糖肝煎联合电针治疗肝郁脾虚、湿热蕴结型单纯性肥胖的临床疗效观察

发布时间：2018-01-04 22:17

本文关键词：糖肝煎联合电针治疗肝郁脾虚、湿热蕴结型单纯性肥胖的临床疗效观察　出处：《湖北中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：研究目的:通过观察糖肝煎联合电针对肝郁脾虚、湿热蕴结型单纯性肥胖症患者的临床症状积分、腰围、体重、BMI、腰臀比、甘油三脂、总胆固醇、低密度脂蛋白、高密度脂蛋白等相关指标的影响,以及三大常规、肝肾功能等变化情况,探讨糖肝煎联合电针治疗肥胖症(肝郁脾虚、湿热蕴结证)的临床疗效和安全性。研究方法:采用完全随机设计,将受试对象按就诊顺序编号,利用随机数字表分为糖肝煎组、糖肝煎联合电针治疗组。两组在同时给予饮食运动控制的基础上,糖肝煎组给予中药汤剂糖肝煎,1剂/日,分2次口服;糖肝煎联合电针组在给予中药汤剂糖肝煎的同时给予指定穴位行电针治疗,电针治疗隔日一次,3个月为一疗程。每2周随访一次,进行一般体格检查,记录临床症状表现,观察两组治疗前后的临床疗效(总有效率)、症状积分、体重、BMI、腰围、腰臀比、甘油三脂、总胆固醇、低密度脂蛋白、高密度脂蛋白等指标的变化,以及三大常规、肝肾功能等变化情况,以评价本方法的临床疗效和安全性。研究结果:本研究共入组60人,因个人原因中断治疗,或医从性差,或联系方式虚假,共剔除5例,最终糖肝煎组28例,糖肝煎联合电针组27例。在研究前,通过统计学分析,发现糖肝煎组及糖肝煎联合电针组两组之间的患者各方面数据,包括性别、年龄、身高、体重、腰围、腰臀比、BMI、中医症状积分以及血脂全套等各项指标组与组之间的差异无统计学意义(P0.05),具有可比性。经过2个疗程的治疗后,⑴从临床治疗总效果来看,糖肝煎组总有效率达89.29%;糖肝煎联合电针组总有效率为96.30%(P0.05),差别有统计学意义。⑵两组患者的症状积分在治疗后均有所降低(P0.01),糖肝煎联合电针组分值更低于糖肝煎组(P0.01),差别有统计学意义,提示运用糖肝煎联合电针治疗肥胖症可有效减轻患者的临床不适症状,提高生活质量。⑶两组治疗后腰围、体重、BMI、腰臀比与治疗前相比,有明显的改善,两者均有显著性差异(P0.01)。糖肝煎联合电针组指标下降程度明显大于糖肝煎组(P0.01或P0.05)。⑷两组治疗后血脂全套指标(TC、TG、HDL、LDL)数值均有所改善(P0.01),差别有统计学意义,将两组组间差值进行比较,并无统计学意义(P0.05)。结论糖肝煎联合电针治疗单纯性肥胖具有较好的临床疗效。其在临床总疗效及改善临床症状上明显优于糖肝煎组,能有效的缓解多种肥胖导致的临床不适症状,明显提高患者生活质量,并能有效的改善脂代谢。整个研究过程中未见明显的毒副作用,具有绿色、环保、无毒副作用的中医特色,彰显了中医辨证论治、整体观念的治疗法则,对现代临床治疗单纯性肥胖症提供了新的安全有效的治疗手段,有很广泛的应用前景。
[Abstract]:Objective: to observe the clinical symptom score, waist circumference, body weight, BMIs, waist-to-hip ratio, triglyceride, total cholesterol in patients with simple obesity with liver stagnation and spleen deficiency and damp-heat accumulation. The effects of low density lipoprotein, high density lipoprotein and other related indexes, as well as the changes of three major routine, liver and kidney function, etc., in order to explore the treatment of obesity (liver stagnation and spleen deficiency) with the combination of Tanggan decoction and electroacupuncture. The clinical efficacy and safety of dampness and heat accumulation syndrome). Methods: totally random design was adopted, the subjects were numbered according to the order of seeing a doctor, and were divided into Tanggan decoction group by random number table. The two groups were given diet and exercise control at the same time, the two groups were given 1 dose of traditional Chinese medicine decoction sugar liver decoction per day, divided into 2 oral; Tanggan decoction combined with electroacupuncture group was given traditional Chinese medicine decoction Tanggan decoction at the same time given the designated acupoints electroacupuncture treatment, electroacupuncture treatment every other day, 3 months as a course of treatment. Follow up every 2 weeks, general physical examination. The clinical symptoms were recorded and the clinical efficacy (total effective rate, symptom score, body weight, waist circumference, waist-hip ratio, triglyceride, total cholesterol, low density lipoprotein) were observed before and after treatment. The changes of high density lipoprotein and three major routine, liver and kidney function were used to evaluate the clinical efficacy and safety of this method. Results: 60 patients were enrolled in this study. The treatment was interrupted for personal reasons, or the medical treatment was poor, or the way of contact was false, 5 cases were excluded, 28 cases in the final decoction group and 27 cases in the combined electroacupuncture group. Statistical analysis was made before the study. It was found that there were all kinds of data between the two groups, including gender, age, height, weight, waist circumference, waist-to-hip ratio (WHR) and BMI. There was no significant difference in the scores of symptoms and blood lipids between the two groups, which was comparable. After two courses of treatment, there was no significant difference between the two groups. After two courses of treatment, the total effect of clinical treatment was analyzed. The total effective rate of Tanggan decoction group was 89.29; The total effective rate of Tanggan decoction combined with electroacupuncture group was 96.30g / kg P0.05A, the difference was statistically significant. 2. The symptom score of the two groups decreased after treatment (P 0.01). The score of Tanggan decoction combined with electroacupuncture group was lower than that of Tanggan decoction group (P 0.01), the difference was statistically significant, suggesting that the use of Tanggan decoction combined with electroacupuncture treatment of obesity can effectively reduce the clinical symptoms of patients. After treatment, the waist circumference, body weight and waist-to-hip ratio of the two groups were significantly improved compared with those before treatment. There was a significant difference between the two groups (P 0.01). The decrease degree of indexes in the Tanggan decoction combined with electroacupuncture group was significantly higher than that in the Tanggan decoction group (P0.01 or P0.05.4) after treatment, the total blood lipid index of the two groups was higher than that of the control group (P 0.01 or P 0.05.4). The values of TGV HDL and LDL were all improved (P 0.01), the difference was statistically significant, and the difference between the two groups was compared. Conclusion Tanggan decoction combined with electroacupuncture has a better clinical effect on simple obesity. It is superior to Tanggan decoction group in the total clinical efficacy and improvement of clinical symptoms. Can effectively alleviate a variety of obesity caused by clinical symptoms, significantly improve the quality of life of patients, and can effectively improve lipid metabolism. The characteristics of traditional Chinese medicine without toxic side effects highlight the treatment principle of differentiation of symptoms and signs of traditional Chinese medicine and the whole concept of treatment. It provides a new safe and effective treatment method for modern clinical treatment of simple obesity and has a very broad application prospect.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259

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