摘要
目的:探讨针刺加叩刺治疗阴虚夹瘀型2型糖尿病患者的临床疗效及其作用机制。方法:将112例患者采用先针刺后叩刺的治疗方法,先取太溪、神门、太白、太渊、三阴交、足三里行提插捻转补法为主,太冲、合谷、血海、丰隆行平补平泻法,留针30min;起针后取膈俞、胰俞、肝俞、肾俞、脾俞梅花针叩刺,隔日治疗1次,治疗3个月。观察患者治疗前后脂肪-胰岛轴相关指标空腹血糖(FPG)、空腹瘦素(FLP)、空腹胰岛素(FINS)、胰岛素敏感性指数(ISI)、胰岛素抵抗指数(Homa-IR)、胰岛素分泌指数(Homa-β)以及肥胖和血脂等指标的变化。结果:治疗后总有效率为84.8%(95/112),且瘀证为主者疗效优于阴虚为主者[92.9%(52/56)vs 76.8%(43/56),P<0.05];治疗前患者FPG、FLP、FINS、Homa-IR、胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、体质量、体质指数(BMI)、肥胖指标百分率(F%)、肥胖度(A)均明显高于正常组水平(均P<0.01);高密度脂蛋白胆固醇(HDL-C)、ISI低于正常组水平(均P<0.01)。治疗后FPG、FLP、FINS、Homa-IR、TC、TG、LDL-C、体质量、BMI、F%、A均较治疗前明显下降(均P<0.01),ISI、HDL-C明显升高(均P<0.01)。轻度肥胖者疗效均优于中度肥胖、重度肥胖者,年龄小者疗效优于年龄大者,男性患者疗效优于女性,但差异均无统计学意义(均P>0.05);病程10年以内者疗效优于病程10年以上者(P<0.01)。结论:针刺加叩刺治疗阴虚夹瘀型2型糖尿病疗效显著,其机制可能与良性调整患者糖、脂质代谢及脂肪-胰岛轴有关。
ABSTRACT Objective To explore the clinical efficacy and mechanism of acupuncture and tapping therapy in the treatment of type 2 diabetes of yin deficiency pattern combined with stasis in the patients. Methods One hundred and twelve patients were treated with acupuncture, followed by tapping method. The reinforcing method with lift- ing, thrusting and rotating needle technique was used at Taixi （KI 3）, Shenmen （HT 7）, Taibai （SP 3）, Taiyuan （LU 9）, Sanyinjiao （SP 6） and Zusanli （ST 36） ; and the even-needling technique was used at Taichong （LR 3）, Hegu （LI 4）, Xuehai （SP 10） and Fenglong （ST 40）. The needles were remained for 30 min. After needle remov- al, the tapping method with plum-blossom needle was applied to Geshu （BL 17）, Yishu （EX-B 3）, Ganshu （BL 18）, Shenshu （BL 23） and Pishu （BL 20）, once every two days. The treatment of 3 months was required. The changes were observed before and after treatment in the relevant indices of fat-islet axis such as fasting plasma glu- cose （FPG）, fasting leptin （FLP）, fasting insulin （FINS）, insulin sensitivity index （ISI）, insulin resistance （Ho- ma IR）, insulin secretion index （Homa-l]） and the indices of obesity and blood lipids in the patients. Results Af- ter treatment, the total effective rate was 84.8% （95/112）, in which the efficacy on the stasis predominated syn- drome was better than that of yin deficiency predominated syndrome [92.9% （52/56） vs 76.8% （43/56）, P〈0.05]. Before treatment, FPG, FLP, FINS, Homa-IR, total cholesterol （TC）, trigtyceride （TG）, low-density lipoprotein cholesterol （LDL-C）, body mass, body mass index （BMI）, fat percentage （F%） and obesity degree in thepatients were higher obviously than those in the normal group （all P〈0.01） ; high-density lipoprotein cholesterol （HDL-C） and ISI were lower than those in the normal group （both P%0. 01）. After treatment, FPG, FLP, FINS, Homa-IR, TC, TG, LDL-C, body mass, BMI, F~/00 and obesity degree were all reduced obviously as com- pared with those before treatment （all P〈0.01）. ISI and HDL-C were increased apparently （both P〈0.01）. The efficacy on mild obesity was superior to that on moderate and severe obesity, and the efficacy in the young patients was better than that in the elderly, the efficacy in the males was better than that in the females, hut the differences were not significant （all P〉0.05）. The efficacy in the cases with 10 years duration of sickness was superior to those with over 10 years duration of sickness （P〈0.01）. Conclusion Acupuncture and tapping therapy achieves the significant efficacy on type 2 diabetes of yin deficiency pattern combined with stasis and its effect mechanism is related to the positive regulation of glucose, lipid metabolism and fat-islet axis.
出处
《中国针灸》
CAS
CSCD
北大核心
2014年第8期731-735,共5页
Chinese Acupuncture & Moxibustion
基金
国家自然科学基金资助项目:39770929
高等学校博士学科点专项科研基金资助项目:20040315008
关键词
2型糖尿病
针刺疗法
叩刺
脂肪-胰岛轴
血脂
type 2 diabetes
acupuncture therapy
tapping method
fat-islet axis
blood lipid
