气街理论治疗糖尿病患者肢体远端对称性多神经病变疗效评价
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摘要
研究目的：
本课题旨在观察应用气街理论治疗糖尿病患者肢体远端对称性多神经病变的疗效评价,为临床针灸治疗糖尿病周围神经病变提供一种有效、廉便的治疗手段。
研究方法：
本研究采取前瞻性随机对照试验的研究方法,收集2011年3月至2011年12月广州市中医医院针灸科门诊、住院部以及内分泌科住院部符合诊断标准、纳入标准的患者共70例作为研究对象。随机分为治疗组35例,对照组35例。其中治疗组脱落1例,实际完成34例,对照组脱落2例,实际完成病例33例。治疗组给予针刺气冲、承山、跗阳。对照组给予针刺髀关透伏兔、风市透中渎、风市透伏兔、阳陵泉,两组穴位均得气后,接上然后接上G6805-1型治疗仪,选用疏密波,电流强度以患者能忍受为止,通电15-20分钟。每日1次,15日为一疗程,连续进行1个疗程,分别于治疗前、治疗第15天完成临床症状评分表、Toronto临床评分系统、肌电图检查：测定治疗前、治疗第15天腓总神经的运动神经传导速度(MNC)与感觉神经传导速度(SCV),观察两组治疗前后的各项指标的变化。
研究结果：
1.一般资料：
共完成病例67例,分别为治疗组34例,对照组33例,两组在年龄、性别构成、糖尿病病程、周围神经病变病程、空腹血糖、餐后2h血糖均无统计学差异(P>0.05)；两组具有可比性。
2.症状积分：
两组治疗前糖尿病周围神经病变症状积分无统计学差异(P>0.05),两组具有可比性。两组治疗后的症状积分比较,P<0.05,有统计学差异,说明治疗组的方法在改善症状积分方面要优于对照组的方法。治疗组前后症状积分的比较,P<0.05,说明治疗组的方法有效,对照组前后症状积分的比较,P<0.05,说明对照组的方法有效。
3.Toronto临床评分：
两组治疗前Toronto临床评分积分(症状分、反射分、感觉分)的比较,无统计学差异(P>0.05),两组具有可比性。两组治疗后症状分的比较,经t检验,P<0.05,有统计学差异,说明治疗后两组在改善症状分方面,治疗组要优于对照组；两组治疗后反射分的比较,经t检验,P>0.05,无统计学差异,说明治疗后两组在改善反射分方面治疗组与对照组的疗效相当；两组治疗后感觉分的比较,经t检验,P<0.05,有统计学差异,说明治疗后两组在改善感觉分方面,治疗组要优于对照组。治疗组治疗前后在症状分、反射分、感觉分的比较,P<0.05,有统计学差异；对照组治疗前后在症状分、反射分、感觉分的比较,P<0.05,有统计学,差异,说明两组的治疗方法均有效。
4.测定治疗前后腓总神经的运动神经传导速度(MCV)与感觉神经传导速度(SCV)的比较：
两组在治疗前腓总神经的感觉、运动传导速度的比较无统计学差异(P>0.05)表明两组均有可比性。两组在治疗后腓总神经的感觉、运动传导速度的比较,无统计学差异(P>0.05),说明两组的治疗方法在改善腓总神经的感觉、运动传导速度以及波幅方面的疗效相当。治疗组治疗前后在改善腓总神经的感觉、运动传导速度的比较,P均小于0.05,有统计学差异,说明治疗组治疗的方法在改善腓总神经的感觉和运动神经传导速度以及波幅方面有效。对照组治疗前后在改善腓总神经的感觉、运动传导速度的比较,P均小于0.05,有统计学差异,说明对照组的治疗方法在改善腓总神经的感觉和运动传导速度以及波幅方面有效。
研究结论：
两组治疗后治疗组的总有效率为88.2%,对照组的有效率为84.8%,两组x2检验,P>0.05,无统计学差异,说明两组在改善症状积分、Toronto临床评分、腓总神经的感觉和运动神经传导速度方面的总体的疗效相当。但在组间方面的比较,经秩和检验,P=0.015,(P<0.05),有统计学差异,说明治疗组治疗后在组间方面的比较要明显优于对照组。
Objective:
This project aims to observe application tibial gas street in the treatment of diabetes theory at the far more than the symmetry of neuropathy effect assessment, for clinical treatment of diabetic peripheral neuropathy acupuncture therapy provide an efficient and cheap and treatment method.
Method:
This study take prospective randomized controlled trials research met hods, the collection in March2011to December2011TCM acupuncture clini c hospital of guangzhou, the inpatient department and endocrine division with the inpatient department diagnostic criteria, into the standard of p atients with a total of70patients as the research object.35cases were randomly divided into treatment group and control group in35patients. Among them the treatment group fall off in1, actual finish34cases and control fall off in2cases, actual finish cases of33cases. The treatme nt group give acupuncture qi chong, ChengShan hocks, Yang. The control gr oup to chop off through v acupuncture rabbit, the wind in the day of the city through, through v rabbit, YangLingQuan, two groups of meridians are gas and connect and then grafted in G6805-type1instrument,, choose den sity wave, current strength to the patient can tolerate so far, electrici ty15to20minutes. Every day1,15days for one period of treatment, co ntinuously a course1, respectively, in the treatment,15days before tre atment through clinical symptoms scale, Toronto clinical scoring system, electromyography, check:determine treatment,15days before the treatmen t of the movement of the total nerve and nerve conduction velocity (MNC) and sensory nerve conduction velocity (SCV), watch two groups before and after treatment of various indexes of the change.
Results:
1. General information:
67cases of were done, respectively, for the treatment group34cases and control of33cases, two groups in age, gender structure, duration of diabetes, peripheral neuropathy course, fasting blood sugar, blood glucose after meal2h, there were no statistical difference (P>0.05); Two groups of comparable
2. Symptom scores:
The two groups before treatment diabetic peripheral neuropathy symptom scores is no statistical difference (P>0.05), two groups of comparable. Two groups of symptom scores more after treatment, P<0.05, statistically significant, explain the treatment group in the method to improve symptom scores than the method of control group. Before and after the treatment group of symptom scores more, P<0.05, explain the treatment group and control group in the method is effective and the comparison of the symptom scores, P<0.05, the control group that the method is effective.
3. Toronto clinical markers:
Eflection points, the t test, P>0.05, no statistically significant, two groups that after treatment in the improvement of reflection points in treatment group is the curative effect; Two groups of treatment the comparison of the feeling after points, the t test, P<0.05, statistically significant after treatment, explain two groups in improving, the treatment group feel points than the control group. Before and after treatment group in symptoms, reflex points, feel points the comparison of the points, P<0.05, statistically significant; The control group in symptoms points before and after treatment, reflection, feel the comparison of the points points, P<0.05, statistics, difference, the two groups of treatments that are effective.
4. Before and after treatment were always the movement of nerve and nerve conduction velocity (or MCV and sensory nerve conduction velocity (SCV) quite:
Two groups in treatment. The feeling of total nervous before, motor conduction speed is no significant differences (P>0.05), shows that both groups are comparable. Two groups in treatment of total nervous feeling, and the comparison of the motor conduction speed, no statistical difference (P>0.05), explain two groups in treatment of improve total nerve feeling, Philip motor conduction speed fluctuation and the effect of quite. The treatment group in improving before and after treatment. The feeling of total nerve conduction velocity, the comparison of the movement, P is less than0.05, statistically significant, explain the method of treatment group in improving the feeling of total nerve and nerve conduction velocity and exercise effective and volatility. The control group before and after treatment in improving phil always feel, the nerve conduction velocity is the movement, P is less than0.05, statistically significant, explain the control group in treatment of improving the feeling of total nerve Philip and motor conduction speed fluctuation and effective.
Conclusion:
Two groups of the treatment group of the total effective rate was88.2%, the effective rate was84.8%in the control group, two groups of x2inspection, P>0.05, no statistically significant, two groups in that improve symptoms integral, Toronto clinical scores, phil. Always nervous feeling and sports nerve conduction velocity of the overall treatment group. But in the comparison between groups, the rank and inspection, P=0.015,(P<0.05), statistically significant, explain the treatment group after treatment in groups to compare was better than control.
本课题旨在观察应用气街理论治疗糖尿病患者肢体远端对称性多神经病变的疗效评价,为临床针灸治疗糖尿病周围神经病变提供一种有效、廉便的治疗手段。
研究方法：
本研究采取前瞻性随机对照试验的研究方法,收集2011年3月至2011年12月广州市中医医院针灸科门诊、住院部以及内分泌科住院部符合诊断标准、纳入标准的患者共70例作为研究对象。随机分为治疗组35例,对照组35例。其中治疗组脱落1例,实际完成34例,对照组脱落2例,实际完成病例33例。治疗组给予针刺气冲、承山、跗阳。对照组给予针刺髀关透伏兔、风市透中渎、风市透伏兔、阳陵泉,两组穴位均得气后,接上然后接上G6805-1型治疗仪,选用疏密波,电流强度以患者能忍受为止,通电15-20分钟。每日1次,15日为一疗程,连续进行1个疗程,分别于治疗前、治疗第15天完成临床症状评分表、Toronto临床评分系统、肌电图检查：测定治疗前、治疗第15天腓总神经的运动神经传导速度(MNC)与感觉神经传导速度(SCV),观察两组治疗前后的各项指标的变化。
研究结果：
1.一般资料：
共完成病例67例,分别为治疗组34例,对照组33例,两组在年龄、性别构成、糖尿病病程、周围神经病变病程、空腹血糖、餐后2h血糖均无统计学差异(P>0.05)；两组具有可比性。
2.症状积分：
两组治疗前糖尿病周围神经病变症状积分无统计学差异(P>0.05),两组具有可比性。两组治疗后的症状积分比较,P<0.05,有统计学差异,说明治疗组的方法在改善症状积分方面要优于对照组的方法。治疗组前后症状积分的比较,P<0.05,说明治疗组的方法有效,对照组前后症状积分的比较,P<0.05,说明对照组的方法有效。
3.Toronto临床评分：
两组治疗前Toronto临床评分积分(症状分、反射分、感觉分)的比较,无统计学差异(P>0.05),两组具有可比性。两组治疗后症状分的比较,经t检验,P<0.05,有统计学差异,说明治疗后两组在改善症状分方面,治疗组要优于对照组；两组治疗后反射分的比较,经t检验,P>0.05,无统计学差异,说明治疗后两组在改善反射分方面治疗组与对照组的疗效相当；两组治疗后感觉分的比较,经t检验,P<0.05,有统计学差异,说明治疗后两组在改善感觉分方面,治疗组要优于对照组。治疗组治疗前后在症状分、反射分、感觉分的比较,P<0.05,有统计学差异；对照组治疗前后在症状分、反射分、感觉分的比较,P<0.05,有统计学,差异,说明两组的治疗方法均有效。
4.测定治疗前后腓总神经的运动神经传导速度(MCV)与感觉神经传导速度(SCV)的比较：
两组在治疗前腓总神经的感觉、运动传导速度的比较无统计学差异(P>0.05)表明两组均有可比性。两组在治疗后腓总神经的感觉、运动传导速度的比较,无统计学差异(P>0.05),说明两组的治疗方法在改善腓总神经的感觉、运动传导速度以及波幅方面的疗效相当。治疗组治疗前后在改善腓总神经的感觉、运动传导速度的比较,P均小于0.05,有统计学差异,说明治疗组治疗的方法在改善腓总神经的感觉和运动神经传导速度以及波幅方面有效。对照组治疗前后在改善腓总神经的感觉、运动传导速度的比较,P均小于0.05,有统计学差异,说明对照组的治疗方法在改善腓总神经的感觉和运动传导速度以及波幅方面有效。
研究结论：
两组治疗后治疗组的总有效率为88.2%,对照组的有效率为84.8%,两组x2检验,P>0.05,无统计学差异,说明两组在改善症状积分、Toronto临床评分、腓总神经的感觉和运动神经传导速度方面的总体的疗效相当。但在组间方面的比较,经秩和检验,P=0.015,(P<0.05),有统计学差异,说明治疗组治疗后在组间方面的比较要明显优于对照组。
Objective:
This project aims to observe application tibial gas street in the treatment of diabetes theory at the far more than the symmetry of neuropathy effect assessment, for clinical treatment of diabetic peripheral neuropathy acupuncture therapy provide an efficient and cheap and treatment method.
Method:
This study take prospective randomized controlled trials research met hods, the collection in March2011to December2011TCM acupuncture clini c hospital of guangzhou, the inpatient department and endocrine division with the inpatient department diagnostic criteria, into the standard of p atients with a total of70patients as the research object.35cases were randomly divided into treatment group and control group in35patients. Among them the treatment group fall off in1, actual finish34cases and control fall off in2cases, actual finish cases of33cases. The treatme nt group give acupuncture qi chong, ChengShan hocks, Yang. The control gr oup to chop off through v acupuncture rabbit, the wind in the day of the city through, through v rabbit, YangLingQuan, two groups of meridians are gas and connect and then grafted in G6805-type1instrument,, choose den sity wave, current strength to the patient can tolerate so far, electrici ty15to20minutes. Every day1,15days for one period of treatment, co ntinuously a course1, respectively, in the treatment,15days before tre atment through clinical symptoms scale, Toronto clinical scoring system, electromyography, check:determine treatment,15days before the treatmen t of the movement of the total nerve and nerve conduction velocity (MNC) and sensory nerve conduction velocity (SCV), watch two groups before and after treatment of various indexes of the change.
Results:
1. General information:
67cases of were done, respectively, for the treatment group34cases and control of33cases, two groups in age, gender structure, duration of diabetes, peripheral neuropathy course, fasting blood sugar, blood glucose after meal2h, there were no statistical difference (P>0.05); Two groups of comparable
2. Symptom scores:
The two groups before treatment diabetic peripheral neuropathy symptom scores is no statistical difference (P>0.05), two groups of comparable. Two groups of symptom scores more after treatment, P<0.05, statistically significant, explain the treatment group in the method to improve symptom scores than the method of control group. Before and after the treatment group of symptom scores more, P<0.05, explain the treatment group and control group in the method is effective and the comparison of the symptom scores, P<0.05, the control group that the method is effective.
3. Toronto clinical markers:
Eflection points, the t test, P>0.05, no statistically significant, two groups that after treatment in the improvement of reflection points in treatment group is the curative effect; Two groups of treatment the comparison of the feeling after points, the t test, P<0.05, statistically significant after treatment, explain two groups in improving, the treatment group feel points than the control group. Before and after treatment group in symptoms, reflex points, feel points the comparison of the points, P<0.05, statistically significant; The control group in symptoms points before and after treatment, reflection, feel the comparison of the points points, P<0.05, statistics, difference, the two groups of treatments that are effective.
4. Before and after treatment were always the movement of nerve and nerve conduction velocity (or MCV and sensory nerve conduction velocity (SCV) quite:
Two groups in treatment. The feeling of total nervous before, motor conduction speed is no significant differences (P>0.05), shows that both groups are comparable. Two groups in treatment of total nervous feeling, and the comparison of the motor conduction speed, no statistical difference (P>0.05), explain two groups in treatment of improve total nerve feeling, Philip motor conduction speed fluctuation and the effect of quite. The treatment group in improving before and after treatment. The feeling of total nerve conduction velocity, the comparison of the movement, P is less than0.05, statistically significant, explain the method of treatment group in improving the feeling of total nerve and nerve conduction velocity and exercise effective and volatility. The control group before and after treatment in improving phil always feel, the nerve conduction velocity is the movement, P is less than0.05, statistically significant, explain the control group in treatment of improving the feeling of total nerve Philip and motor conduction speed fluctuation and effective.
Conclusion:
Two groups of the treatment group of the total effective rate was88.2%, the effective rate was84.8%in the control group, two groups of x2inspection, P>0.05, no statistically significant, two groups in that improve symptoms integral, Toronto clinical scores, phil. Always nervous feeling and sports nerve conduction velocity of the overall treatment group. But in the comparison between groups, the rank and inspection, P=0.015,(P<0.05), statistically significant, explain the treatment group after treatment in groups to compare was better than control.
引文
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