Page 29 - วารสารกรมการแพทย์แผนไทยฯ ปีที่ 10 ฉบับที่ 3

Journal of Thai Traditional & Alternative Medicine Vol. 10 No. 3 September-December 2012 179

°“√π”«‘∏’°“√Ωí߇¢Á¡¡“„™â„πºŸâªÉ«¬ DPN æ∫«à“ °“√ Semmes - Weinstien monofilament

Ωí߇¢Á¡™à«¬∑”„À⧫“¡‡√Á«°“√ ◊ËÕπ”ª√– “∑ (nerve
11 «‘∏’°“√»÷°…“
conduction velocity; NCV) ¥’¢÷Èπ ∫“ß°“√»÷°…“
æ∫«à“ πÕ°®“°∑”„Àâ NCV ¥’¢÷Èπ·≈⫬—ß∑”„Àâ §«“¡ °“√«‘®—¬π’ȇªìπ°“√»÷°…“·∫∫ ÿࡇª√’¬∫‡∑’¬∫

Àπ◊¥¢Õ߇≈◊Õ¥≈¥≈ß ·≈–Õ“°“√¢Õߪ√– “∑ à«π (Randomized controlled study) √–¬–‡«≈“°“√
12
ª≈“¬≈¥≈ߥ⫬ À√◊Õ∑”„À⇰‘¥°“√‡æ‘Ë¡¢÷Èπ¢Õß »÷°…“√–À«à“߇¥◊Õπ¡°√“§¡-情¿“§¡ 2554 „π
Õ‘π´Ÿ≈‘π„πæ≈“ ¡“ °“√‡æ‘Ë¡¢÷Èπ¢Õß c-peptide ·≈– Õ“ “ ¡—§√∑’ˉ¥â√—∫°“√«‘π‘®©—¬«à“‡ªìπºŸâªÉ«¬‡∫“À«“π
13
Opioid peptide ¥â«¬ „π°≈ÿà¡ DPN ∑’Ë¡’Õ“°“√ª«¥ ∑’Ë¡’Õ“°“√™“∫√‘‡«≥ª≈“¬‡∑â“‚¥¬‰¡à¡’‚√§ª√–®”μ—«Õ◊Ëπ
√ÿπ·√ßæ∫«à“ °“√Ωí߇¢Á¡™à«¬≈¥Õ“°“√ª«¥‰¥â º≈ ®”π«π 48 §π ∑—È߇滙“¬ ·≈–‡æ»À≠‘ß∑’Ë¡’Õ“¬ÿ 40
14
¥’ πÕ°®“°π’Ȭ—ßæ∫«à“ “¡“√∂∑”„À⺟âªÉ«¬°≈ÿà¡π’È ªï¢÷Èπ‰ª∑’Ë¡“√—∫∫√‘°“√√—°…“Õ“°“√™“∑’˧≈‘π‘°‡∫“À«“π
ª≈Õ¥®“°Õ“°“√‰¥âπ“π∂÷ß 6 ‡¥◊Õπμ‘¥μàÕ°—πÀ≈—ß ‚√ß欓∫“≈‡ “‰À⇩≈‘¡æ√–‡°’¬√μ‘ 80 æ√√…“
10
°“√Ωí߇¢Á¡ ®—ßÀ«—¥ √–∫ÿ√’
°“√»÷°…“π’ȉ¥â√—∫Õπÿ¡—μ‘®“°§≥–°√√¡°“√ °“√§”π«≥∑“ß ∂‘쑧”π«≥‚¥¬‡ß◊ËÕπ‰¢¥—ßμàÕ
®√‘¬∏√√¡°“√«‘®—¬„π§π¥â“π°“√·æ∑¬å·ºπ‰∑¬·≈– ‰ªπ’È

°“√·æ∑¬å∑“߇≈◊Õ°·≈â« 1. μÕ∫ πÕßμàÕ°“√√—°…“ ∂◊Õ‡ªìπ‡°≥±åÀ≈—°
„π°“√ª√–‡¡‘πº≈°“√√—°…“
√–‡∫’¬∫«‘∏’»÷°…“ 2. Õ—μ√“¢ÕߺŸâμÕ∫ πÕß„π°≈ÿࡧ«∫§ÿ¡§“¥

«à“®–¡’ª√–¡“≥ 25% à«πÕ—μ√“¢ÕߺŸâμÕ∫ πÕß„π
μ—«Õ¬à“ß∑’Ë»÷°…“
°≈ÿà¡Ωí߇¢Á¡§“¥«à“®–¡’ª√–¡“≥ 75%
ºŸâªÉ«¬‚√§‡∫“À«“π ≥ §≈‘π‘°‡∫“À«“π¢Õß‚√ß 3. §à“·Õ≈øÉ“ (alpha) = 0.05 ·≈–‡∫μ“ (beta)

欓∫“≈‡ “‰À⇩≈‘¡æ√–‡°’¬√μ‘ 80 æ√√…“ Õ”‡¿Õ = 0.01
‡ “‰Àâ ®—ßÀ«—¥ √–∫ÿ√’ ®”π«π 48 §π ·∫à߇ªìπ 2 °≈ÿà¡ ®“°¢âÕ°”Àπ¥‡∫◊ÈÕßμâπ·≈–Õ“»—¬°“√∑¥ Õ∫

°≈ÿà¡≈– 24 §π °≈ÿࡧ«∫§ÿ¡„Àâ°“√√—°…“¥â«¬¬“ ‰§ ·§«√å·∫∫ Õß∑“ß (Chi-square test, two-
μ“¡ª°μ‘ °≈ÿà¡∑¥≈Õß„™â°“√Ωí߇¢Á¡√à«¡°—∫„™â¬“ tailed) §”π«≥‰¥â«à“®–μâÕß„™âºŸâªÉ«¬®”π«π 19 √“¬
√—°…“Õ“°“√ μàÕ°≈ÿà¡ ·≈–§“¥«à“®–¡’ºŸâªÉ«¬‰¡à‰¥â√à«¡°“√»÷°…“
ºŸâªÉ«¬∑’ˇ¢â“√à«¡‚§√ß°“√¡’§ÿ≥ ¡∫—μ‘¥—ßπ’È ®π ‘Èπ ÿ¥°“√»÷°…“ (drop out) ®”π«πÀπ÷Ëß ®”π«π

1) ¡’Õ“¬ÿμ—Èß·μà 18 ªï¢÷Èπ‰ª ·≈–¬‘π¥’‡¢â“ ºŸâªÉ«¬„π·μà≈–°≈ÿà¡®÷߇æ‘Ë¡¢÷Èπ‡ªìπ 25 √“¬
‚§√ß°“√«‘®—¬ ·∫àߺŸâªÉ«¬‡ªìπ 2 °≈ÿà¡ °≈ÿà¡≈– 25 §π ‚¥¬
2) ‰¥â√—∫°“√«‘π‘®©—¬«à“‡ªìπ‚√§‡∫“À«“π «‘∏’ ÿà¡·∫∫ßà“¬ (Simple randomization) §◊Õ „™â

‚¥¬„™â‡°≥±å Fasting plasma glucose ¡“°°«à“ «‘∏’®—∫ ≈“°·∫àß°≈ÿࡧ«∫§ÿ¡·≈–°≈ÿà¡∑¥≈Õß °≈ÿà¡
À√◊Õ‡∑à“°—∫ 126 mg/dl §«∫§ÿ¡®–‰¥â√—∫‚ª√·°√¡°“√√—°…“¥â«¬¬“μ“¡ª°μ‘
3) ¡’Õ“°“√™“∑’ˇ∑â“ ∑¥ Õ∫‚¥¬„™â‡§√◊ËÕß¡◊Õ 1 §√—Èß„π 12 —ª¥“Àå °≈ÿà¡∑¥≈Õß®–‰¥â√—∫‚ª√·°√¡