【摘要】：目的通過對(duì)寧波市江東區(qū)社區(qū)居民中2型糖尿病并發(fā)凍結(jié)肩患者的問卷調(diào)查,初步了解2型糖尿病并發(fā)凍結(jié)肩的疾病特征和針灸治療情況,進(jìn)而分析針灸治療2型糖尿病并發(fā)凍結(jié)肩的臨床現(xiàn)狀和療效影響因素,以期為提高針灸臨床療效和拓寬針灸適應(yīng)癥提供客觀依據(jù)。方法采用普查的方法,以寧波市江東區(qū)6個(gè)社區(qū)1971名2型糖尿病伴發(fā)凍結(jié)肩患者為研究對(duì)象。對(duì)所有研究對(duì)象進(jìn)行問卷調(diào)查,采集一般情況、體格檢查、空腹血糖、糖化血紅蛋白、總膽固醇、甘油三酯、患病情況及凍結(jié)肩治療情況等指標(biāo),分析2型糖尿病并發(fā)凍結(jié)肩患者的針灸治療率,描述不同針灸療法治療此類肩痛的分布情況及療效。最后運(yùn)用Spearman相關(guān)系數(shù)分析得出糖尿病病程、糖化血紅蛋白水平與該類肩痛針灸治療療效的相關(guān)性。結(jié)果(1)本研究共調(diào)查了寧波市江東區(qū)6個(gè)社區(qū),13996名2型糖尿病患者,其中同時(shí)伴發(fā)凍結(jié)肩的有1971名,2型糖尿病并發(fā)凍結(jié)肩在2型糖尿病患者中的患病率為14.1%。寧波市江東區(qū)2型糖尿病伴發(fā)凍結(jié)肩人群中,男性患病率高于女性(1:0.9);以45-54周歲年齡段患者居多。(2)經(jīng)調(diào)查,凍結(jié)肩可在2型糖尿病的任何一個(gè)時(shí)間段發(fā)生。其中糖尿病病程在5年內(nèi)及20年以上伴發(fā)凍結(jié)肩的患者相對(duì)較少,分別占18.8%及4.4%。2型糖尿病伴發(fā)凍結(jié)肩患者調(diào)查時(shí)(一周內(nèi))的空腹血糖為6.41±1.32mmol/L、糖化血紅蛋白為6.56±1.08%、總膽固醇為5.24±0.71mmol/L、甘油三酯為2.0±1.52mmol/L,均高出正常水平值。(3)調(diào)查1971名2型糖尿病伴發(fā)凍結(jié)肩患者近3個(gè)月內(nèi)的治療情況,以針灸療法治療2型糖尿病伴發(fā)凍結(jié)肩為最多。(4)922名接受針灸療法的2型糖尿病伴發(fā)凍結(jié)肩患者,采用的各種針灸療法中以溫針法、單純灸法最為常用。(5)針灸治療2型糖尿病患者凍結(jié)肩的有效率為83.3%。不同針灸療法間有效率各異,其中毫針刺法的有效率為77.2%、艾條灸法的有效率為84.5%、溫針灸法的有效率為87.1%、電針療法的有效率為82.1%、火針療法的有效率為66.7%、穴位注射療法的有效率為78.8%、針刀療法的有效率為67.2%。(6)糖尿病病程為6-10年的凍結(jié)肩患者針灸治療有效率最高(88.4%)。糖尿病病程時(shí)間與針灸療效呈一定負(fù)相關(guān)(R2=0.028,P=0.00),即糖尿病病程越短,針灸治療療效越佳。(7)糖化血紅蛋白正常組針灸治療有效率(95.7%)高于比糖化血紅蛋白偏高組(76.4%)。糖化血紅蛋白值與針灸療效呈一定負(fù)相關(guān)(R2=0.111,P=0.00),即糖化血紅蛋白值越低,針灸治療療效越佳。結(jié)論2型糖尿病并發(fā)凍結(jié)肩患者中男性多于女性;糖尿病病程、血糖水平與該類凍結(jié)肩針灸治療的療效存在負(fù)相關(guān)。在治療糖尿病伴發(fā)的凍結(jié)肩時(shí)應(yīng)該積極治療及控制糖尿病病情。
[Abstract]:Objective to investigate the disease characteristics and acupuncture treatment of type 2 diabetes mellitus complicated with frozen shoulder by questionnaire survey in Jiangdong District residents of Ningbo City. The clinical status and influencing factors of acupuncture and moxibustion in treating type 2 diabetes mellitus complicated with frozen shoulder were analyzed in order to provide an objective basis for improving the clinical efficacy of acupuncture and moxibustion and widening the indication of acupuncture and moxibustion. Methods 1971 patients with type 2 diabetes with frozen shoulder in 6 communities of Jiangdong District of Ningbo City were studied by general survey. All the subjects were investigated by questionnaire, general condition, physical examination, fasting blood glucose, glycosylated hemoglobin, total cholesterol, triglyceride, illness and frozen shoulder treatment, and so on. To analyze the rate of acupuncture and moxibustion in patients with type 2 diabetes mellitus complicated with frozen shoulder, and to describe the distribution and curative effect of different acupuncture and moxibustion therapy for this kind of shoulder pain. Finally, the correlation between the course of diabetes, the level of glycosylated hemoglobin and the curative effect of acupuncture and moxibustion for shoulder pain was obtained by Spearman correlation coefficient analysis. Results (1) A total of 13996 patients with type 2 diabetes were investigated in 6 communities of Jiangdong District, Ningbo City. Among them, 1971 patients with type 2 diabetes mellitus complicated with frozen shoulder were found to have a prevalence rate of 14.1in type 2 diabetes mellitus. The prevalence rate of type 2 diabetes with frozen shoulder in Jiangdong District of Ningbo City was higher in men than in women (1: 0.9), and was mostly in patients aged 45-54 years. (2) the frozen shoulder could occur in any time of type 2 diabetes mellitus. Among them, the number of patients with diabetes with frozen shoulder within 5 years and more than 20 years was relatively few. The fasting blood glucose, glycosylated hemoglobin, total cholesterol, triglyceride and triglyceride were 6.41 鹵1.32 mmol / L, 6.56 鹵1.08, 5.24 鹵0.71 mmol / L and 2.0 鹵1.52 mmol / L, respectively. (3) 1971 patients with type 2 diabetes mellitus were investigated. Treatment of patients with frozen shoulder in the past 3 months, (4) 922 patients with type 2 diabetes mellitus accompanied with frozen shoulder were treated by acupuncture and moxibustion therapy, and all kinds of acupuncture and moxibustion methods were used to warm up the shoulder. Simple moxibustion is the most commonly used method. (5) the effective rate of acupuncture and moxibustion on frozen shoulder of type 2 diabetes mellitus is 83.3%. The effective rate varies among different acupuncture and moxibustion treatments, The effective rate of filiform acupuncture is 77.2, the effective rate of moxa moxibustion is 84.5, the effective rate of warming acupuncture is 87.1, the effective rate of electroacupuncture is 82.1, the effective rate of fire acupuncture is 66.7, the effective rate of acupoint injection is 78.8, the effective rate of acupuncture is 87.1, the effective rate of acupuncture is 78.8, the effective rate of acupuncture is 87.1, the effective rate of acupuncture is 82.1, the effective rate of fire acupuncture is 66.7, the effective rate of acupoint injection is 78.8, and the effective rate of acupuncture is 87.1. The effective rate was 67.2%. (6) the effective rate of acupuncture and moxibustion was the highest (88.4%) in frozen shoulder patients whose diabetes course was 6-10 years. The duration of diabetes was negatively correlated with the effect of acupuncture and moxibustion (R2 / 0.028), that is, the shorter the course of diabetes was, the better the therapeutic effect of acupuncture was. (7) the effective rate of acupuncture and moxibustion in the normal hemoglobin glycosylated group (95.7%) was higher than that in the higher glycosylated hemoglobin group (76.4%). The value of glycosylated hemoglobin was negatively correlated with the curative effect of acupuncture and moxibustion (R _ 2: 0.111 P ~ (0.00), that is, the lower the value of glycosylated hemoglobin, the better the curative effect of acupuncture and moxibustion. Conclusion there are more males than females in patients with type 2 diabetes mellitus complicated with frozen shoulder, and there is a negative correlation between the course of diabetes and the therapeutic effect of acupuncture and moxibustion on frozen shoulder of type 2 diabetes mellitus. In the treatment of diabetes associated with frozen shoulder should be actively treated and control the diabetic condition.
【學(xué)位授予單位】：浙江中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R246

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