Acupuncture artery technique at Zusanli (ST 36) for Wagner grade 0 diabetic foot

Abstract

To observe the clinical efficacy of acupuncture artery technique at Zusanli (ST 36) for Wagner grade 0 diabetic foot. Sixty patients with Wagner grade 0 diabetic foot were randomly divided into an observation group and a control group, with 30 patients in each group. Both groups selected bilateral Zusanli (ST 36). In the control group, the needle was inserted about 10 mm under ultrasound guidance to avoid blood vessels in the Zusanli (ST 36) area, with needle retention for 5 min without manipulation. In the observation group, the needle was inserted about 25 mm under ultrasound guidance to the anterior tibial artery branch below Zusanli (ST 36), followed by lifting and thrusting manipulation for 5 min before withdrawing the needle. Both groups were treated twice a week for 4 weeks. The traditional Chinese Medicine (TCM) syndrome scores were observed; infrared thermography was used to measure the temperature difference between the left and right sides in four areas, i.e. the medial malleolus, lateral malleolus, and upper and lower parts of the sole of the foots; Doppler ultrasound was used to measure the logarithm of the peak systolic velocity (ln PS) and the logarithm of the time average maximum velocity (ln TAMAX) of the anterior tibial artery below the right Zusanli (ST 36); the ankle-brachial index (ABI) was measured using Doppler blood flow detector and blood pressure monitor before treatment, after the first treatment, and at the end of treatment. Clinical efficacy was compared between the two groups. Compared before treatment, the TCM syndrome scores in both groups were reduced after the first treatment and at the end of treatment (P<0.01, P<0.05), and the scores in the observation group were lower than those in the control group (P<0.01). In the observation group, compared before treatment, the maximum, minimum, and average temperature differences between the left and right sides of the upper and lower parts of the sole of the foots, medial malleolus, and lateral malleolus were reduced after the first treatment and at the end of treatment (P<0.05, P<0.01). After the first treatment, the maximum temperature difference between the left and right sides of the upper part of the sole of the foots and the medial malleolus in the observation group was lower than that in the control group (P<0.05). At the end of treatment, except for the average temperature difference of the medial malleolus, the maximum, minimum, and average temperature differences between the left and right sides of the upper and lower parts of the sole of the foots, medial malleolus, and lateral malleolus in the observation group were lower than those in the control group (P<0.01, P<0.05). After the first treatment and at the end of treatment, the ln PS, ln TAMAX, and ABI of the anterior tibial artery below the right Zusanli (ST 36) in the observation group were higher than those before treatment (P<0.01) and higher than those in the control group (P<0.01). The total effective rate in the observation group was 96.7% (29/30), higher than 3.3% (1/30) in the control group (P<0.05). Acupuncture artery technique at Zusanli (ST 36) could effectively improve the clinical symptoms of patients with Wagner grade 0 diabetic foot, increase blood flow velocity in the lower limb vessels, and reduce the temperature difference between the left and right lower limbs.