单纯性肥胖临床基本证型分析与针灸辨证施治的临床研究

发布时间：2018-02-03 10:06

本文关键词： 基本证型辨证论治单纯性肥胖临床疗效　出处：《南京中医药大学》2016年博士论文　论文类型：学位论文

【摘要】：目的探讨单纯性肥胖的临床基本证型以及针灸辨证施治的临床疗效及作用机制。为临床辨证论治个性化治疗提供依据。方法：首先对单纯性肥胖基本证型进行分析,按统一设计调查表登记,并根据临床常见证型症状表现进行辨证分型,总结出常见证型的分布。其次,针灸辨证施治的临床研究,随机选取临床最常见的三种证型共计70例,其中阴阳平和型26例,脾虚湿阻型20例,胃肠实热型24例。70名患者被随机分为二组,每组35例,分为用辨证取穴电针组和电针组。结果：(1)肥胖患者中,女性225例,占62.5%；男性135例,占37.5%；最多见的证型是阴阳平和型106例,占29.44%；脾虚湿阻型84例,占23.33%；胃肠实热证69例,占19.16%；肝郁气滞型57例,占15.83%；脾胃虚弱型27例,占7.50%；脾肾阳虚型17例,占4.72%。肝郁气滞型以女性多见,多并发妇科疾病,男性多并发脂肪肝等病；脾胃虚弱和脾肾阳虚以中老年患者为多见,其他证型以青年为主。(2)辨证治疗电针组治疗后,FAT、VFA、体重指数、臀围、腰围都降低。治疗前后对比P0.01,差异有极显著性。治疗后电针组病人FAT、VFA、体重指数、上臂围、小腿围、大腿围、臀围、腰围都降低,治疗前后对比,P0.05差异有显著性。辨证论治电针组与电针组比较,腰围、臀围、体重指数、FAT及VFA下降值比较具有显著差异性(P0.05)。(3)辨证取穴组总有效率高于电针组,两组总有效率比较P0.01,差异有极显著性。结论：(1)单纯性肥胖临床常见证型主要是阴阳平和型,脾虚湿阻型,胃肠实热型。(2)辨证论治疗效优于单纯电针组。
[Abstract]:Objective to explore the clinical basic syndrome types of simple obesity and the clinical curative effect and mechanism of acupuncture and moxibustion treatment based on differentiation of symptoms and signs, and to provide the basis for individualized treatment based on differentiation of symptoms and signs. Methods:. At first, the basic syndromes of simple obesity were analyzed. According to the unified design of questionnaire registration, and according to the clinical symptoms of common syndromes, summed up the distribution of common syndrome types. Secondly, the clinical study of acupuncture and moxibustion syndrome differentiation. A total of 70 cases of the three most common syndromes were randomly selected, including 26 cases of Yin and Yang mild type, 20 cases of spleen deficiency and dampness obstruction type, and 24 cases of gastrointestinal solid heat type .70 cases were randomly divided into two groups, 35 cases in each group. Results among the obese patients, 225 cases were female (62.5%). There were 135 males (37.5%); The most common syndromes were Yin and Yang mild type in 106 cases (29.44%). Spleen deficiency and dampness obstruction in 84 cases (23.33%); There were 69 cases (19.16%) with gastrointestinal heat syndrome. There were 57 cases with stagnation of qi in liver, accounting for 15.83%. The spleen and stomach were weak in 27 cases (7.50%); There were 17 cases with deficiency of spleen and kidney yang (4.72%). The type of stagnation of liver-qi was more common in women, more complicated with gynecological diseases, and more complicated with fatty liver in men. Deficiency of spleen and stomach and deficiency of spleen and kidney yang were more common in middle-aged and elderly patients, and other syndromes were mainly in youth. 2) after treatment of electroacupuncture group, FATV VFA, body mass index and hip circumference were found in electroacupuncture group. After treatment, the patients in electroacupuncture group had lower FATV, body mass index, upper arm circumference, calf circumference, thigh circumference, hip circumference and waist circumference. Before and after treatment, there was significant difference between the two groups. Compared with electroacupuncture group, waist circumference, hip circumference and body mass index were compared between syndrome differentiation group and electroacupuncture group. The total effective rate of acupoint differentiation group was higher than that of electroacupuncture group, and the total effective rate of the two groups was higher than that of electroacupuncture group (P0.01). Conclusion the common syndromes of simple obesity are Yin and Yang type, spleen deficiency and dampness obstruction type, gastrointestinal solid heat type. Conclusion the curative effect of differentiation of symptoms and signs is better than that of simple electroacupuncture group.
【学位授予单位】：南京中医药大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R246.1

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