Liang Jinghua, Feng Zhendi, Feng Shengkui, Bao Shude, Wang Kejia
Department of TCM, Beijing Fengsheng Special Hospital of Traditional Medical Traumatology and Orthopaedics, Beijing 100033, China.
Beijing University of CM.
Zhongguo Zhen Jiu. 2018 Jan 12;38(1):12-6. doi: 10.13703/j.0255-2930.2018.01.003.
To explore the effect difference between the skin needle embedding therapy and western medication for obese impaired glucose tolerance (IGT).
A total of 300 cases of obese IGT were assigned into an embedding group and a western medication group by random number table, 150 cases in each one. Standardized diagnosis and treatment programs were applied to reduce blood pressure, lipid, weight, and exercise and scientific diet management were used. 0.25 g oral deltamine was prescribed three times a day in the western medication group. Thumb-tack needle for subcutaneous embedding was at bilateral Weiwanxiashu (EX-B 3), Ganshu (BL 18), Pishu (BL 20), Tianshu (ST 25) and Zusanli (ST 36) for 36 to 48 hours on Monday and Thursday, 3 months as a session, with other acupoints differentiated. All the treatment was given for 2 years. The indexes included the blood sugar indexes [fasting plasma glucose (FPG), 2 h postprandial blood glucose (2 h PG), glycosylated hemoglobin (HbA1c)], incidence of hypoglycemia, obesity indexes [waist circumference, body mass index (BMI)], blood lipid indexes [serum total cholesterol (TC), serum triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)], liver and kidney function indexes [serum creatinine (Scr), blood urea nitrogen (BUN) and blood uric acid (UA), glutamic-pyruvic transaminase (ALT)] and TCM symptom score. The effects and the incidence of type 2 diabetes were evaluated.
After treatment, 2 h PG and HbA1c reduced in the two groups (<0.01, <0.05) and the results in the embedding group were better (both <0.05). After treatment, the incidence of hypoglycemia in the embedding group was 0.7% (1/150), and that in the western medication group was 1.3% (2/150), without statistical difference (>0.05). After treatment, waist circumference and BMI reduced in the two groups (both <0.01) and the improvements in the embedding group were better (both <0.05). TC, TG and LDL-C after treatment were lower than those before treatment, and HDL-C were higher in the two groups (all <0.05), without statistical different values before and after treatment between the two groups (all >0.05). Scr, BUN, UA and ALT before and after treatment in the two groups had no statistical difference (all >0.05), without statistical difference after treatment between the two groups (all >0.05). The TCM score after treatment was lower than that before treatment in the embedding group (<0.05), and the difference was not statistical in the western medication group (>0.05). The different value of TCM score in the embedding group was better than that in the western medication group (<0.01). The total effective rate in the embedding group was 98.0% (147/150), which was superior to 92.7% (139/150) in the western medication group (<0.05). The incidence of type 2 diabetes was 2.0% (3/150) in the embedding group, and that was better than 7.3% (11/150) in the western medication group (<0.05).
Thumb-tack needle for subcutaneous embedding for 2 years could apparent improve the indexes of IGT, which is better than western medication, without liver and kidney damage.
探讨皮内针埋线疗法与西药治疗肥胖型糖耐量受损（IGT）的疗效差异。
将300例肥胖型IGT患者采用随机数字表法分为埋线组和西药组，每组150例。采用标准化诊疗方案进行降压、降脂、减重，并进行运动及科学饮食管理。西药组口服二甲双胍0.25g，每日3次。于每周一、周四用揿针在双侧胰尾下俞（EX-B 3）、肝俞（BL 18）、脾俞（BL 20）、天枢（ST 25）、足三里（ST 36）进行皮下埋线36～48小时，3个月为1个疗程，其他穴位辨证选用。所有治疗均持续2年。观察指标包括血糖指标[空腹血糖（FPG）、餐后2小时血糖（2h PG）、糖化血红蛋白（HbA1c）]、低血糖发生率、肥胖指标[腰围、体重指数（BMI）]、血脂指标[血清总胆固醇（TC）、血清三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）]、肝肾功能指标[血清肌酐（Scr）、血尿素氮（BUN）、血尿酸（UA）、谷丙转氨酶（ALT）]及中医症状评分。评价疗效及2型糖尿病发生率。
治疗后，两组2h PG及HbA1c均降低（<0.01，<0.05），且埋线组改善更明显（均<0.05）。治疗后，埋线组低血糖发生率为0.7%（1/150），西药组为1.3%（2/150），差异无统计学意义（>0.05）。治疗后，两组腰围及BMI均降低（均<0.01），且埋线组改善更明显（均<0.05）。治疗后两组TC、TG及LDL-C均低于治疗前，HDL-C均高于治疗前（均<0.05），两组治疗前后比较差异无统计学意义（均>0.05）。两组治疗前后Scr、BUN、UA及ALT比较差异无统计学意义（均>0.05），两组间治疗后比较差异无统计学意义（均>0.05）。埋线组治疗后中医症状评分低于治疗前（<0.05），西药组差异无统计学意义（>0.05）。埋线组中医症状评分差值优于西药组（<0.01）。埋线组总有效率为98.0%（147/150），优于西药组的92.7%（139/150）（<0.05）。埋线组发生2型糖尿病2.0%（3/150），优于西药组的7.3%（11/150）（<0.05）。
揿针皮下埋线2年可明显改善IGT指标，疗效优于西药，且无肝肾损害。
