Clinical Observation Of Press-needle In The Treatment Of CKD4-5 Peripheral Neuropathy

Objective:To observe the clinical efficacy and safety of press-needle in the treatment of chronic kidney disease(CKD)stage 4-5 peripheral neuropathy of both lower limbs with spleen-kidney qi deficiency and blood stasis type,and to explore the feasibility of press-needle in the treatment of CKD peripheral neuropathy,so as to provide rich ideas for the treatment of this disease.Method:Sixty patients who met the inclusion criteria of CKD4-5 peripheral neuropathy(spleen-kidney qi deficiency and blood stasis syndrome)were selected from the outpatient and ward patients of the Second Department of Nephrology,the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from December 2021 to December 2022.According to the random number table method,they were divided into the experimental group and the control group,with 30 cases in each group.The patients in the control group were treated with routine acupuncture,while the patients in the experimental group were treated with press-needle.The treatment was 3courses,each course lasted for 1 week.The TCM syndrome scores,total neuropathy score-clinical(TNSc),sural nerve sensory nerve conduction velocity(SNCV),tibial nerve motor nerve conduction velocity(MNCV),serum creatinine(Scr),blood urea nitrogen(BUN)and parathyroid hormone(PTH)levels were observed before and after treatment,and the data were recorded.SPSS statistical software was used for statistical analysis.Results:1.Baseline data: there were no significant differences in gender,age,duration of CKD,CKD stage,Scr,BUN,PTH,SNCV of sural nerve,MNCV of tibial nerve,TNSc and TCM syndrome scores between the two groups before treatment(P > 0.05),and the two groups of data were comparable.2.Total effective rate of TCM syndromes: The total effective rate of the experimental group was 86.21%,and the total effective rate of the control group was 79.31%,the experimental group was better than the control group,the difference was statistically significant(P < 0.05).3.After 3 courses of treatment,the TCM syndrome scores,TNSc,sural nerve SNCV,tibial nerve MNCV,Scr,BUN and PTH levels of the two groups were improved compared with those before treatment,and the differences were statistically significant(P < 0.01),and the experimental group was better than the control group,and the differences were statistically significant(P < 0.05).Conclusion:1.Both press-needle and routine acupuncture are effective in the treatment of CKD4-5 peripheral neuropathy of both lower limbs with spleen-kidney qi deficiency and blood stasis type,and press-needle is more effective.2.To a certain extent,the thumb-press needling can reduce the serum creatinine level,urea nitrogen level,parathyroid hormone level,TCM syndrome score,TNSc score,and improve nerve conduction velocity in patients with CKD4-5 lower extremity peripheral neuropathy of spleen and kidney qi deficiency and blood stasis type,which is superior to conventional acupuncture.