【作者】 张欣；

【导师】 李光善；

【作者基本信息】 山东中医药大学 ， 中医硕士（专业学位）， 2023， 硕士

【摘要】 目的:观察通痹滋阴方配合黄帝内针治疗消渴病痹症阴虚血瘀证患者的临床疗效及安全性,探索更为有效的治疗方案。方法:选取青岛市海慈医疗集团内分泌科病房就诊的消渴病痹症阴虚血瘀证患者80例,治疗组与对照组各40例,在基础治疗上,治疗组用通痹滋阴方配合黄帝内针治疗,对照组用通痹滋阴方配合甲钴胺治疗,2周后比较两组血糖、血脂、神经传导速度、Toronto评分、中医症状积分、不良反应等情况,进行统计学分析。结果:1.治疗前:两组患者在性别、年龄、病程、体重指数及治疗前的血糖、血脂、神经传导速度、Toronto评分、中医症状积分上无统计学差异(P>0.05),具有可比性。2.治疗后:两组患者的血糖值组内比较较治疗前血糖值降低(P<0.01),组间比较无明显差异(P>0.05);两组患者的糖化血红蛋白、血脂组内比较、组间比较较治疗前无明显变化(P>0.05);两组患者的神经传导速度、Toronto评分组内比较较治疗前明显改善(P<0.01),组间比较治疗组优于对照组(P<0.05);两组患者中医症状积分组内比较较治疗前降低(P<0.05),组间比较在肢软麻木、四肢疼痛、口干、腰膝酸软症状上治疗组优于对照组(P<0.05),在感觉减退、肌肉萎缩、五心烦热、盗汗、便秘、头晕耳鸣症状上无明显差异(P>0.05)。3.中医证候疗效:治疗后两组患者中医症状积分组内比较较治疗前明显降低(P<0.01),治疗组有效率是76.9%,对照组有效率是48.7%,组间比较治疗组优于对照组(P<0.01)。4.安全性分析:两组患者在研究期间均未发生不良反应。结论:通痹滋阴方配合黄帝内针治疗消渴病痹症阴虚血瘀证的临床疗效显著,在改善肢软麻木、四肢疼痛、口干、腰膝酸软的症状及降低Toronto评分、提高神经传导速度方面比通痹滋阴方配合甲钴胺效果明显。更多还原

【Abstract】 Objective: To observe the clinical efficacy and safety of Tongbi Ziyin recipe combined with Huangdi internal acupuncture in the treatment of patients with arthralgia syndrome of Yin deficiency and blood stasis,and explore more effective treatment schemes.Method: Eighty patients with arthralgia syndrome of Yin deficiency and blood stasis were selected from the endocrinology ward of Qingdao Haici Medical Group,40 patients in the treatment group and 40 patients in the control grou P.In terms of basic treatment,the treatment group was treated with Tongbi Zi Yin recipe combined with Huangdi internal acupuncture,while the control group was treated with Tongbi Zi Yin recipe combined with mecobalide.Two weeks later,blood glucose,blood lipid,nerve conduction velocity,Toronto score,TCM symptom score,adverse reactions and other conditions of the two groups were compared for statistical analysis.Results:1.Before treatment: There were no statistically significant differences between the two groups in gender,age,course of disease,body mass index,blood glucose,blood lipid,Toronto score,nerve conduction velocity and TCM symptom score before treatment(P>0.05),indicating that the two groups were comparable.2.After treatment: the blood glucose of the two groups decreased in comparison with that before treatment(P<0.01),but there was no significant difference between the two groups(P>0.05);There were no significant changes in glycosylation and blood lipid between two groups compared with before treatment(P>0.05).The Toronto score and nerve conduction velocity of the two groups were significantly improved compared with that before treatment(P<0.01),and the treatment group was better than the control group(P<0.05).The scores of TCM symptoms in the two groups were lower than those before treatment(P<0.05),and the scores of TCM symptoms in the two groups were lower than those before treatment(P<0.05).The symptoms of limb pain,dry mouth,waist and knee pain and tenderness in the treatment group were better than those in the control group(P<0.05).There were no significant differences in symptoms of regression,muscle atrophy,five upset fever,night sweat,constipation,dizziness and tinnitus(P>0.05).3.Curative effect of TCM syndrome: After treatment,the score of TCM symptoms in the two groups decreased significantly compeared with that before treatment(P<0.01),the effective rate of the treatment group was76.9%,and that of the control group was 48.7%,and the treatment group was better than the control group(P<0.01).4.Safety analysis: No adverse reactions occurred in the two groups during the study.Conclusion: Tongbi Ziyin Recipe combined with Huangdi internal acupuncture has significant clinical efficacy in the treatment of Yin deficiency and blood stasis syndrome of Xiaoke arthralgia syndrome.It is more effective than Tongbi Ziyin Recipe combined with mecobalamine in improving the symptoms of limb numbness,limb pain,dry mouth,waist and knee pain,reducing Toronto score and im Proving nerve conduction velocity.更多还原