| ObjectiveThe clinical efficacy,safety and related factors of Lingnan Fire Needle for Distal Symmetrical Polyneuropathy(DSPN)in diabetes were observed.Methods1.Acuputure on DSPN Meta analysisSystematic seareaches were carried out in the full-text database in Chinese journals such as China Knowledge CNKI,Wanfang,VIP full-text journals and SinoMed"diabetes mellitus OR consumptive thirst arthralgia syndrome OR bi syndrome OR blood arthralgia OR atrophy syndrome OR upper,middle and lower three elimination" AND "peripheral neuropathy OR diabetes mellitus with neuropathy OR limbs of peripheral phlebitis neuropathy OR peripheral phlebitis OR limbs tip peripheral phlebitis neuropathy OR DSPN";with the following[keywords]"treatment OR therapy OR acupuncture OR moxibustion with acupuncture OR moxibustion OR warm acupuncture OR fire needle OR electroacupuncture OR acupoint injection OR plum blossom needle OR scalp needle OR gua sha OR Meta".And a search of foreign databases such as PubMed,Science Direct and the Cochrane Library,with an open-ended start date and a cut-off date of December 2022.The formula used was the sum of(cure+significant+effective)divided by the study sample size*100%and weighted and M-H fixed effect model(OR)and(CI 95%),with Meta-analysis to evaluate effectiveness and related acupunture points.2.Clinical Study on of Lingnan fire needle treatment on DSPNFrom March 2019 to July 2020,in the First Affiliated Hospital of the University of Traditional Chinese Medicine,the department of Endocrinology was an inpatient department,using a prospective randomized controlled clinical trial,divided into three groups,treatment group,control group 1,control group 2,40 cases each,a total of 120 cases were collected by random number table method by envelope method.Treatment group(group A)is fire needle therapy+basic therapy,1 week,fire needle once the next day,3 times;control group 1(Group B),acupunture+basic therapy,1 week,acupunture once the next day,3 times;control group 2(group C),Oral vitamin B12+methanobalamin tablets,1 week;fire needle adopts:Baihui,Fenglong,Xuehai,Sanyinjiao,Zusanli,Lidui,Shangyang,Zhiyin,Kunlun,Jiexi,Zhigou,Yanglingquan,Quchi,Weizhong,fire needle using frequent shallow stab,each acupoint three times,each time seven times.The acupunture group acupoints are the same,the operation is not burning needle frequently shallow stab.The three groups performed clinical observational trials with blood glucose stabilization,met the diagnosis for inclusion of study subjects and signed informed consent.Main bureau observation index:the TCSS scale evaluates the difference between before and after treatment.Secondary observation indicators:pain level VAS scale,quality of life scale.Observation time points were before treatment(t0),post-treatment(t1-t7),and at follow-up(t30);each group of blood drawing uses ELSA to detect serum HIF-la and VEGF content during the treatment.A questionnaire survey of TCM symptoms and related information was conducted afterwards to analyze the relevant factors of TCM symptoms by regression analysis.Results1.Meta AnalysisRelevant articles were found and included in journals such as SCI,EI,Core,CSSCI and CSCD,finally CNKI(765),Wanfang(460),VIP(211),SinoMed(1),PubMed(50),Science Direct(32)and Cochrane(1),a total of 1,520 articles were obtained.A total of 18 publications were included and a total of 1,472 patients with these diseases were tested,including 748 in the treatment group and 724 in the control group,with a fixed effect model OR=3.69,95%CI=[2.79,4.87],Z=9.21(P<0.001),I~2=0%,df=1 7,x~2=16.32,satisfying no heterogeneity and P<0.05 for I~2=0%,and differences were statistically significant.Meta-analysis showed that the effective gold standard was 50%～100%;the subgroup analysis results showed that acupuncture was 91.96%,electroacupuncture was 89.01%,and among different treatments,fire needle was 95%,but not enough for subgroup analysis;and 211 acupuncture points with the highest frequency were Zusanli,Shenshu,Quchi,Yinlingquan,Sanyinjiao,and Hegu;mainly acupoints for lower limbs.2.Clinical Studies(1)A total of(37 cases)in the treatment group A,a total of 38 cases in the group B and a total of 40 cases in the group C.There were 5 cases of shedding,4 of which were workrelated and one was fearing of acupuncture.Baseline data,age,sex,disease duration,TCSS scale,VAS score,and quality of life score,were not different and were comparable(P>0.05).Group A cured 8,effective 27,2 ineffective;group B cured 2,effective 23,13 ineffective;group C cured 2,effective 26,12 ineffective(example);total efficacy of the three groups 94.59%,65.79%and 70.00%,respectively.Group A was significantly higher than groups B and C,and the difference was statistically significant(P<0.01).(2)The total score of the TCSS scale was significantly higher in group A after treatment than in group B and C(P<0.01),Differences between treatment,before and after treatment,There were all differences at the follow-up visit(P<0.01);Among them,there was no difference among the groups after the treatment of nerve pain dysfunction score,However,the difference between pre-post treatment in group A was significantly higher than that in groups B and C,Groups also varied before and after treatment(P<0.01),No difference at follow-up(P>0.05);The paresia score was significantly higher than group C(P<0.01)but no different from group B.No difference at follow-up(P>0.05);Comprehensive recovery situation score,After treatment and at follow-up,when compared to group A,significant increase in groups B and C(P<0.01),Group A had a good recovery;In terms of abnormal reflex function,There was no difference between the groups at all time points(P>0.05).Subgroup analysis of group A showed that Lingnan fire had a significant effect on ten finger numbness pain,hands and palm face numbness pain(P<0.05).(3)The difference between VAS score and before and after treatment,group A are significantly better compared with group B and group C(P<0.01),group A has good analgesia,thumb pain,abnormal temperature sensation,burning,in group A.All patients improved significantly(P<0.01).(4)Quality of Life Scale after treatment and follow-up(P<0.05),the quality of life of group A improved significantly when compared with group B and C.The difference of group A was statistically significant(P<0.001).(5)There is no difference between serum HIF-la and VEGF content before treatment(P>0.05),and the content of each group after treatment had decreased significantly(P<0.01),and with differences among all groups.The decline of the group A was significantly lower than group B and group C(P<0.01).(6)Sputum and blood stasis block collateral type DSPN in addition to diabetes some "three more" symptoms,that is,polydrink,polyurine,eat more,more prominent symptoms are emaciation,headache,sleepless,fear of cold,fatigue and so on.Lingnan fire needle can effectively improve the symptoms of palpitations,body pain,low urination,sleepless,or more dreams(P<0.05).After regression analysis,the three groups showed poor sleep OR=1.55,OR=0.28,OR=3.46 and OR=4.71,all meeting P<0.05.The history of diabetes>10 years and diabetic neuropathy>3 years was a related factor(P<0.05).(7)Abnormalities in total cholesterol,triglycerides,pre-treatment heart rate,systolic,and diastolic blood pressure in the cardiovascular system were all related factors for DSPN(P<0.05),especially as Group A after treatment(P<0.05).Conclusion(1)Lingnan Fire Needle combined with western medicine treatment of phlegm and stasis resistance DSPN is a safe and fast effective treatment method.Especially for patients with finger and palm pains,the effects can be relieved.(2)It may be related to the reducing of serum HIF-1α and VEGF content.(3)To improve the cardiovascular environment and sleepless;monitoring of cardiovascular indicators such as blood lipids,blood pressure,and heart rate;phlegm and blood stasis blocking of diabetes is a great significance to the development of DSPN. |
PDF Full Text Request