College of Acupuncture-Moxibustion and Tuina, Chengdu University of TCM, Chengdu 611137, Sichuan Province, China.
Second Clinical College, Shanxi University of CM.
Zhongguo Zhen Jiu. 2024 Mar 12;44(3):245-250. doi: 10.13703/j.0255-2930.20230705-k0002.
To observe the clinical efficacy of acupotomy combined with metformin hydrochloride tablet for type 2 diabetes mellitus (T2DM) and its effect on serum levels of inflammatory factors.
A total of 68 patients with T2DM were randomized into an acupotomy group (34 cases, 2 cases dropped out) and a western medication group (34 cases, 2 cases dropped out). Metformin hydrochloride tablet was given orally in the western medication group, 0.5-1 g each time, twice a day, for continuous 8 weeks. On the basis of the treatment in the western medication group, acupotomy was applied at bilateral Geshu (BL 17), Weiwanxiashu (EX-B 3), Ganshu (BL 18) in the acupotomy group, once a week for continuous 8 weeks. Before and after treatment, in the two groups, blood glucose (fasting blood glucose [FBG], 2-hour plasma glucose [2 h PG] and glycosylated hemoglobin [HbA1c]), TCM syndrome score, blood lipids (total cholesterol [TC], triglyceride [TG], low density lipoprotein cholesterol [LDL-C] and high density lipoprotein cholesterol [HDL-C]), insulin (fasting insulin [FINS] and 2-hour insulin [2 h INS]), C-peptide indexes (fasting C-peptide [FC-P] and 2-hour C-peptide [2 h C-P]), dosage of metformin hydrochloride tablet and diabetes specific quality of life (DSQL) score were observed, the serum levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-17 were measured by ELISA.
After treatment, the FBG, 2 h PG, HbA1c, TCM syndrome scores, TC, TG, LDL-C, FINS, 2 h INS, FC-P, 2 h C-P, DSQL scores as well as the serum levels of TNF-α, IL-6, IL-17 were decreased compared with those before treatment (0.01), HDL-C was increased compared with that before treatment (0.01) in the two groups; the dosage of metformin hydrochloride tablet was decreased compared with that before treatment in the acupotomy group (0.01). After treatment, in the acupotomy group, the FBG, HbA1c, TCM syndrome score, TC, TG, LDL-C, FINS, 2 h INS, FC-P, 2 h C-P, dosage of metformin hydrochloride tablet, DSQL score as well as the serum level of TNF-α were lower than those in the western medication group (0.05).
Acupotomy combined with metformin hydrochloride tablet can improve the blood glucose, clinical symptoms and quality of life in patients with T2DM, its mechanism may be related to the regulation of inflammatory reaction.
观察针刀联合盐酸二甲双胍片治疗 2 型糖尿病（T2DM）的临床疗效及对血清炎症因子水平的影响。
将 68 例 T2DM 患者随机分为针刀组（34 例，2 例脱落）和西药组（34 例，2 例脱落）。西药组给予盐酸二甲双胍片口服，每次 0.5~1 g，每日 2 次，连续 8 周。针刀组在西药组治疗的基础上，于双侧膈俞（BL17）、胃皖下俞（EX-B3）、肝俞（BL18）处行针刀治疗，每周 1 次，连续 8 周。两组患者治疗前后分别观察血糖（空腹血糖[FBG]、餐后 2 h 血糖[2 hPG]和糖化血红蛋白[HbA1c]）、中医证候评分、血脂（总胆固醇[TC]、三酰甘油[TG]、低密度脂蛋白胆固醇[LDL-C]和高密度脂蛋白胆固醇[HDL-C]）、胰岛素（空腹胰岛素[FINS]和餐后 2 h 胰岛素[2 h INS]）、C 肽指标（空腹 C 肽[FC-P]和餐后 2 h C 肽[2 h C-P]）、盐酸二甲双胍片用量和糖尿病特异性生存质量（DSQL）评分，采用 ELISA 法检测血清肿瘤坏死因子（TNF）-α、白细胞介素（IL）-6 和 IL-17 水平。
治疗后，两组 FBG、2 hPG、HbA1c、中医证候评分、TC、TG、LDL-C、FINS、2 h INS、FC-P、2 h C-P、DSQL 评分及血清 TNF-α、IL-6、IL-17 水平均较治疗前降低（P<0.01），HDL-C 较治疗前升高（P<0.01）；针刀组盐酸二甲双胍片用量较治疗前减少（P<0.01）。治疗后，针刀组 FBG、HbA1c、中医证候评分、TC、TG、LDL-C、FINS、2 h INS、FC-P、2 h C-P、盐酸二甲双胍片用量、DSQL 评分及血清 TNF-α水平低于西药组（P<0.05）。
针刀联合盐酸二甲双胍片可改善 T2DM 患者的血糖、临床症状和生存质量，其作用机制可能与调节炎症反应有关。
