针药结合干预糖尿病胃轻瘫患者的长期疗效观察

目的探讨针药结合治疗对糖尿病合并胃轻瘫症状患者长期疗效的影响。方法 70例糖尿病合并胃轻瘫症状患者随机分为2组,治疗组35例予针药结合治疗,对照组35例予莫沙比利治疗,4周为1个疗程,比较2组治疗前后及随访20周后的胃轻瘫症状及糖化血红蛋白(HbA1c)、平均血糖(MBG)、平均血糖波动幅度(MAGE)、低血糖次数等指标的改变。结果治疗4周后,治疗组患者的症状好转率明显高于对照组(P<0.05),其平均血糖(MBG)、平均血糖波动幅度(MAGE)、低血糖次数也明显低于对照组(P均<0.05);随访20周后,对照组有6例因为药物不良反应退出治疗,治疗组有3例因为药物不良反应退出;治疗组胃轻瘫症状复发率低于对照组(P<0.05),其HbA1c、低血糖次数也低于对照组(P均<0.05)。结论针药结合治疗较单纯莫沙比利能更有效改善糖尿病胃轻瘫症状,进而改善血糖控制及减少血糖波动,其长期效果更为显著,复发率低。

Long term effect of intervention by western medicine combined with acupuncture on patients with diabetic gastroparesis

Objective It is to observe the influence of long-term effect of treatment by western medicine combined with acupuncture on symptoms of patients with diabetic gastroparesis.Methods Seventy diabetic patients with gastroparesis symptoms were randomly divided into two groups,there was thirty-five cases in each group.Treatment group was treated by acupuncture-medicine therapy and control group was treated with mosapride.Changes of symptoms of gastroparesis,glycated hemoglobin A1c(HbA1c),the mean blood glucose(MBG),mean amplitude of glycemic excursions(MAGE) and the number of hypoglycemia were measured and compared between two groups after 4 weeks’ treatment and after 20 weeks’ follow-up.Results After 4 weeks’ treatment,improvement rate of gastroparesis symptoms of treatment group were significantly greater than that of control group(P<0.05).The level of MBG,MAGE and the number of hypoglycemia in treatment group were also significantly lower than those in control group(P<0.05).After 20 weeks’ follow-up,six patients of control group withdrew because of adverse drug reactions and so did three patients of treatment group;Recurrence rate of gastroparesis symptoms of treatment group was lower than that of control group(P<0.05),the level of HbA1c,the number of hypoglycemia of treatment group were also lower than that of control group(P<0.05).Conclusion Treatment by western medicine combined with acupuncture is more effective than simple mosapride treatment in improving symptoms of diabetic gastroparesis and thereby improving blood glucose control and reducing blood glucose fluctuations.Its long-term effect is more significant,especially low recurrence rate.