Wang Jun-Yuan, Zhang Jun, Liu Ying, Gao Yan-Man, Sun Jia-Jia, Liu Xiao-Man
Department of Endocrinology, Tangshan Hospital of TCM, Tangshan 063000, Hebei Province, China.
Zhongguo Zhen Jiu. 2021 Apr 12;41(4):371-5. doi: 10.13703/j.0255-2930.20200329-k0001.
To compare the therapeutic effect on type 2 diabetes mellitus (T2DM) complicated with angina pectoris of coronary heart disease between the combined therapy of acupuncture and western medication and the simple administration of western medication.
A total of 134 patients with T2DM and angina pectoris of coronary heart disease were randomly divided into two groups, i.e. an acupuncture plus medication group (67 cases, 3 cases dropped off) and a medication group (67 cases, 4 cases dropped off). The routine western medication was used according to symptoms in the patients of both groups. In the acupuncture plus medication group, on the base of medication, acupuncture was applied to Jianshi (PC 5), Quchi (LI 11), Neiguan (PC 6), etc. The needles were retained for 20 min in each treatment and 3 treatments of acupuncture were required weekly. The treatment was given consecutively for 8 weeks in the two groups. Separately, before and after treatment, the symptom scores of TCM were observed and the indexes were detected, including glycolipid metabolism [fasting plasma glucose (FPG), 2-h plasma glucose (2hPG), glucosylated hemoglobin (HbA1c), triacylglycerol (TG) and total cholesterol (TC)], islet β cell function [homeostasis model assessment-β (HOMA-β), homeostasis model assessment-IR (HOMA-IR), fasting insulin (FINS) and insulin sensitivity index (ISI)], cardiac function indexes [cardiac output (CO), early diastolic peak velocity/late diastolic peak velocity (E/A), left ventricular end diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF)], as well as electrocardiogram QT dispersion (QTd). Besides, the clinical therapeutic effects were compared between the two groups.
After treatment, the TCM symptom scores and the values of FPG, 2hPG, HbA1c, TG, TC, HOMA-IR, FINS, E/A and LVEDD as well as QTd were all lower than those before treatment in the two groups (<0.05), and the levels of the above-mentioned indexes in the acupuncture plus medication group were all lower than those in the medication group (<0.05). The values of HOMA-β, ISI, CO and LVEF after treatment were higher than those before treatment in the two groups (<0.05), and the levels of the above-mentioned indexes in the acupuncture plus medication group were all higher than those in the medication group (<0.05). The total effective rate was 93.8% (60/64) in the acupuncture plus medication group, higher than 79.4% (50/63) in the medication group (<0.05).
The combined therapy of acupuncture and medication is effective in treatment of T2DM complicated with angina pectoris of coronary heart disease. Such therapy effectively improves glucolipid metabolism, islet β cell function, cardiac function and myocardial blood supply. Its curative effect is better than the simple administration of western medicine.
比较针刺联合西药与单纯西药治疗2型糖尿病（T2DM）合并冠心病心绞痛的疗效。
将134例T2DM合并冠心病心绞痛患者随机分为两组，即针刺加药物组（67例，脱落3例）和药物组（67例，脱落4例）。两组患者均根据症状使用常规西药。针刺加药物组在药物治疗基础上，针刺间使（PC 5）、曲池（LI 11）、内关（PC 6）等穴位。每次留针20分钟，每周针刺3次。两组均连续治疗8周。分别观察两组治疗前后中医症状评分，并检测相关指标，包括糖脂代谢[空腹血糖（FPG）、餐后2小时血糖（2hPG）、糖化血红蛋白（HbA1c）、三酰甘油（TG）和总胆固醇（TC）]、胰岛β细胞功能[稳态模型评估-β（HOMA-β）、稳态模型评估-胰岛素抵抗（HOMA-IR）、空腹胰岛素（FINS）和胰岛素敏感指数（ISI）]、心功能指标[心输出量（CO）、舒张早期峰值速度/舒张晚期峰值速度（E/A）、左心室舒张末期内径（LVEDD）和左心室射血分数（LVEF）]以及心电图QT离散度（QTd）。此外，比较两组的临床疗效。
治疗后，两组中医症状评分及FPG、2hPG、HbA1c、TG、TC、HOMA-IR、FINS、E/A、LVEDD及QTd值均低于治疗前（P<0.05），且针刺加药物组上述指标水平均低于药物组（P<0.05）。两组治疗后HOMA-β、ISI、CO及LVEF值均高于治疗前（P<0.05），且针刺加药物组上述指标水平均高于药物组（P<0.05）。针刺加药物组总有效率为93.8%（60/64），高于药物组的79.4%（50/63）（P<0.05）。
针刺与药物联合治疗T2DM合并冠心病心绞痛疗效显著。该疗法能有效改善糖脂代谢、胰岛β细胞功能、心功能及心肌供血。其疗效优于单纯西药治疗。
