针灸治疗对单纯性肥胖患者肠道菌群的调节效应

发布时间：2018-01-08 09:11

本文关键词：针灸治疗对单纯性肥胖患者肠道菌群的调节效应　出处：《广西中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:通过观察针灸治疗对单纯性肥胖的临床疗效,特别注意其对肠道菌群的的调节效应,探讨肠道菌群与肥胖发生的关系,佐证以“健脾温肾”为则论治单纯性肥胖的学术思想,为针灸临床防治单纯性肥胖提供客观的理论依据。方法:本研究采用随机分组法将符合纳入标准的单纯性肥胖患者60例分成2组,每组30人。分别为针灸治疗组30例、基础对照组30例。对照组予健康知识宣教,饮食控制配合合理运动。针灸治疗组在对照组基础上予针灸治疗。隔日1次,10次为1疗程,持续治疗3个疗程。以及选择30例健康志愿者。用实时荧光定量PCR法检测健康组及治疗前后两组患者肠道主要菌群的变化情况,并观察身高、体重、BMI指数、腰围、臀围、腰臀比、中医症状量化积分与疗效及血脂的变化情况。全部数据以SPSS17.0统计软件进行统计学分析。结果:(1)肠道主要菌群:两组患者治疗前肠杆菌、肠球菌均高于健康组,经治疗后,治疗组肠杆菌、肠球菌数量与本组治疗前比较均明显降低(P0.05),与健康组比较无统计学意义(P㧐0.05)。对照组治疗前后比较差异无统计学意义(P㧐0.05),与健康组比较差异显著(P0.05)。两组患者治疗前拟杆菌均低于健康组,治疗后治疗组拟杆菌数量与本组治疗前比较均明显升高(P0.05),与健康组比较无统计学意义(P㧐0.05)。对照组治疗前后比较差异无统计学意义(P㧐0.05),与健康组比较差异显著(P0.05)。两组双歧杆菌、乳杆菌治疗前后与健康组比较均无显著差异(P㧐0.05)。(2)体重、BMI、WHR:治疗组在体重、BMI、WHR方面治疗前后有显著性差异(P0.05),而对照组虽然治疗前后有差异,但(P0.05),没有统计学意义。(3)血脂:治疗组各项血脂指标均显著改善(P0.05),对照组除HDL-C外其余各项指标治疗前后均有显著性差异(P0.05)(4)中医症状积分:治疗组中医证候积分相对于治疗前具有统计学差异(P0.05),治疗组相对于对照组积分降低,具有统计学差异(P0.05)。(5)中医临床疗效评价:治疗后对两组病人进行中医症状疗效评分,治疗组显效7例,有效20例,无效3例,总有效率90.0%;对照组显效1例,有效9例,无效20例,总有效率30.3%;治疗组与对照组比较有显著性差异(P0.05)。结论:(1)肠道菌群与肥胖发生关系密切,体内肠道微生态调节失衡可能是单纯性肥胖发生重要机制之一。(2)针灸治疗肥胖的机理之一可能是通过调节肠道菌群,纠正其紊乱,恢复机体微生态的动态平衡,纠正其异常的代谢功能,从而加速能量的消耗,达到减肥之效。(3)以“健脾温肾”为法论治单纯性肥胖的学术思想具有临床指导意义,而基于此的针灸组方合理有效。
[Abstract]:Objective: to investigate the relationship between intestinal flora and obesity by observing the clinical effect of acupuncture and moxibustion on simple obesity and paying special attention to its regulating effect on intestinal flora. It is proved that "invigorating the spleen and warming the kidney" is the academic thought of treating simple obesity. Methods: 60 patients with simple obesity who met the inclusion criteria were divided into two groups by random grouping method in order to provide an objective theoretical basis for clinical prevention and treatment of simple obesity by acupuncture and moxibustion. 30 persons in each group were divided into acupuncture treatment group (n = 30) and basic control group (n = 30). The control group was given health education. Diet control combined with reasonable exercise. Acupuncture and moxibustion treatment group in the control group on the basis of acupuncture and moxibustion treatment. Three courses of continuous treatment and 30 healthy volunteers were used to detect the changes of main intestinal flora in healthy group and before and after treatment by real-time fluorescence quantitative PCR, and to observe their height and weight. BMI index, waist circumference, hip circumference, waist-to-hip ratio. Quantitative score of TCM symptoms, curative effect and changes of blood lipids. All data were statistically analyzed by SPSS17.0 software. Results: main intestinal flora: two groups of patients treated with Enterobacter probioticum. After treatment, the number of Enterobacter and Enterococcus in the treatment group was significantly lower than that before treatment, but there was no significant difference between the treatment group and the healthy group. There was no significant difference between control group and control group before and after treatment. Compared with the healthy group, the difference was significant (P 0.05). Both groups were lower than the healthy group before treatment. After treatment, the number of Bacteroides in the treatment group was significantly higher than that before treatment, but there was no significant difference between the treatment group and the healthy group. There was no significant difference between control group and control group before and after treatment. There was no significant difference between the two groups in Bifidobacterium and Lactobacillus before and after treatment. BMI-WHR: there was a significant difference in the weight of BMI-WHR before and after treatment in the treatment group, while in the control group there was significant difference before and after treatment. However, there was no significant difference in blood lipids (P 0.05, P 0.05): all blood lipid indexes in the treatment group were significantly improved (P 0.05). In the control group, there were significant differences in the other indexes except HDL-C before and after treatment. (P0.05 / 4) the TCM symptom score of the treatment group was statistically different from that of the pre-treatment group (P < 0.05). P0.05). Compared with the control group, the score of the treatment group was lower than that of the control group, with statistical difference (P 0.05. 0. 05. 5) the clinical efficacy of TCM was evaluated: after treatment, 7 patients in the treatment group were scored with TCM symptom efficacy. 20 cases were effective, 3 cases were ineffective, the total effective rate was 90.0%. In the control group, there were 1 case with remarkable effect, 9 cases with effective effect and 20 cases with no effect, and the total effective rate was 30.3%. There was a significant difference between the treatment group and the control group (P 0.05). Conclusion the intestinal flora is closely related to obesity. The imbalance of intestinal microecological regulation may be one of the important mechanisms of simple obesity.) one of the mechanisms of acupuncture and moxibustion in treating obesity may be to correct the disorder by regulating the intestinal flora. To restore the dynamic balance of microecology, correct its abnormal metabolic function, and thus accelerate the energy consumption. The academic thought of "invigorating the spleen and warming the kidney" for treating simple obesity has clinical guiding significance, and the acupuncture formula based on it is reasonable and effective.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.1

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