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Traditional Chinese medicine nursing in diabetic peripheral neuropathy: A literature review
Yue He1, Yu Cui1, Tong Ye1, Li Dong2*
1Graduate College, Tianjin University of Traditional Chinese Medicine, Tianjin China; 2Nursing Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
*Correspondence to: Li Dong, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China. E-mail:[email protected]
Highlights Editor’s Summary Evidences has shown that the traditional Chinese Traditional Chinese medicine (TCM) in patients medicine nursing not only can improve symptoms with DPN was considered to be promising option; of diabetic peripheral neuropathy (DPN), the however several specific techniques have been function of the nerve conduction in the foot and investigated in extensive trials. And thus, it is blood circulation in patients with diabetes mellitus, es-sental to systematically and comprehensively but also can adjust the patient’s mood. In addition, search and summary the latest findings in this it is at a modest price, and thus it should be field for the purpose of providing reference for extensively considered in clinical practice. DPN.
Citation: He Y, Cui Y, Ye T, et al. Traditional Chinese medicine nursing in diabetic peripheral neuropathy: A literature review. TMR Integrative Nursing, 2018, 2(2): 56-60. DOI: 10.12032/TMRIN20180621 Submitted: 10 March 2018, Accepted: 30 March 2018, Online: 16 May 2018.
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ABSTRACT t At present, unified and effective treatment for diabetic peripheral neuropathy (DPN) is still lacking, however Chinese medicine techniques characterized by syndrome differentiation and treatment, for example traditional Chinese medicine preparations, acupuncture, and fumigation, have been considered the promising alternative for DPN. Traditional Chinese medicine nursing, which is development on the basis of traditional Chinese medicine (TCM) theory, uses not only acupuncture, acupoint application and other treatments but also cares for the patient’s diet and emotions in order to promote the recovery of skin and nerve endings in patients with DPN. Vast amounts of studies have explored the efficacies of various TCM nursing techniques in managing DPN, however, the article, which comprehensively documented these TCM nursing techniques in DNP patients, cannot be captured. In the present article, we summarized the latest findings of TCM research on DPN in recent years in order to provide a reference for DPN.
Key words: Diabetic mellitus, Diabetic peripheral neuropathy, Traditional Chinese medicine, Traditional Chinese medicine nursing, Literature review
摘要
目前，糖尿病周围神经病变（DPN）仍旧缺乏统一有效的治疗手段，而以辨证论治为特点的中医技术 （如中药制剂、针刺、熏蒸）则被视为 DPN 潜在的有效治疗方法。中医护理技术是在中医理论的基础上 发展而来的照护手段，其对 DPN 的照护不仅包括针灸、穴位敷贴等疗法的应用，而且还涉及到患者饮食 及情绪的调护，其最终目的在于促进 DPN 患者皮肤和神经末梢的恢复。本文通过总结近年来国内外有关 DPN 的中医护理研究成果，以期为 DPN 的治疗提供参考。
关键词：糖尿病；糖尿病周围神经病变；中医；中医护理；文献综述
Abbreviations: DM, Diabetes mellitus; DPN, diabetic peripheral neuropathy; TCM, Traditional Chinese medicine; QoL, Quality of life; CFT, Chinese food therapy; DFUs, diabetic foot ulcers. Competing interests: The authors declare that there is no conflict of interests regarding the publication of this paper. Copyright: © 2018 TMR Publishing Group. This is an open access article distributed under the terms of the Creative Commons Attribution Non Commercial license. Executive Editor: Jing Liang
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1. Introduction Shujin Tongluo, promoting blood circulation and pain. Radix Salviae Miltiorrhizae can relieve vasospasm, Diabetic peripheral neuropathy (DPN) is one of the accelerate microcirculation, promote peripheral nerve complications of diabetes mellitus (DM) which caused by metabolism, and has a protective effect on nerve, which is the deficiency of insulin action and subsequent commonly used with Astragalus and Chuanxiong and hyperglycemia [1]. Issued data illustrated that DNP significantly inhibits aldose reductase, thereby improving affects up to 50% of patients with DM [2]. The clinical nerve conduction function. Based on the conventional manifestations of DPN include painful neuropathic treatment of western medicine, Zhang [6] added 33 cases symptoms and insensitivity, which will increase the risk of diabetic foot with Podiatric bath with Chinese of these patients to suffer from burns, injuries and foot medicine and compared it with 31 cases of treated with ulceration [3], and thus the systematic and comprehensive routine methods, that is to say western medicine care for DPN is extremely important for the purpose of treatment. The treatment group took 1 day a day, wuhuo further improving the quality of life (QoL) and the decocted juice, poured into the sterilized tub. After prognosis of the DNP patients. Traditional Chinese cooling to about 40, the affected foot was immersed for medicine (TCM) nursing is development on the basis of 20-30 min and 20 d for one course of treatment. After two TCM theories, which uses not only acupuncture, acupoint courses of treatment, the total effective rate of the two application and other techniques, but also considers the groups was significantly different (P < 0.05) group. patient’s diet and emotions in order to ultimately promote the recovery of skin and nerve endings in DNP patients. 2.3 Acupoint sticking TCM nursing emphasizes nursing based on syndrome Acupoint sticking mainly through the absorption of differentiation and holistic nursing. In recent years, acupuncture points through the acupuncture points, while several TCM nursing techniques targeted for DPN have stimulating to achieve expelling wind and dampness, been explored to be good efficacy in the vast amounts of blood stasis, dredge the role of the veins. Zhang [7] met literatures, for example diet under syndrome the inclusion criteria of 6o patients with DPN, according differentiation and podiatric bath with herbal medicine, to the randomized controlled grouping method was and thus it is important to summarize the latest findings in divided into observation group of 30 cases and control this filed in order to provid more comprehensive and group of 30 cases, the observation group in the control systematic evidence summary for clinical decision in group on the basis of routine nursing Acupoint dressing DPN patients. Paste, once daily for 2 hours each for 2 months, the results show that the application of Chinese medicine acupuncture point application Stasis pathological DPN 2. Promising traditional Chinese medicine patients can improve the clinical symptoms and signs of nursing thechiques for diabetic peripheral patients. Li [8] included 161 patients with DPN as study neuropathy subjects. It was randomly divided into study group 81 cases and control group 80 cases. The study group 2.1 Diet under syndrome differentiation acupoint application on the basis of routine nursing, after Diet prescribed according to the patient’s condition: (i) treatment, the study group all aspects of DPN The scores the patients with cold limb numbness need white wine were lower, indicating that the curative effect is better, the and purple salvia, soaked for 1 week before drinking, 1 or difference between the two groups was statistically 2 times a day; (ii) the patients with limb pain need rice significant (P < 0.05). wine and safflower, soaked for 3 days before drinking, 1 or 2 times a day; (iii) the patients with polydipsia need 2.4 Foot massage Pueraria, Ophiopogon, reed rhizome, Chine, honeysuckle Foot massage can stimulate the foot multiple points and to drink; (iv) the patients with constipation need rhubarb meridians, improve circulation, increase blood flow, and senna to drink; and (v) the patients with frequency of improve nerve tissue nutrition, to correct metabolic urination and polyuria need wolfberry soup to drink [4]. disorders, thereby improving neurological symptoms and signs. In this study, 40 patients with grade 0 diabetic foot 2.2 Podiatric bath with herbal medicine were randomly divided into an experimental group (20 Podiatric bath with herbal medicine is a kind of treatment cases) and control group (20 cases). The experimental method after decocting TCM, which is an important part group with the control group, based on the increase of of traditional external treatment in mainland China [5]. In foot acupressure treatment. There was significant the soaking process, with the help of the medicinal and difference between the two groups after intervention for 3 the thermal effect of water, through the pores and point of months and 6 months (P < 0.05) [9]. Foot acupressure the skin that will remove the lesion. Chinese herbal and diabetes health education had some secondary prescriptions include Astragalus Qi, Radix, Chuanxiong, preventive effect on the occurrence and development red peony Huoxue Hualiao, papaya, Guizhi, Shenjin grass diabetic foot ulcers (DFUs) with zero grade.
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2.5 Acupuncture 2.8 Grading nursing Acupuncture of DPN, the general application of According to the severity of the disease to provide the hypoglycemic drugs or insulin on the basis of stable appropriate nursing interventions. Ren [14] in nursing, control of blood glucose with the treatment. Clinically, according to the severity of the patient to its grading, thus most of the limbs of Yangming acupoints, if necessary, giving different care methods, including early patients, to use replenishing Qi and blood, Qi and activating blood provide fumigation treatment of TCM, liquid submerged points [10]. Li [11] use homemade pills as moxibustion Yanglingquan; for midterm patients, taking the pancreas moxibustion, taking camphor, musk, Chuanwu, Yu, Feishu and spleen Yu eleven acupoints for TCM stick Chuanxiong, Aconitum and Chinese angelica and other massage treatment; for patients with advanced, take the herbs into powder, fully reconcile the production of pills, limbs around the acupuncture points for massage, and wrapped with gauze to the pills, suspended above the local dressing dressing Dan Huang scattered. alcohol lamp baking time Quickly placed in the acupuncture points, the temperature to patients feel 3. Summary comfortable is appropriate. Take Shenque, Yongquan and Ashi points, line medicine moxibustion treatment, the TCM intervention for DPN obtained promising observation group of patients with clinical outcomes achievements, and patients with weak pain and slight significantly better than the control group. trauma. However, TCM methods have not yet formed an unified program, so it needs to be further standardized. In 2.6 Chinese medicine iontophoresis addition, nursing practitioners working in TCM nursing Most of iontophoresis were Chuanwu, Atractylodes, filed need to grasp a wealth of TCM theories and Viag-ra, Mustard Seed, Millettia, Red Herb, Achyranthes standardized operating skills. Therefore, it is very Bi-dentata, Yuanhu, safflower, decoction concentration, important to strengthen the training of nurse of TCM. take medicine liquid line ion implantation. Ion-introduced liquid Chuanwu, Aconitum, Speranskia, Mustard Seed, References Millettia, red herb, Achyranthes, Yuanhu, safflower, decoction concentration, take the line of ions in the line. 1. Rachana KS, Manu MS, Advirao GM. 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