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针刺能否增加外周动脉疾病和糖尿病足综合征的微循环?——一项初步研究。

Can acupuncture increase microcirculation in peripheral artery disease and diabetic foot syndrome? - a pilot study.

作者信息

Valentini Jan, Sigl Martin, Dunckel Cornelia, Krisam Johannes, Amendt Klaus, Greten Henry Johannes

机构信息

Institute of General Practice and Interprofessional Care, University Hospital Tuebingen, Tuebingen, Germany.

First Department of Medicine, Division of Angiology, Faculty of Medicine of the University of Heidelberg, University Medical Center Mannheim, Mannheim, Germany.

出版信息

Front Med (Lausanne). 2024 Feb 27;11:1371056. doi: 10.3389/fmed.2024.1371056. eCollection 2024.

Abstract

BACKGROUND

Globally, diabetes mellitus (DM) and peripheral artery disease (PAD) have an increasing incidence and a high prevalence and are both associated with high morbidity and complication rates, e.g., as chronic non-healing peripheral ulcers. Impaired macro- and microcirculation and peripheral neuropathy lead to an increased risk of foot ulcers and infections. These complications are difficult to treat, have a high risk of becoming chronic and often lead to lower limb amputation. The aim of this planned study was to investigate the potential effects of acupuncture on improving microcirculation in patients with Diabetic Foot Syndrome (DFS) and PAD.

MATERIALS AND METHODS

In 18 patients with chronic non-healing peripheral ulcers and diagnosed DM or PAD, data on 8 microcirculatory parameters were collected simultaneously on intact skin close to the wound margin. Microcirculation was assessed using an O2C device combining laser Doppler shift and white light spectroscopy (LEA Medizintechnik GmbH, Giessen, Germany). Unilateral and bilateral acupuncture was performed on the connecting line between acupuncture points Stomach 14 and Stomach 15.

RESULTS

After unilateral acupuncture (ipsilateral to the wound side), a statistically significant improvement in 7 out of 8 microcirculatory parameters was demonstrated compared to baseline measurements before acupuncture. After bilateral acupuncture, there was an additional improvement and statistical significance in all parameters in both DFS and PAD patients.

DISCUSSION

These results show an improvement in the microcirculation and peripheral blood flow at the edges of the wound. As impaired micro- and macrocirculation is considered to be a critical prognostic factor for the healing of a peripheral lesion, the intervention could have a positive impact on the healing of (chronic) peripheral wounds.

摘要

背景

在全球范围内,糖尿病(DM)和外周动脉疾病(PAD)的发病率和患病率不断上升,且均与高发病率和并发症发生率相关,例如慢性不愈合的外周溃疡。大循环和微循环受损以及外周神经病变会导致足部溃疡和感染的风险增加。这些并发症难以治疗,有很高的慢性化风险,并且常常导致下肢截肢。这项计划研究的目的是调查针刺对改善糖尿病足综合征(DFS)和PAD患者微循环的潜在作用。

材料与方法

在18例患有慢性不愈合外周溃疡且已诊断为DM或PAD的患者中,在靠近伤口边缘的完整皮肤上同时收集8个微循环参数的数据。使用结合激光多普勒频移和白光光谱技术的O2C设备(德国吉森的LEA Medizintechnik GmbH公司)评估微循环。在胃经穴位胃14和胃15之间的连线上进行单侧和双侧针刺。

结果

与针刺前的基线测量相比,单侧针刺(伤口同侧)后,8个微循环参数中有7个显示出统计学上的显著改善。双侧针刺后,DFS和PAD患者的所有参数均有进一步改善且具有统计学意义。

讨论

这些结果表明伤口边缘的微循环和外周血流得到改善。由于微循环和大循环受损被认为是外周病变愈合的关键预后因素,该干预措施可能对(慢性)外周伤口的愈合产生积极影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3771/10927840/d863163fe794/fmed-11-1371056-g001.jpg

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