穴位埋线合并中药治疗脾虚痰湿型肥胖的临床研究

发布时间：2018-04-06 22:09

本文选题：穴位埋线　切入点：单纯性肥胖　出处：《广州中医药大学》2016年博士论文

【摘要】：目的：肥胖症是一种慢性代谢性疾病,它由多因素引起,与基因、环境、炎症和生活方式等密切相关。随着工业化的发展,经济的进步,肥胖症在一些发达国家和地区广泛流行。肥胖是心血管疾病、糖尿病、痛风、癌症、高血压等慢性疾病的重要危险因子,因此,治疗肥胖成为公共卫生事业的重要内容：本研究旨在探讨穴位埋线结合中药治疗脾虚痰湿型正常代谢性肥胖症患者的临床疗效,为今后中医药治疗肥胖症奠定研究基础,同时提供更好的临床治疗策略。方法：台湾宜森中医诊所,肥胖门诊,符合病例选择标准肥胖病例共60例。按随机数字法,将其随机分为治疗组和对照组,各30例。其中治疗组女25例,男5例,对照组女25例,男5例。治疗组采用穴位埋线加基础中药治疗,方用厚朴夏苓汤加减,埋线穴位选取为,主穴：带脉、环跳、足三里、中脘、三阴交、肩骼。辅穴：胃俞、天枢、水分、丰隆、地机、脾俞、气海、大横、阴陵泉。每次治疗选取7-10个穴位,进行穴位埋药线。对照组单纯采用中药治疗。观察治疗前后BMI、腰围、臀围及糖脂代谢指标。比较两组疗效差异。结果：本研究通过对60例脾虚痰湿证正常代谢性肥胖症的患者进行观察并收集资料分析,经过统计学检验,在年龄、性别、病程、肥胖程度、观察指标(包括BMI、体重、腰臀围、糖脂代谢各指标)、中医体质上,差异无统计学意义,故具有可比性(P0.05)。穴位埋线结合中药组和单用中药组在治疗后各项观察指标与治疗前比较,经检验差异均有统计学意义(P0.05),可以认为两组治疗均对单纯肥胖患者有效,能降低患者体重、腰臀围和改善糖脂代谢状况。治疗组的总有效率为93%,对照组的总有效率为80%,经统计学检验,p0.05,可以认为穴位埋线结合中药组在疗效方面优于单用中药组,而且在BMI、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)这些观察指标上改善程度优于单用中药组(P0.05),其它观察指标则无显着性的差别(P0.05)。结论：加用穴位埋线之后,减肥效果明显好于单用中药,具体体现在：1、能显着减少腰围、臀围,降低BMI指数；2、能有效改善内分泌代谢状态,能降低甘油三酯、胆固醇,升高高密度脂蛋白。其机制可能与长效刺激穴位、增强机体代谢状态、调节中枢食欲等有关。
[Abstract]:Objective: obesity is a chronic metabolic disease, which is caused by many factors and is closely related to gene, environment, inflammation and lifestyle.With the development of industrialization and economic progress, obesity is widespread in some developed countries and regions.Obesity is an important risk factor for chronic diseases such as cardiovascular disease, diabetes, gout, cancer, hypertension, etc.Treatment of obesity has become an important part of public health. The purpose of this study was to explore the clinical effect of acupoint catgut embedding combined with traditional Chinese medicine in the treatment of normal metabolic obesity with spleen deficiency and phlegm dampness, and to lay a foundation for the future treatment of obesity with traditional Chinese medicine.At the same time, to provide a better clinical treatment strategy.Methods: a total of 60 obese patients met the criteria of case selection in Taiwan Yisen TCM Clinic and Obesity Clinic.According to the method of random number, it was randomly divided into treatment group and control group, 30 cases each.In the treatment group, 25 cases were female, 5 cases were male, 25 cases were female and 5 cases were male in the control group.The treatment group was treated with acupoint catgut embedding plus basic Chinese medicine, and the treatment group was treated with Houpu Xia Ling decoction. The main points were selected as main points: with pulse, ring jump, Zusanli, Zhongwan, Sanyinjiao, shoulder ilium.Auxiliary points: Weishu, Tianshu, water, Fenglong, ground machine, spleen Yu, air sea, big transverse, Yin Lingquan.Each treatment selected 7-10 points, point embedding line.The control group was treated with traditional Chinese medicine only.BMI, waist circumference, hip circumference and glucose and lipid metabolism were observed before and after treatment.The difference of curative effect between the two groups was compared.Results: in this study, 60 cases of normal metabolic obesity with spleen deficiency and phlegm dampness syndrome were observed and analyzed. After statistical test, the indexes of age, sex, course of disease, degree of obesity, observation index (including BMI, body weight, waist-hip circumference) were observed.The indexes of glucose and lipid metabolism have no statistical significance in constitution of traditional Chinese medicine, so it is comparable to P0.05.The observation indexes of acupoint catgut embedding combined with traditional Chinese medicine group and single Chinese medicine group after treatment were compared with those before treatment. The difference was statistically significant (P 0.05). It can be concluded that the treatment of both groups is effective for simple obesity patients and can reduce the body weight of the patients.Waist hip circumference and improve glucose and lipid metabolism.The total effective rate of the treatment group was 93.The total effective rate of the control group was 80. By statistical test, p0.05, we can conclude that the acupoint catgut embedding combined with traditional Chinese medicine group is superior to the single Chinese medicine group in the curative effect.Moreover, in BMI, TGN, TCX, HDL-C), the improvement of these indexes was better than that of P0.05 in the single Chinese medicine group, but there was no significant difference in other observation indexes.Conclusion: the effect of catgut embedding at acupoint is better than that of traditional Chinese medicine alone. It can significantly reduce waist circumference hip circumference and BMI index. It can effectively improve endocrine metabolism state and reduce triglyceride and cholesterol.Elevated high density lipoprotein.The mechanism may be related to long-term stimulation of acupoints, enhancement of metabolic state and regulation of central appetite.
【学位授予单位】：广州中医药大学
【学位级别】：博士
【学位授予年份】：2016
【分类号】：R246.1

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