本文選題：腕式激光針灸儀 + 糖尿病血管病變��； 參考：《成都中醫(yī)藥大學》2016年碩士論文

【摘要】：目的：糖尿病作為一種高發(fā)病率疾病,其并發(fā)癥嚴重影響患者的生命質量。臨床上采用針灸結合減量西藥能較好控制血糖,但部分病人難以堅持針灸治療,基于此課題組研制了一種新型腕式激光針灸儀,前期研究證實激光治療較優(yōu)輸出功率為lOmw,從12min開始療效明顯。在此基礎上,本研究主要探索腕式激光針灸儀對糖尿病血管病變的治療作用,為糖尿病甚至其他疾病提供新的家庭保健方法,同時也有益于激光針灸儀的臨床推廣。方法：納入符合標準的,來自成都中醫(yī)藥大學第三附屬醫(yī)院門診和住院的72例2型糖尿病患者,隨機分組,腕式激光治療儀(正常激光照射)治療組36例；模擬腕式激光治療儀(儀器顯示屏亮,但無激光照射)對照組36例,脫落2例；數據分析共計納入70例。均選用l0mw激光照射太淵、內關、神門三穴,施行平補平瀉治療法模式(模式三),每日1次,每次治療30min；每周治療4次,4周／療程；連續(xù)12周；12周后隨訪。治療前后及隨訪期間分別對糖尿病患者的血糖(0、1、2、4、8、12、24周)、糖化血紅蛋白、N0、血脂(0、12、24周)及頸部血管彩超(0、12、24周)等指標進行評價,探討新型腕式激光針灸儀對糖尿病血管病變的影響。結果：1、血液相關指標(1)血糖：兩組間的每個時間點和治療前后(0、1、2、4、8、12周)空腹及三餐后2h血糖值采用獨立樣本t檢驗,對兩組時間點的評分變化采用重復測量方差分析,結果顯示組內比較：治療組治療前后的差異均有統(tǒng)計學意義(P0.05)；組間比較：第2周到第12周的差異均有統(tǒng)計學意義(P0.05)。3月后隨訪,兩組間血糖的差異均有統(tǒng)計學意義(P0.05)。(2)糖化血紅蛋白(HbAlc):采用獨立樣本t檢驗,入組前兩組HbAlc差異無統(tǒng)計學意義(P0.05),兩組間在治療12周后、3月后隨訪差異有統(tǒng)計學意義(P0.05)。(3)一氧化氮(NO)變化：采用獨立樣本t檢驗,入組前兩組NO的差異無統(tǒng)計學意義(P0.05),在治療12周后、3月后隨訪兩組間NO的差異均有統(tǒng)計學意義(P0.05)。(4)血脂變化：采用獨立樣本t檢驗,兩組間血脂的各項指標值差異均無統(tǒng)計學意義(P0.05)。2、頸部血管彩超：采用獨立樣本t檢驗,兩組間彩超的各項指標值的差異均無統(tǒng)計學意義(P0.05)。3、兩組治療均未出現不良反應報道。結論：1、糖尿病基礎治療聯合激光治療能夠更為有效安全的調節(jié)血糖、血管內皮因子NO水平。2、激光治療在控制血糖和調節(jié)NO方面對糖尿病基礎治療可能有增效作用。3、在本試驗的12周療程內及3個月的隨訪中未觀察到激光針灸儀對頸動脈病變在彩超下有顯著改善。
[Abstract]:Objective: diabetes mellitus as a high incidence disease, its complications seriously affect the quality of life of patients. Clinical application of acupuncture and moxibustion combined with less western medicine can control blood sugar better, but it is difficult for some patients to adhere to acupuncture and moxibustion therapy. Based on this research group, a new type of carpal laser acupuncture and moxibustion instrument has been developed. Previous studies have confirmed that the optimal output power of laser therapy is lOmw, which is effective from 12min. On this basis, the purpose of this study is to explore the therapeutic effect of carpal laser acupuncture instrument on diabetic vascular diseases, and to provide a new family health care method for diabetes mellitus and even other diseases, which is also beneficial to the clinical popularization of laser acupuncture and moxibustion instrument. Methods: a total of 72 patients with type 2 diabetes mellitus from the third affiliated Hospital of Chengdu University of traditional Chinese Medicine were randomly divided into two groups: 36 patients in the treatment group treated with carpal laser therapy instrument (normal laser irradiation). There were 36 cases in the control group and 2 cases in the control group, and 70 cases were included in the data analysis. All patients were treated with l0mw laser irradiation at Taiyuan, Neiguan and Shenmen three points, and were followed up for 12 weeks and 12 weeks after treatment (mode 3: 1, once a day for 30 minutes each time), 4 times a week for 4 weeks per course of treatment, and 12 weeks after 12 weeks of follow-up. Before and after treatment, and during the follow-up period, the indexes of blood glucose of patients with diabetes were evaluated, such as 24 weeks of diabetes, 24 weeks of glycosylated hemoglobin, 24 weeks of blood lipids, and 24 weeks of cervical vascular color Doppler ultrasound), and the effects of a new type of wrist laser acupuncture instrument on diabetic vascular lesions were investigated. Results (1) Blood glucose (1) Blood glucose: at each time point between the two groups and 12 weeks before and after treatment) fasting and 2 h postprandial blood glucose values were tested by independent sample t test. The scores of the two groups were evaluated by repeated measurement ANOVA. The results showed that the difference before and after treatment was statistically significant in the treatment group, the difference between the two groups was significant in the 2nd week and the 12th week in the treatment group (P 0.05). The differences of blood glucose between the two groups were statistically significant (P0.05, P < 0.05). HbAlcP: a t test of independent samples was used. There was no significant difference in HbAlc between the first two groups after 12 weeks of treatment and 3 months after treatment. There were significant changes of nitric oxide (no) after 12 weeks of treatment between the two groups: t test of independent sample was used. There was no significant difference in no between the first two groups after 12 weeks of treatment and 3 months after treatment. There were statistically significant changes in blood lipid between the two groups after 12 weeks of treatment and 3 months after treatment. There was no significant difference in the index values of blood lipids between the two groups (P 0.05). There was no significant difference in each index value between the two groups by using independent sample t test. No adverse reactions were reported in the two groups. Conclusion the combination of basic diabetes therapy and laser therapy can regulate blood glucose more effectively and safely. No level of vascular endothelial factor, laser treatment in blood glucose control and regulation of no may have a synergistic effect on the basic treatment of diabetes. 3. During the course of 12 weeks and 3 months of follow-up, laser acupuncture and moxibustion instrument was not observed on the neck. Arterial lesions were significantly improved under color Doppler ultrasound.
【學位授予單位】：成都中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2016
【分類號】：R246.1

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