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[目的]观察针刺联合格列齐特与甲钴胺治疗糖尿病周围神经病变疗效。[方法]使用随机平行对照方法,将86例住院患者按病志号抽签方法简单随机分为两组。对照组43例格列齐特80mg/次,2次/d,口服;甲钴胺0.5mg/次,1次/d,肌注。治疗组43例针刺,主穴:关元、肾俞、胃脘下俞、足三里、三阴交、曲池及合谷,辨证施针,上肢麻木感强烈加手三里、外关及尺泽等;下肢麻木感明显加足三里、太冲及阳陵泉等;患肢瘀血较重加膈俞、血海及阴陵泉等;痰浊较盛加丰隆及膻中等,局部消毒,0.35mm不锈钢毫针,平补平泻,插、捻、转手法,酸麻重胀为宜,留针20~30min/次,1次/d;西药治疗同对照组。连续治疗6d为1疗程。观测临床症状、空腹血糖值(FBG)、糖化血红蛋白(HbA1c)、疼痛评分、不良反应。连续治疗5疗程,判定疗效。[结果]治疗组显效14例,有效21例,无效8例,总有效率84.40%。对照组显效9例,有效15例,无效9例,总有效率55.81%。治疗组疗效优于对照组(P<0.01)。FBG、HbA1c、疼痛评分改善治疗组优于对照组(P<0.01)。[结论]针刺联合格列齐特与甲钴胺治疗糖尿病周围神经病变,疗效满意,无严重不良反应,值得推广。
[Objective] To observe the curative effect of acupuncture combined with gliclazide and mecobalamin in the treatment of diabetic peripheral neuropathy. [Methods] Using randomized parallel control method, 86 inpatients were randomly divided into two groups randomly according to the method of lot drawing of disease symbols. Control group, 43 cases of gliclazide 80mg / times, 2 times / d, oral; mecobalamin 0.5mg / time, 1 / d, intramuscular injection. Treatment group of 43 cases of acupuncture, the main points: Guanyuan, Shenshu, Stomach Xia Yu, Zusanli, Sanyinjiao, Quchi and Hegu, dialectical and needles, upper limb numbness plus a strong hand three miles, Lower limb numbness significantly increased Zusanli, Taichong and Yanglingquan; limb bleeding heavier Geshu, blood sea and Yin Lingquan; phlegm turbid more Sheng plus 隆 及 and 膻 medium, local disinfection, 0.35mm Stainless steel needle, flat fill diarrhea, plug, twist, turn method, sore bulge is appropriate, needle 20 ~ 30min / time, 1 / d; Western medicine treatment with the control group. Continuous treatment of 6d for a course of treatment. Clinical symptoms, fasting blood glucose (FBG), glycosylated hemoglobin (HbA1c), pain score and adverse reactions were observed. Continuous treatment of 5 courses to determine the efficacy. [Result] In the treatment group, 14 cases were markedly effective, 21 cases were effective, 8 cases were ineffective, and the total effective rate was 84.40%. In the control group, 9 cases were markedly effective, 15 cases were effective, 9 cases were ineffective, and the total effective rate was 55.81%. The treatment group than the control group (P <0.01). FBG, HbA1c, pain score improved in treatment group than in control group (P <0.01). [Conclusion] Acupuncture combined with gliclazide and mecobalamin in the treatment of diabetic peripheral neuropathy has satisfactory curative effect and no serious side effects. It is worth popularizing.