补气通脉方联合针刺治疗气虚血瘀型2型糖尿病下肢周围血管病变OA
Buqi Tongmai Formula Combined with Acupuncture on Peripheral Vascular Lesions of Lower Limbs in Type 2 Diabetes with Qi Deficiency and Blood Stasis Pattern
目的 观察补气通脉方联合针刺治疗对气虚血瘀型2型糖尿病下肢周围血管病变患者的临床疗效.方法 选择符合纳入标准的气虚血瘀型2型糖尿病下肢周围血管病变患者,依据随机数字表随机分为观察组和对照组,每组各53例.对照组给予控制血糖、血脂及改善下肢循环的常规治疗,观察组在对照组基础上给予补气通脉方联合针刺治疗,治疗周期12 d.比较两组患者治疗前后中医症状评分变化情况,并比较临床疗效;使用彩色多普勒超声测定两组患者治疗前后下肢趾肱比、踝肱比和足背动脉、股总动脉、腘动脉的血管内径和血流速度;酶联免疫法测定两组患者治疗前后丝氨酸蛋白酶抑制剂(Vaspin)、转化生长因子-β1(TGF-β1)、血管生长素样蛋白4(ANGPTL4)水平;采用多伦多临床神经病变量表(TCSS)评价两组患者治疗前后下肢症状.结果 观察组总有效率92.5%(49/53),高于对照组总有效率75.5%(40/53)(P<0.01);治疗后,两组中医各症状评分均明显降低,且观察组治疗后中医各症状评分均低于对照组(P<0.05);治疗后,两组下肢趾肱比和踝肱比均明显增高(P<0.05),且观察组下肢趾肱比和踝肱比明显高于对照组(P<0.01);治疗后,两组足背动脉、股总动脉、腘动脉的血管内径和血流速度均较治疗前明显增高(P<0.05),且观察组改善情况优于对照组(P<0.05);与治疗前比较,两组治疗后Vaspin、ANGPTL4水平升高(P<0.05),TGF-β1水平降低(P<0.05),且观察组改善情况优于对照组(P<0.01).结论 补气通脉方联合针刺治疗气虚血瘀型2型糖尿病下肢周围血管病变,可减轻患者临床症状,降低血液黏稠度,缓解下肢血管损伤情况
Objective To observe the clinical efficacy of Buqi Tongmai Formula combined with acupuncture on patients of peripheral vascular lesions of lower limbs in type 2 diabetes with qi deficiency and blood stasis pattern.Methods Patients of peripheral vascular lesions of lower limbs in type 2 diabetes who met the inclusion criteria were randomly divided into an observation group and a control group according to a random number table,with 53 cases in each group.The control group received conventional treatment,including blood glucose and blood lipids control,and lower limb circulation improvement,while the observation group received Buqi Tongmai Formula combined with acupuncture on the basis of the treatment in the control group.The treatment lasted for 12 days.Changes in the traditional Chinese medicine(TCM)syndrome scores before and after treatment of two groups were compared,as well as the clinical efficacy.The toe-brachial index(TBI),ankle-brachial index(ABI),as well as the intravascular diameter and blood flow velocity of the dorsalis pedis artery,common femoral artery,and popliteal artery were measured by color Doppler ultrasound.Enzyme-linked immunosorbent assay(ELISA)was employed to measure serum levels of serine protease inhibitor(Vaspin),transforming growth factor-β1(TGF-β1),and angiopoietin-like protein 4(ANGPTL4).Lower limb symptoms in both groups were evaluated before and after treatment using the Toronto Clinical Scoring System(TCSS).Results The total effective rate of observation group was 92.5%(49/53),which was higher than 75.5%(40/53)in the control group(P<0.01).After treatment,both groups showed a significant decrease in TCM syndrome scores,with scores in the treatment group being lower than those in the control group(P<0.05).The TBI and ABI were markedly increased in both groups after the treatment(P<0.05),with the observation group demonstrating significantly higher values than the control group(P<0.01).The intravascular diameter and blood flow velocity of the dorsalis pedis artery,common femoral artery,and popliteal artery were evidently increased in both groups after the treatment(P<0.05),with the observation group showing a significantly greater improvement than the control group(P<0.05).Compared to the treatment before,serum levels of Vaspin and ANGPTL4 increased in both groups(P<0.05),while TGF-β1 decreased in both groups(P<0.05).Moreover,these changes were more pronounced in the treatment group compared to the control group(P<0.01).Conclusion Buqi Tongmai Formula combined with acupuncture can alleviate clinical symptoms,reduce blood viscosity,and mitigate vascular injury in the treatment of peripheral vascular disease of lower limbs in type 2 diabetes with qi deficiency and blood stasis pattern.
李静;周克飞;李晓辉
开封市中医院,河南 开封 475000开封市中医院,河南 开封 475000开封市中医院,河南 开封 475000
2型糖尿病下肢周围血管病变气虚血瘀针刺补气通脉方
Type 2 diabetesPeripheral vascular lesions of lower limbsQi deficiency and blood stasis patternAcupunctureBuqi Tongmai Formula
《中医药信息》 2026 (5)
67-71,5
河南省中医药科学研究专项课题(2024ZY2175)
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