| 引用本文: |
丁颖, 陈思宇, 付甜甜, 杨玉环, 董怡君.穴位埋线联合药罐疗法对糖尿病周围神经病变患者神经修复及微循环状态的影响[J].湖南中医药大学学报,2026,46(6):1151-1157[点击复制] |
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| 穴位埋线联合药罐疗法对糖尿病周围神经病变患者神经修复及微循环状态的影响 |
| 丁颖,陈思宇,付甜甜,杨玉环,董怡君 |
| (省部共建中亚高发病成因与防治国家重点实验室(新疆医科大学), 新疆 乌鲁木齐 830028;新疆医科大学第七附属医院康复医学科, 新疆 乌鲁木齐 830028) |
| 摘要: |
| 目的 探讨穴位埋线联合药罐疗法对糖尿病周围神经病变（DPN）患者的临床疗效及对神经修复和微循环的影响。方法 纳入2024年2月至2025年2月新疆医科大学第七附属医院康复医学科收治的DPN患者60例，按随机数字表法分为对照组和观察组，每组30例。两组患者均接受基础治疗，对照组口服甲钴胺片（0.5 mg/次，3次/d），观察组在对照组基础上给予穴位埋线（1次/15 d）和药罐疗法（10 min/次，1次/3 d）联合干预，两组疗程均为6个月。治疗结束后对两组进行临床疗效评价，观察两组治疗前后的中医证候积分、视觉模拟量表（VAS）评分、密西根糖尿病神经病变评分（MDNS）及血糖指标[空腹血糖（FBG）、餐后2 h血糖（2hBG）、糖化血红蛋白（HbA1c）]水平变化；使用肌电图仪测定正中神经、腓总神经的运动神经传导速度（MNCV）及感觉神经传导速度（SNCV）；微循电视电脑环诊断仪评估甲襞微循环状态；ELISA检测血清神经营养因子[神经生长因子（NGF）、脑源性神经营养因子（BDNF）、神经营养因子-3（NT-3）]水平。记录治疗期间患者不良反应情况，于治疗后第3、6个月随访MDNS、VAS评分，并比较复发率。结果 与治疗前比较，两组患者治疗后中医证候积分、VAS评分、MDNS、甲襞微循环各项积分及总分和FBG、2hBG、HbA1c水平均降低（P＜0.05），正中神经、腓总神经的MNCV、SNCV水平及血清NGF、BDNF、NT-3水平均升高（P＜0.05）。与对照组比较，观察组的中医证候积分、VAS评分、MDNS、甲襞微循环各项积分及总分和FBG、2hBG、HbA1c水平均降低（P＜0.05），正中神经、腓总神经的MNCV、SNCV水平及血清NGF、BDNF、NT-3水平均升高（P＜0.05）。两组不良反应发生率差异无统计学意义（P＞0.05）。观察组临床总有效率高于对照组（P＜0.05）。治疗后第3、6个月随访显示，观察组的MDNS、VAS评分均显著低于对照组（P＜0.05），复发率亦低于对照组（P＜0.05）。结论 穴位埋线联合药罐疗法可有效改善DPN患者的临床症状和血糖水平，促进神经功能修复，且安全性良好，其作用机制可能与上调血清神经营养因子表达、改善微循环状态有关。 |
| 关键词: 糖尿病周围神经病变 穴位埋线 药罐疗法 神经营养因子 微循环障碍 |
| DOI：10.3969/j.issn.1674-070X.2026.06.008 |
| 投稿时间：2026-01-07 |
| 基金项目:省部共建中亚高发病成因与防治国家重点实验室开放课题项目（SKL-HIDCA-2024-QF）。 |
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| Effects of acupoint catgut embedding combined with medicinal cupping therapy on nerve repair and microcirculation status in patients with diabetic peripheral neuropathy |
| DING Ying, CHEN Siyu, FU Tiantian, YANG Yuhuan, DONG Yijun |
| (State Key Laboratory of Pathogenesis, Prevention, and Treatment of High Incidence Diseases in Central Asia (Xinjiang Medical University), Urumqi, Xinjiang 830028, China;Department of Rehabilitation Medicine, the Seventh Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830028, China) |
| Abstract: |
| Objective To investigate the clinical efficacy of acupoint catgut embedding combined with medicinal cupping therapy in patients with diabetic peripheral neuropathy (DPN) and its effects on nerve repair and microcirculation. Methods A total of 60 patients with DPN admitted to the Department of Rehabilitation Medicine of the Seventh Affiliated Hospital of Xinjiang Medical University from February 2024 to February 2025 were enrolled and randomly divided into control group and observation group using a random number table method, with 30 patients in each group. Both groups received standard basic treatment. The control group received oral mecobalamin tablets (0.5 mg per dose, three times daily). The observation group received additional acupoint catgut embedding (once every 15 days) and medicinal cupping therapy (10 minutes per session, once every 3 days) on top of the conventional treatment. The treatment course for both groups was 6 months. After treatment, clinical efficacy was evaluated in both groups. The following parameters were observed before and after treatment: TCM pattern scores, Visual Analogue Scale (VAS) scores, Michigan Diabetic Neuropathy Score (MDNS), and levels of fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hBG), and glycated hemoglobin (HbA1c). Motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV) of the median nerve and common peroneal nerve were measured using an electromyograph. Nailfold microcirculation status was assessed using a microcirculation diagnostic instrument. Serum levels of neurotrophic factors, including nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), and neurotrophin-3 (NT-3), were checked by ELISA. Adverse reactions during the treatment period were recorded. Follow-up assessments of MDNS and VAS scores were conducted at 3 and 6 months post-treatment, and the recurrence rate was compared between the two groups. Results Compared with baseline values before treatment, both groups showed significant decreases in TCM pattern scores, VAS scores, MDNS scores, nailfold microcirculation scores, and levels of FBG, 2hBG, and HbA1c after treatment (P<0.05), as well as significant increases in MNCV and SNCV of the median and common peroneal nerves, and in serum NGF, BDNF, and NT-3 levels (P<0.05). Compared with the control group, the observation group showed significantly greater reductions in TCM pattern scores, VAS scores, MDNS scores, nailfold microcirculation scores, and levels of FBG, 2hBG, and HbA1c (P<0.05), and significantly greater increases in MNCV and SNCV of the median and common peroneal nerves, as well as in serum NGF, BDNF, and NT-3 levels (P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). The total clinical effective rate in the observation group was significantly higher than that in the control group (P<0.05). Follow-up at 3 and 6 months post-treatment showed that MDNS and VAS scores in the observation group were significantly lower than those in the control group (P<0.05), and the recurrence rate was also lower in the observation group than in the control group (P<0.05). Conclusion Acupoint catgut embedding combined with medicinal cupping therapy can effectively relieve clinical symptoms and blood glucose levels, promote nerve function repair in DPN patients, and demonstrate good safety. Its mechanism of action may be related to upregulating the expression of serum neurotrophic factors and improving microcirculation status. |
| Key words: diabetic peripheral neuropathy acupoint catgut embedding medicinal cupping therapy neurotrophic factors microcirculation dysfunction |
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