标题：子午流注择时耳穴压豆对2型糖尿病患者血糖控制、上消症状及失眠状况的干预效果

      作者：吕洁，张珍丽，蔺虹丽，张社峰    河南省中西医结合医院内分泌科，河南 郑州 450003

      卷次： 2024年35卷4期

      【摘要】 目的 探讨子午流注择时耳穴压豆治疗对2型糖尿病(T2DM)患者血糖控制、上消症状及失眠状况的影响。方法 选取2020年1月至2022年12月河南省中西医结合医院内分泌科收治的138例T2DM患者作为研究对象，依据电脑数表随机抽取法分为西医组(常规西医干预) 46例、中医1组(耳穴压豆干预) 46例和中医2组(子午流注择时耳穴压豆干预) 46例，连续干预 4周。比较三组患者的治疗总有效率、治疗前后的血糖水平[空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(Hb1Ac)]、上消症状、睡眠质量[匹兹堡睡眠治疗指数(PSQI)]、Toll样受体4 (TLR4)/细胞核因子κB (NF-κB)炎症信号通路因子[外周血TLR4、NF-κB、血清肿瘤坏死因子-α (TNF-α)、白细胞介素-6 (IL-6)]水平及不良反应发生情况。结果 中医 2组、中医 1组患者的治疗总有效率分别为 93.48%、84.78%，明显高于西医组的 71.74%，差异均有统计学意义(P<0.05)；干预 4周后，中医 2组患者的 FBG、2 h PBG、Hb1Ac水平分别为(6.36±0.83) mmol/L、(8.18±1.05) mmol/L、(6.13±0.59)%，明显低于中医1组的(7.05±1.02) mmol/L、(9.37±1.16) mmol/L、(6.91±0.83)%及西医组的(7.81±1.10) mmol/L、(10.80±1.44) mmol/L、(7.88±0.75)%，差异均有统计学意义(P<0.05)；干预4周后，中医2组患者的口干、多饮症状积分、PSQI各维度评分及总分明显低于中医1组、西医组，中医1组明显低于西医组，差异均有统计学意义(P<0.05)；干预 4周后，中医 2组患者的外周血TLR4、NF-κB蛋白及血清TNF-α、IL-6水平分别为1.26±0.24、1.31±0.25、(26.76±4.38) pg/mL、(17.72±3.34) pg/mL，明显低于中医1组的1.59±0.31、1.53±0.29、(31.54±4.71) pg/mL、(20.53±4.11) pg/mL及西医组的2.02±0.35、2.06±0.37、(34.07±5.23) pg/mL、(23.18±3.62) pg/mL，差异均有统计学意义(P<0.05)；三组患者治疗期间的总不良反应发生率比较差异无统计学意义(P>0.05)。结论 子午流注择时耳穴压豆治疗T2DM具有一定的治疗效果，其可控制血糖水平，改善上消症状，提高睡眠质量，且具有一定安全性，其治疗机制可能与调节TLR4/NF-κB炎症信号通路有关。
      【关键词】 2型糖尿病；子午流注择时；耳穴压豆；血糖；失眠；干预效果
      【中图分类号】 R587.1 【文献标识码】 A 【文章编号】 1003—6350（2024）04—0497—06

Treatment effect of auricular points plaster therapy based on Meridian flow timing on blood glucose control,upper consumption symptoms, and insomnia condition in patients with type 2 diabetes mellitus.
LV Jie, ZHANGZhen-li, LIN Hong-li, ZHANG She-feng. Department of Endocrinology, Henan Integrative Medicine Hospital, Zhengzhou450003, Henan, CHINA
【Abstract】 Objective To investigate the clinical effect of auricular points plaster therapy based on Meridianflow timing in the treatment of type 2 diabetes mellitus (T2DM), and to analyze its influence on blood glucose control,upper consumption symptoms, and insomnia condition. Methods A total of 138 T2DM patients admitted to the Depart-ment of Endocrinology, Henan Integrative Medicine Hospital from January 2020 to December 2022 were selected and di-vided into the Western medicine group (46 cases, treated with conventional Western medicine), TCM group 1 (46 cases,treated with auricular points plaster therapy), and TCM group 2 (46 cases, treated with auricular points plaster therapybased on Meridian flow timing) according to the random number table method. All the patients were given consecutivetreatments for 4 weeks. The total effective rate, blood glucose levels before and after treatment [fasting blood glucose(FBG), 2 h postprandial blood glucose (2 hPBG), glycated hemoglobin (Hb1Ac)], upper consumption symptoms, sleepquality [Pittsburgh Sleep Therapy Index (PSQI)], Toll-like receptor 4 (TLR4)/nuclear factor κB (NF-κB) inflammatorysignaling pathway factors [peripheral blood TLR4, NF-κ B, serum tumor necrosis factor-α (TNF-α), interleukin-6(IL-6)] levels, and adverse reactions before and after treatment were compared among the three groups. Results The to-tal effective rate of TCM group 2 and TCM group 1 was 93.48% and 84.78%, respectively, both significantly higher than71.74% of Western medicine group (P<0.05). After 4 weeks of treatment, the FBG, 2-hour PBG, and Hb1Ac levels inTCM group 2 were (6.36±0.83) mmol/L, (8.18±1.05) mmol/L, and (6.13±0.59)%, respectively, which were significantlyZYZX-005)。lower than (7.05±1.02) mmol/L, (9.37±1.16) mmol/L, and (6.91±0.83)% in TCM group 1 and (7.81±1.10) mmol/L,(10.80±1.44) mmol/L, and (7.88±0.75)% in Western medicine group (P<0.05). After 4 weeks of treatment, the score ofdry mouth and excessive drinking symptoms, PSQI scores in all dimensions, and total score in TCM group 2 were signif-icantly lower than those of the TCM group 1 and the Western medicine group, and the scores in the TCM group 1 weresignificantly lower than those of the Western medicine group, with statistically significant differences (P<0.05). After 4weeks of treatment, the peripheral blood TLR4, NF-κB protein, serum TNF-α, and IL-6 levels in TCM group 2 were1.26±0.24, 1.31±0.25, (26.76±4.38) pg/mL, and (17.72±3.34) pg/mL, respectively, which were significantly lower than1.59±0.31, 1.53±0.29, (31.54±4.71) pg/mL, (20.53±4.11) pg/mL in the TCM group 1 and 2.02±0.35, 2.06±0.37, (34.07±5.23) pg/mL, and (23.18±3.61) pg/mL in Western medicine group, with statistically significant differences (P<0.05).There was no statistically significant difference in the total rate of adverse events during treatment among the threegroups of patients (P>0.05). Conclusion The treatment of T2DM with auricular points plaster therapy based on Meridi-an flow timing has certain therapeutic effect, which can control blood glucose levels, improve upper consumption symp-toms, improve sleep quality, and has a certain degree of safety. Its therapeutic mechanism may be related to the regula-tion of the TLR4/NF-κB inflammatory signaling pathway.
      【Key words】 Type 2 diabetes mellitus; Meridian flow timing; Auricular points plaster therapy; Blood glucose; In-somnia; Treatment effect