基于人体成分分析观察穴位埋线及电针法对单纯性肥胖的临床疗效

发布时间：2018-04-25 11:22

本文选题：电针 + 穴位埋线　；参考：《南京中医药大学》2016年博士论文

【摘要】：目的：鉴于电针和埋线疗法在治疗单纯性肥胖中的大量临床运用,观察对比分析常见电针、穴位埋线及两者结合治疗的疗效差异,并进一步基于人体成分分析来比较三种疗法对人体成分尤其是脂肪分布的影响,明确其在治疗单纯性肥胖中的安全性、作用机制及各自优势,便于临床选择。方法：采用随机原则,将单纯性肥胖患者分配到“电针组”35例,“埋线组”40例和“电针结合埋线组”33例,剔除不能严格接受治疗安排的患者11例,最终符合研究要求的病例有97例,电针组31例,埋线组34,电针结合埋线组32例。选取主穴：中脘、天枢、水道、气海、足三里、梁丘等,大腿肥胖明显者加伏兔,小腿肥胖明显者加丰隆,上肢肥胖明显加曲池、肩髑穴。电针组腹部用2组穴,双下肢各选用1组穴,使用频率f1(为2Hz,10/100 Hz,3种频率交替循环),强度以病人能耐受为度,留针30min,隔日1次,共治疗6周；埋线组同样穴位进行埋线,7-10天一次；电针结合埋线组在埋线基础上加电针处理,每次埋线后的第4天针刺1次,随后隔天一次,直至下次埋线。三组均治疗6周。治疗前及治疗结束后由同一体检医生(并不提供对患者的治疗)对每位患者测量身高,并采用InBody720人体成份分析仪采集数据(包含健康评估分值、BMI、WHR、BF%、 VFA%、BMR、蛋白质、无机盐、细胞内液、细胞外液、节段性脂肪分布)。结果：1、三种疗法的总有效率分别为77.42%、73.53%、90.62%,电针结合埋线组治疗单纯性肥胖患者的疗效最佳(P0.05),其次为电针组,埋线组疗效最差。2、三种疗法均能降低各项肥胖指标BMI、WHR、BF%、VFA%等,其中电针结合埋线组降低幅度最大(P0.05)。3、三组对于躯干部位脂肪(主要在腹部)脂肪量的减少,均明显高于对四肢脂肪的减少量,电针组对于下肢和躯干部位脂肪减少的作用强于埋线组(P0.05),而埋线结合电针组无论对于上肢、下肢还是躯干,其疗效均优于其余两组(P0.05)。4、三种疗法均能提高单纯性肥胖患者低下的基础代谢率,使人体脂肪含量减少而肌肉相对增多(P0.05)；并能升高健康评估分值,多数患者由原来的小于70分的弱体质,恢复到70-90的正常范围之内。5、三种疗法在治疗过程中并不影响患者其他成分如蛋白质、无机盐、细胞内外水液的正常分布范围,四项指标在治疗前后无明显改变,均在正常范围内(P0.05)。
[Abstract]:Objective: in view of the large amount of clinical application of electroacupuncture and catgut embedding therapy in the treatment of simple obesity, the curative effect of common electroacupuncture, acupoint catgut embedding and their combination were observed and analyzed. The effects of the three therapies on the distribution of body components, especially fat, were further compared based on the analysis of human body composition, and the safety, mechanism and advantages of the three therapies in the treatment of simple obesity were clarified, which was convenient for clinical selection. Methods: the patients with simple obesity were divided into "electroacupuncture group" (35 cases), "embedding group" (40 cases) and "electroacupuncture combined with catgut embedding group" (33 cases). Eleven patients who could not be treated strictly were excluded. There were 97 cases in accordance with the requirements of the study, 31 cases in the electroacupuncture group, 34 cases in the embedding group and 32 cases in the group of electroacupuncture combined with embedding thread. Main points: Zhongwan, Tianshu, waterway, Qihai, Zusanli, Liang Qiu, and so on. In the electroacupuncture group, two points were used in the abdomen and one point in each of the lower limbs was used. The frequency f _ 1 (10 / 100 ~ 100 Hz ~ +) was used alternately, the intensity of which was to be tolerated by the patient, the needle was kept for 30 minutes, once every other day for 6 weeks, and the same acupoint was implanted once for 7-10 days in the wire embedding group. The electroacupuncture combined with wire embedding group was treated with electroacupuncture on the basis of embedding wire. The acupuncture was needled once on the 4th day after each embedding, and then every other day until the next embedding. All the three groups were treated for 6 weeks. The height of each patient was measured before and after treatment by the same examining doctor (who did not provide treatment for the patient), and the data were collected by InBody720 anthropometric analyzer (including health assessment score, BMI-WHR BF, protein, inorganic salt, intracellular fluid). Extracellular fluid, segmental fat distribution. Results the total effective rates of the three treatments were 77.42 and 73.53, respectively. Electroacupuncture combined with catgut embedding group had the best curative effect on simple obesity patients (P 0.05), followed by electroacupuncture group, embedding thread group and embedding thread group. All three kinds of therapy could reduce BMIWHRBFFV FAA% and so on. Among them, electroacupuncture combined with embedding thread group had the largest decrease in the amount of fat in the trunk (mainly in the abdomen), which was significantly higher than that in the limbs, and the decrease of fat in the trunk was significantly higher in the three groups than in the extremities. The effect of electroacupuncture group on lower extremity and trunk fat loss was stronger than that on thread embedding group (P 0.05), but the combination of embedding wire group and electroacupuncture group was not only for upper limb, lower extremity and trunk, but also for upper limb, lower extremity and trunk. The therapeutic effect was better than that of the other two groups (P 0.05. 4). All the three treatments could increase the basal metabolic rate of simple obesity patients, decrease the fat content of human body and increase the muscle mass, and increase the score of health assessment. Most patients recovered from the original weak constitution of less than 70 points to within the normal range of 70-90. The three treatments did not affect the normal distribution of other components of the patient, such as protein, inorganic salt, and extracellular water, during the course of treatment. There was no significant change in the four indexes before and after treatment, all of them were within normal range (P 0.05).
【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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