Clinical Study On The Combination Of Acupuncture And Medicine In The Treatment Of Diabetes With Qi And Yin Deficiency Syndrome

ObjectiveBased on the clinical research on the distribution of diabetes in Singapore,the type of deficiency of both qi and yin accounts for the largest proportion of the total number of cases.The combination of acupuncture and medicine in the treatment of diabetes with deficiency of both qi and yin is clinically tested to evaluate the clinical efficacy and safety of acupuncture and medicine in the treatment of both deficiency of qi and yin in diabetes.MethodsClinical research:(1)Analysis of the distribution of type 2 diabetes syndromes in Singapore:First,refer to the syndrome differentiation standard of "2002 Clinical Research of New Chinese Medicines for Diabetes Treatment",and divide them into 5 types,including yin deficiency and excessive heat,internal dampness and heat,There are 5 types of syndromes:deficiency of both qi and yin,deficiency of both yin and yang,and blood stasis.A total of 105 cases were sampled from the computerized database of patients in the Diabetes Group of Singapore Chung Hwa Hospital,and summarized according to the syndrome types in the medical records.If the syndrome type does not meet the prescribed syndrome type standards,then the records of clinical symptoms,tongue and pulse conditions should be reviewed,sorted out,inductively analyzed and typed,and then input into the computer to find out the result of syndrome differentiation.(2)Clinical research on the treatment of type 2 diabetes with Qi and Yin Deficiency Syndrome with acupuncture and medicine.Patients who clinically meet the diagnostic criteria of diabetes in Western medicine and the diagnostic criteria of "qi and yin deficiency syndrome" in traditional Chinese medicine were randomized and divided into acupuncture and medicine group(treatment group)and control group(drug group)according to the principle of 1:1.The control group was treated with the basic treatment of western medicine and the antidiabetic prescription of traditional Chinese medicine.The medicines included 20g of astragalus,15g of rehmannia root,20g of salvia miltiorrhiza,15g of scrophulariaceae,15g of pueraria lobata,and 15g of kudzu root.The acupuncture and medicine group received basic western medicine treatment,and the control group received acupuncture and moxibustion in addition to antidiabetic prescriptions.Acupuncture and moxibustion points refer to the textbook "Acupuncture and Moxibustion" published by China Press of Traditional Chinese Medicine,and the teaching materials planned by the national colleges and universities of traditional Chinese medicine.The main points are Feishu,Yishu,Pishu,Shenshu,Sanyinjiao and Taixi points(both on both sides).Clinically,according to the different symptoms of patients,acupoints are assigned according to the symptoms:for upper disappearance,add Taiyuan and Shaofu;for middle disappearance,add Neiting and Diji;for lower disappearance,add Fuliu and Taichong.For those with dry mouth,add Lianquan,Chengjiang or Jinjin,and Yuye;for those who eat too much and are prone to hunger,add Hegu,Shangjuxu,Fenglong,and Zhongwan;for constipation,add Tianshu,Yanglingquan,and Dadun;For polyuria and night sweats,add Fuliu and Guanyuan;for both yin and yang deficiency,add Guanyuan and Mingmen;for blurred vision,add Guangming,Cuanzhu,and Tauwei;for dizziness,add Xing;For those with numbness and pain in the lower limbs,add Fengshi,Yinshi,Yanglingquan,Jiexi;for itchy skin,add Fengchi,Dazhui,Quchi,Xuehai,and Zhaohai.After the acupoints are selected and positioned,the needles are strictly sterilized and inserted,the needles are retained for 30 minutes each time,and the needles are performed once every 10 minutes.Scale scores were performed before and after treatment in both groups,and adverse reactions were recorded at any time.The clinical curative effect evaluation refers to the disease curative effect evaluation criteria in the "Guiding Principles of Clinical Research of New Chinese Medicines",which are divided into markedly effective,effective,and ineffective,to evaluate clinical symptoms and signs,and observe the improvement of fasting blood glucose,postprandial blood glucose,and glycosylated hemoglobin indicators.All collected data were statistically analyzed using SPSS28 software.The enumeration data were described by the number of cases and percentages,and the differences between groups were compared by chi-square test;the data with normal distribution were expressed by mean±standard deviation(x±s)for statistical representation,and the t test was used for comparison;Normally distributed measurement data were described by median and interquartile range M(P25,P75),and were compared by Mann-Whitney U test.The changes before and after treatment in the two groups were compared by analysis of variance(Anova)and Wilcoxon rank sum test.Statistical results,P<0.05 indicates that the detected difference is statistically significant.Results(1)Sampling survey of 105 cases(2010-2015)of type 2 diabetic patients in the computer system of the Diabetes Special Disease Group of Singapore Chung Hwa Hospital,summarized and analyzed TCM syndromes,and found that among type 2 diabetic patients,Qi and Yin The two-deficiency type has the highest proportion,and at the same time,there are some phenomena of stasis,including limb numbness and blurred vision.As a result,diabetic patients with Qi and Yin deficiency account for the majority,so this research direction is to conduct in-depth clinical research on diabetic patients with Qi and Yin deficiency.(2)There will be a total of 62 patients who meet the diagnostic criteria of type 2 diabetes in western medicine and the diagnostic criteria of deficiency of both qi and yin in traditional Chinese medicine.Randomly divided into treatment group and control group,for 2 courses of observation.According to the clinical symptoms and signs of the patients,including dry mouth and throat,frequent eating and hunger,frequent urination at night,fatigue,fatigue,upset and insomnia,numbness and backache;fasting blood sugar,postprandial blood sugar,and glycated hemoglobin were compared before and after treatment.All the collected data were statistically tested using the TCM syndrome curative effect evaluation method and the SPSS28 software package.Research result:(1)62 patients with type 2 diabetes mellitus of both qi and yin deficiency were included in the case standard,among which 2 cases were dropout cases and 60 cases were effective cases.(2)The gender distribution of the two groups,the ratio of male to female is close to 1:1.The youngest was 38 years old,the oldest was 75 years old,and the average age was 63.83 ±8.98 years old.There is no significant difference between males and females with deficiency of both qi and yin in diabetes,which is comparable.(3)The distribution of gender,age,fasting blood sugar,postprandial blood sugar,and glycosylated hemoglobin between the two groups had no statistical difference and were comparable.(4)The relationship between age and curative effect of treatment,the research shows that the age of onset has no correlation with the curative effect of diabetes mellitus with qi and yin deficiency syndrome.The elderly have the same therapeutic effect as the young.(5)Comparison and improvement of glycosylated hemoglobin after treatment.There was a correlation between glycosylated hemoglobin and curative effect in the acupuncture and medicine group,and the effect was relatively stable.(6)The glycated hemoglobin blood glucose index decreased before and after treatment in the acupuncture and medicine group,and the difference was statistically significant.Compared with the results of the study,the level of glycated hemoglobin in the acupuncture and medicine group was better than that in the control group after treatment,and the comparison between the two groups was statistically significant.(7)The fasting blood glucose index in the acupuncture and medicine group decreased before and after treatment,and the difference was statistically significant.Comparing the results of the study,the hypoglycemic degree of the acupuncture and medicine group was better than that of the control group,and there was a statistically significant difference between the two groups.(8)The postprandial blood glucose index decreased before and after treatment in the acupuncture and medicine group,and the difference was statistically significant.The hypoglycemic degree of the acupuncture and medicine group was better than that of the control group,and the comparison between the two groups was statistically significant.(9)Symptom distribution of patients with Qi and Yin deficiency in the two groups,dry mouth and throat were the most common symptoms,followed by lassitude,followed by numbness in limbs,backache,upset and insomnia.(10)The results of the comparison of the overall clinical signs before and after treatment in the two groups showed that the acupuncture and medicine group had a total effective rate of 96.7%in the treatment of clinical signs and symptoms.Compared with the control group,there was a significant difference in the total curative effect of the treatment of clinical signs,which was statistically significant.(11)There were no adverse reactions in the two groups during the treatment process,indicating that the combination of acupuncture and medicine in the treatment of diabetes with both qi and yin deficiency is safe and can be widely used clinically.Acupuncture combined with hypoglycemic prescriptions in the treatment of diabetes mellitus with both qi and yin deficiency can improve fasting blood sugar,postprandial blood sugar,glycosylated hemoglobin,and clinical symptoms and signs better than the control group,which has statistical significance.Conclusions(1)In the distribution of type 2 diabetes syndromes in Singapore,deficiency of both qi and yin is the most,accounting for 37%of the syndrome types of diabetes,and it is the main pathogenesis of diabetes.It has the value of clinical research and is worthy of in-depth discussion.(2)Acupuncture combined with hypoglycemic medicine in the treatment of diabetes mellitus with both qi and yin deficiency can improve TCM symptom scores.In terms of improvement of individual TCM symptoms,the improvement rate of palpitations,insomnia,limb numbness and backache in the acupuncture and medicine group was significant,reflecting the effect of acupuncture on improving viscera functions,bidirectionally benignly adjusting the nervous system,dredging the meridians,promoting blood circulation and removing blood stasis,and making the body achieve a healthy balance effect.(3)Acupuncture and medicine can reduce the levels of fasting blood sugar,postprandial blood sugar,and glycosylated hemoglobin in the treatment of diabetes mellitus with deficiency of both qi and yin,and effectively improve the state of endocrine disorders and metabolic disorders in patients.The hypoglycemic effect is clear,safe and effective.It highlights the effect of two-way regulation of acupuncture and moxibustion,invigorating qi with needles to achieve the effects of dredging qi,promoting blood circulation and removing blood stasis,and balancing endocrine.