Abstract:

Objective　To observe the effect of basic treatment, moxibustion on the Yiyu point, and Tongluo Diitan Decoction for patients with type 2 diabetic peripheral neuropathy. Methods　Ninety-three patients with type 2 diabetic peripheral neuropathy of the phlegm-stasis obstruction type treated at Shangluo Central Hospital from March 2022 to February 2024 were selected as the research objects, and were divided into a control group (46 cases) and an observation group (47 cases) according to the treatment methods. In the control group, there were 26 males and 20 females who were (48.53±6.27) years old. In the observation group, there were 24 males and 23 females who were (49.71±7.34) years old. Both groups received basic treatment. The control group received moxibustion on their Yiyu points, and the observation group took Tongluo Ditan Decoction on the basis of the control group. The scores of traditional Chinese medicine syndromes, nerve conduction velocities, clinical efficacies, blood glucose levels, vascular endothelial function, oxidative stress reaction, and adverse reactions were compared between the two groups. t test and χ² test were used. Results　After the treatment, the total score, score of secondary symptoms, and score of main symptoms of the observation group were lower than those of the control group [(6.28±1.23) vs. (10.12±1.97), (2.17±0.34) vs. (4.09±0.88), and (4.11±0.85) vs. (6.03±1.72)], with statistical differences (all P<0.05). After the treatment, the motor conduction velocity (MNCV) and sensory conduction velocity (SNCV) of the median nerve and common peroneal nerve in the observation group were higher than those in the control group [(47.25±5.76) m/s vs. (43.56±4.54) m/s, (49.31±5.69) m/s vs. (45.82±4.87) m/s, (44.17±5.88) m/s vs. (39.25±4.36) m/s, and (46.51±5.72) m/s vs. (42.69±4.83) m/s], with statistical differences (all P<0.05). The total effective rate of the observation group was higher than that of the control group [93.62% (44/47) vs. 78.26% (36/46); P<0.05]. After the treatment, the levels of glycosylated hemoglobin (HbAlc), 2 h postprandial blood glucose (2hPG), fasting blood glucose (FBG), serum endothelin-1 (ET-1), vascular endothelial growth factor (VEGF), and malondialdehyde (MDA) in the observation group were lower than those in the control group [(6.03±1.25)% vs. (7.28±1.72)%, (7.21±1.24) mmol/L vs. (8.72±1.69) mmol/L, (5.35±0.83) mmol/L vs. (6.72±1.20) mmol/L, (78.32±9.08) ng/L vs. (115.20±12.47) ng/L, (79.85±9.30) ng/L vs. (112.34 ±13.68) ng/L, and (3.65±0.68) mmol/L vs. (4.87±1.02) mmol/L]; the levels of serum nitric oxide (NO) and superoxide dismutase (SOD) in the observation group were higher than those in the control group [(65.41±7.38) μmol/L vs. (49.86±5.94) μmol/L and (165.76±18.40) U/L vs. (108.27±11.34) U/L]; there were statistical differences (all P<0.05). During the treatment, there were no obvious adverse reactions in both groups. Conclusion　Basic treatment, moxibustion on the Yiyu point, and Tongluo Ditan Decoction for patients with type 2 diabetic peripheral neuropathy is effective, can increase nerve conduction speed, reduce oxidative stress reaction, improve vascular endothelial function, and regulate blood sugar level, and is safe and reliable.

Key words:

Type 2 diabetes, Moxibustion, Yiyu point, Tongluo Ditan Decoction, Phlegm-stasis obstruction type, Diabetic peripheral neuropathy,  , Clinical effect

摘要：

目的　观察基础治疗、艾灸胰俞穴联合通络涤痰汤治疗2型糖尿病周围神经病变患者的效果。方法　选取2022年3月至2024年2月商洛市中心医院收治的痰瘀阻络型2型糖尿病周围神经病变患者93例为研究对象。根据治疗方法将其分成对照组46例与观察组47例。对照组男26例，女20例，年龄（48.53±6.27）岁。观察组男24例，女23例，年龄（49.71±7.34）岁。两组均采用基础治疗。对照组艾灸胰俞穴治疗，观察组在对照组的基础上采用通络涤痰汤治疗。对比两组中医症候评分、神经传导速度、临床疗效、血糖水平、血管内皮功能、氧化应激反应及不良反应。采用t检验、χ²检验。结果　治疗后，观察组总评分、次症评分、主症评分均低于对照组［（6.28±1.23）分比（10.12±1.97）分、（2.17±0.34）分比（4.09±0.88）分、（4.11±0.85）分（6.03±1.72）分］，差异均有统计学意义（均P<0.05）。治疗后，观察组正中神经及腓总神经的运动传导速度（motor conduction velocity，MNCV）与感觉传导速度（sensory conduction velocity，SNCV）均高于对照组［（47.25±5.76）m/s比（43.56±4.54）m/s、（49.31±5.69）m/s比（45.82±4.87）m/s、（44.17±5.88）m/s比（39.25±4.36）m/s、（46.51±5.72）m/s比（42.69±4.83）m/s］，差异均有统计学意义（均P<0.05）。观察组总有效率高于对照组［93.62%（44/47）比78.26%（36/46），P<0.05］。治疗后，观察组糖化血红蛋白（HbAlc）、餐后2 h血糖（2 h postprandial blood glucose，2hPG）、空腹血糖（fasting blood glucose，FBG）、血清内皮素-1（endothelin-1，ET-1）、血管内皮生长因子（vascular endothelial growth factor，VEGF）、丙二醛（malondialdehyde，MDA）水平均低于对照组［（6.03±1.25）%比（7.28±1.72）%、（7.21±1.24）mmol/L比（8.72±1.69）mmol/L、（5.35±0.83）mmol/L比（6.72±1.20）mmol/L、（78.32±9.08）ng/L比（115.20±12.47）ng/L、（79.85±9.30）ng/L比（112.34±13.68）ng/L、（3.65±0.68）mmol/L比（4.87±1.02）mmol/L］，血清一氧化氮（nitric oxide，NO）、超氧化物歧化酶（superoxide dismutase，SOD）水平均高于对照组［（65.41±7.38）μmol/L比（49.86±5.94）μmol/L、（165.76±18.40）U/L比（108.27±11.34）U/L］，差异均有统计学意义（P<0.05）。治疗期间，两组均未出现明显不良反应。结论　基础治疗、艾灸胰俞穴联合通络涤痰汤治疗痰瘀阻络型2型糖尿病周围神经病变患者效果确切，可提高神经传导速度，减轻氧化应激反应，改善血管内皮功能，调节血糖水平，且安全可靠。

关键词:

2型糖尿病, 艾灸, 胰俞穴, 通络涤痰汤, 痰瘀阻络型, 糖尿病周围神经病变, 临床疗效