代综方合穴位埋线对肥胖病（脾虚湿阻型）炎症因子、氧化应激的初步观察

发布时间：2018-01-10 13:33

本文关键词：代综方合穴位埋线对肥胖病（脾虚湿阻型）炎症因子、氧化应激的初步观察　出处：《成都中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：探讨代综方合并穴位埋线干预脾虚湿阻型肥胖病患者的临床疗效,观察代综方口服合并穴位埋线后肥胖患者的疗效,比较治疗前后患者的体重、体重指数、腰围、体重指数的变化；观察干预前后对患者高胰岛素血症的影响,并分析干预措施对肥胖病患者慢性炎症因子、氧化应激、microRNA29的影响。方法：选择符合标准的肥胖病患者,共67例,随机分为对照组和治疗组。对照组,共计34例,在生活方式干预的基础上,口服二甲双胍850mg,一日两次及中药汤剂代综方,1日1剂,连续12周；治疗组,共计33例,在生活方式干预的基础上,口服汤剂代综方及穴位埋线治疗,穴位埋线主穴有两组：①天枢、中脘、关元、足三里、丰隆、梁丘②脾俞、胃俞、肾俞、上巨虚、下巨虚。交替选穴,3周埋线1次,连12周。进行临床12周的观察,记录观察患者的年龄、身高,体重、腰围、大腿围,糖耐量试验数值、胰岛素释放实验数值、血脂以及IL-6、TNF-α、SOD、ox-LDL (Elisa检测法)；mir-29 (RT-PCR检测法)等指标的变化。对实验结果采用统计软件进行分析,探讨疗效机理,分析病理机制。结果：1.对照组及治疗组体重的均值分别降低了2.2kg和7kg, BMI分别降低了0.65和2.7,腰围分别降低了3.2cm和5.5cm、臀围降低了5.6cm和7.8cm,组间比较差异有统计学意义(P0.05),两组治疗后与基线水平比较均有显著差异(P0.01)；2.两组治疗前后CHOL与基线水平比较差异无统计学意义(P0.05),两组TG、LDL-C组内、组间比较差异有统计学意义(P0.05),两组组内HDL-C升高有统计学意义(P0.05),组间比较无统计意义(P0.05)。3.两组1hINS、hINS显著降低(P0.01), OhINS、3hINS降低有统计学意义(P0.05); OhINS、1hINS、2hINS、3hINS组间比较差异无统计学意义；两组HOMA-IR、ISI有显著改善(P0.01),组间相比计较差异无统计学意义(P0.05),两组HOMA-β组间、组内比较差异具有统计学意义：4.两组IL-6、TNF-α显著降低、SOD显著升高(P0.01), ox-LDL降低有统计学意义(P0.05)5.两组均可下调microRNA-29水平的表达,下调数值差异具有统计学意义(P0.05)；治疗组下调水平多于对照组,但差异不具有统计学意义(P0.05)。7.mir-29与BMI、HOMA-IR正相关；8.试验过程中,两组患者肝肾功、血常规等安全性指标未见明显异常,不良反应发生率低。结论：在随机试验中代综方及穴位埋线对超重及肥胖患者均有明显减重、减腰围的疗效,调节血脂,显著改善胰岛素抵抗、增加胰岛素敏感性,并改善肥胖病导致的低度炎症反应及氧化应激：抑制mir-29水平的表达；无明显不良反应。
[Abstract]:Objective: to investigate the clinical effect of combined acupoint catgut implantation in treating obesity patients with spleen deficiency and dampness obstruction, observe the curative effect of Daizhuangfang combined with acupoint catgut embedding, and compare the body weight of patients before and after treatment. Body mass index, waist circumference, body mass index; The effects of intervention on hyperinsulinemia were observed, and the effects of intervention on chronic inflammatory factors and oxidative stress in obese patients were analyzed. Methods: 67 obese patients were randomly divided into two groups: control group (n = 34) and control group (n = 34) based on lifestyle intervention. Metformin 850 mg orally, twice in 1st and traditional Chinese medicine decoction, 1 dose on 1st, for 12 weeks; Treatment group, a total of 33 cases, on the basis of lifestyle intervention, oral decoction comprehensive formula and acupoint catgut embedding treatment, the main acupoint embedding points have two groups: 1 day armature, Zhongwan, Guan Yuan, Zusanli, Fenglong, Liang Qiu 2 spleen Shu. Weishu, Shenshu, Shangjuxu, Xia Juxu. Alternate selection of acupoints for 3 weeks embedding thread once for 12 weeks. Clinical observation for 12 weeks, recorded the patient's age, height, weight, waist circumference, thigh circumference. Glucose tolerance test, insulin release test, serum lipids and IL-6 TNF- 伪 SODX ox-LDL Elisa assay; The results of the experiment were analyzed by statistical software, and the mechanism of curative effect was discussed. Results: 1. The average body weight of the control group and the treatment group decreased by 2.2 kg and 7 kg, respectively, and the BMI decreased by 0.65 and 2.7 kg, respectively. The waist circumference and hip circumference decreased by 3.2 cm and 5.5 cm, respectively, and the hip circumference decreased by 5.6 cm and 7.8 cm, respectively. The difference between the two groups was statistically significant (P 0.05). There was significant difference between the two groups after treatment and baseline level (P 0.01). 2. There was no significant difference between CHOL and baseline before and after treatment in the two groups (P 0.05). The increase of HDL-C in the two groups was statistically significant (P 0.05), but there was no statistical significance between the two groups (P 0. 05. 3. 1hINS decreased significantly (P 0. 01)). The decrease of 3hins in OhINS was significantly lower than that of P0.05; There was no significant difference in 3hins between the groups of OhINS 1hINS 2hINS and 3hINS. The HOMA-IRISI of the two groups was significantly improved (P 0.01), and there was no significant difference between the two groups (P 0.05), and there was no significant difference between the two groups (P 0.05), and there was no significant difference between the two groups in terms of HOMA- 尾. The difference between the two groups was statistically significant. The level of IL-6 TNF- 伪 in the two groups was significantly lower than that in the control group and SOD was significantly increased (P0.01). The expression of microRNA-29 was down-regulated in both groups, and the down-regulation was statistically significant (P 0.05). The down-regulation level in the treatment group was higher than that in the control group, but the difference was not statistically significant (P 0.05) .7.mir-29 was positively correlated with BMIHOMA-IR. 8. In the course of the experiment, the safety indexes such as liver and kidney function and blood routine were not obviously abnormal in the two groups. Conclusion: in the random trial, the patients with overweight and obesity have significant weight loss, the effect of reducing waist circumference, the regulation of blood lipid, and the improvement of insulin resistance. Increase insulin sensitivity and improve the low inflammatory response and oxidative stress caused by obesity: inhibit the expression of mir-29; There was no obvious adverse reaction.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.1

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