目的:观察针刺加扣刺治疗女性2型糖尿病阴虚夹瘀型患者的临床疗效。方法:92例女性2型糖尿病阴虚夹瘀型患者依据证候轻重特征将阴虚夹瘀患者分为瘀证为主的阴虚夹瘀型(简称组1)和阴虚为主的阴虚夹瘀型(简称组2)两组各46例。采用针刺加叩刺治疗,隔日治疗1次,持续治疗3个月。观察两组患者治疗前后空腹血糖(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)及总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-c)、高密度脂蛋白胆固醇(HDL-c)水平。取41例正常女性作为对照组,与两组患者治疗前后各项指标项比较。结果:治疗前两组FPG、FLP、FINS、Homa-IR、TC、TG、LDL均明显高于正常组水平;HDLC,ISI低于正常组水平。两组患者治疗后FPG、FLP、FINS、Homa-IR、TC、TG、LDL均较治疗前明显下降(P〈0.01),ISI、HDL明显升高(P〈0.01)。治疗后组1 TG、Homa-IR的改善优于组2(P〈0.05)。组1总有效率为91.3%,组2总有效率为76.09%,两组比较差异无统计学意义(P〉0.05)。结论:针刺加扣刺治疗女性2型糖尿病阴虚夹瘀型患者糖、脂质代谢及胰岛素抵抗具有良性调整作用,且以瘀证为主的阴虚夹瘀型在降低胰岛素、改善胰岛抵抗指数相关参数方面的作用优于以阴虚为主的阴虚夹瘀型患者。
Objective: To observe the clinical efficacy of the acupuncture and buckle thorn treatment on type 2 diabetes with Yin deficiency and blood stasis of female. Methods: 92 female T2 DM patients with Yin deficiency and blood stasis were divided into mainly blood stasis type( group 1) and mainly Yin deficiency type( group 2) according to the severity of symptoms of deficiency,with 46 cases in each group. Two groups were first given acupuncture and then given buckle thorn. Both groups were treated every other day,continued treatment for three months. Fasting plasma glucose( FPG),fasting leptin( FLP),fasting insulin( FINS),insulin sensitivity index( ISI),insulin resistance index( Homa-IR) and total cholesterol( TC),triglyceride( TG),low density lipoprotein cholesterol( LDL-c),high density lipoprotein cholesterol( HDL-c) levels were observed before and after treatment. 41 normal females were as control group. We compared the two groups. Results: After treatment,FPG,FINS,Homa-IR,TC,TG and LDL decreased significantly( P〈0. 01) while ISI and HDL were significantly higher( P〈0. 01) in both groups. After treatment,the improvement of TC and Homa-IR in group 1 were superior to those of the group 2( P〈0. 05). The total effective rate was 91. 3% in group 1 and 76. 09% in group 2 and the difference was not statistically significant( P〉0. 05). Compared to normal group,LDC-c and HDL-c had no statistical significance in both groups( P〉0. 05). Conclusion: Acupuncture and buckle thorn can regulate the glucose metabolism and lipid metabolism,relieve the insulin resistance and enhance the body's sensitivity to insulin in T2 DM. And in reducing insulin and improving insulin resistance,the mainly blood stasis group is more effective than mainly Yin deficiency group. Compared to normal group,LDC-c and HDL-c have no statistical significance in both groups( P〉0. 05).