电针治疗糖尿病周围神经病变的神经电生理观察

目的 :观察固本通络电针法对糖尿病周围神经病变 (DPN)患者周围神经电生理的影响 ,为本疗法的疗效提供可靠的实验依据。方法 :84例DPN病人随机分为电针组和弥可保对照组 ,观察治疗前后神经传导速度 (NCV)、躯体感觉诱发电位 (SEP)、穴位皮肤痛阈 (PSP)的变化。结果 :电针组和对照组的NCV均有部分明显加快 (P <0 0 5) ,PSP显示了双相调整、趋于平衡的变化 ,电针组SEP的N1 波明显缩短 (P <0 0 5) ,在以上 3项指标的改善方面 ,电针组都明显优于对照组 (P<0 0 5,P <0 0 1 )。结论 :固本通络电针法可以改善DPN患者的神经功能 ,是治疗DPN的有效方法

Clinical Observation on Nuroelectrophysiological Changes of Diabetic Peripheral Neuropathy after Electroacupuncture Treatment

Objective:To observe the effect of acupuncture on peripheral nuroelectrophysiological changes in diabetic peripheral neuropathy(DPN)patients in order to provide experimental basis for this therapy. Methods:Eighty-four cases of diabetes patients with DPN were randomly divided into acupuncture group (n=48) and simple medication (Methylcobalamin) control group (n=36). Acupoint groups used were 1) Qihai (CV 6), Guanyuan (CV 4), Fenglong (ST 40) and Sanyinjiao (SP 9); 2) Pishu (BL 20), Shenshu (BL 23), Huantiao (GB 30) and Feiyang (BL 58), which were punctured with reinforcing method or even needling method, and some of which located in the nerve injured area were also stimulated with electroacupuncture (EA). Additionally, patients of two groups were also treated by oral administration of Gliclazide, Dimethyldiguanide, Phenformin and "Xiaoke Wan"(Pills for treating diabetes). The treatment was given once every other day, continuously for 2 months. Changes of nerve conduct velocity (NCV), somesthetic evoked potential(SEP),and the pain threshold (PT) of the acupoint-skin before and after the treatment were observed. Results: Following acupuncture treatment, motor NCV (right median nerve and the left ulnar nerve) and sensory NCV (bilateral median nerve and the left peroneal nerve) in acupuncture group increased evidently (P< 0.05); and motor NCV of acupuncture group is significantly higher than that of control group (P< 0.05). In control group, NCV of the left peroneal nerve (motor N) and the right median nerve (sensory N) also increased significantly (P<0.05). Sensory NCV of the left median nerve and peroneal nerve of acupuncture group were also markedly higher than those of control group (P<0.05). After treatment, only the latency of N 1 of SEP of the left median nerve shortened evidently (P<0.05), while that of control group prolonged, showing that the effect of acupuncture is superior to that of medication (P<0.05). Following treatment, the PT values of Zusanli (ST 36) and Taichong (LR 3) in two groups increased or lowered significantly in comparison with those of pre-treatment (P<0.05～ 0.001). Conclusion:Acupuncture treatment can improve the nerve function of DPN patients,and is thus a valid method for relieving DPN.