和腓总神经的运动神经传导速度（MNCV）和感觉神经传导速度（SNCV）、住院天数及费用。结果 结合组治疗总有效率高于西药组［95.6%（43/45）比75.6%（34/45）］，差异有统计学意义（χ2=22.010，P=0.047）。治疗后，2组正中神经和腓总神经MNCV、SNCV均明显高于治疗前，且结合组高于西药组，差异均有统计学意义（均P<0.05）。结合组住院天数少于西药组、住院费用低于西药组［（13±4）d比（15±6）d、（6 269±524）元比（7 875±404）元］，差异均有统计学意义（t=3.356，P=0.046；t=20.557，P=0.044）。结论 针灸结合硫辛酸注射液、甲钴胺注射液（或片）治疗DPN可以明显改善糖尿病患者神经传导速度，缩短住院日，减少住院费用。

• Objective To observe the clinical benefit of acupuncture and moxibustion combined with conventional western medicine in the treatment of diabetic peripheral neuropathy(DPN). Methods From June 2016 to December 2019, 90 DPN patients hospitalized in the Department of Endocrinology, the 81st Group Army Hospital of Land Force of the Chinese People′s Liberation Army were selected. They were randomly divided into combination group and western medicine group, with 45 cases in each group. The western medicine group was treated with thioctic acid injection and mecobalamin injection(tablets). The combination group was treated with acupuncture and moxibustion therapy on the basis of the western medicine group. In this study, the treatment course is generally 18 d. If the symptoms improve, patients could be discharged in advance according to their wishes after reviewing the electromyogram. The total effective rate, motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV) of median nerve and common peroneal nerve before and after treatment, hospitalization days and expenses were observed. Results The total effective rate of combination group was higher than that of western medicine group［95.6%(43/45) vs 75.6%(34/45)］, and the difference was statistically significant(χ2=22.010, P=0.047). After treatment, MNCV and SNCV of median nerve and common peroneal nerve in the two groups were significantly higher than those before treatment, and those in the combination group were higher than those in the western medicine group(all P<0.05). The hospitalization days and average hospitalization expenses of the combination group were less than those of the western medicine group［(13±4)d vs (15±6)d, (6 269±524)yuan vs (7 875±404)yuan］, and the differences were statistically significant(t=3.356, P=0.046; t=20.557, P=0.044). Conclusion Acupuncture and moxibustion therapy combined with thioctic acid injection and mecobalamin injection(tablets) can significantly improve the nerve conduction velocity of DPN patients, shorten the average hospitalization days, and reduce hospitalization costs.