针药结合治疗脾肾阳虚型单纯性肥胖的临床观察

发布时间：2018-05-18 09:50

本文选题：单纯性肥胖 + 针药结合疗法　；参考：《广西中医药大学》2017年硕士论文

【摘要】：目的:通过观察针灸结合健脾温肾中药对脾肾阳虚型单纯性肥胖的临床疗效,佐证以“健脾温肾”理论指导治疗肥胖症的学术思想,为针灸临床防治肥胖症提供客观的依据。方法:本研究采用随机分组法将符合纳入标准的脾肾阳虚证肥胖患者69例分成3组,其中针药结合组23例,服用健脾温肾中药治疗,每日1剂,同时接受针灸治疗,取穴以脾经、任脉为主,佐以灸法,隔日1次,10次为1个疗程,治疗3个疗程,共2个月;中药组23例,仅服用健脾温肾中药治疗,每日1剂,疗程2个月;针灸组23例,只接受针灸治疗,隔日1次,疗程2个月。观察并记录治疗前后病例的身高、体重、体质指数(BMI)、腰围、臀围、腰臀比(WHR)、中医症状量化积分与疗效及血脂的变化情况。全部数据以SPSS21.0统计软件进行统计学分析。结果:(1)体重、BMI、WHR:3组在体重、BMI、WHR方面组内治疗前后有显著性差异(P0.05),有统计学意义。(2)血脂:3组治疗前血清总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)值两两比较,差异无统计学意义(P0.05)。治疗后TC、TG、LDL-C明显值下降,HDL-C值升高,与治疗前比较差异有统计学意义(P0.05);针药结合组治疗后TC、TG、LDL-C值下降明显,与中药组及针灸组比较差异显著(P0.05),HDL-C值升高明显,与中药组及针灸组比较差异显著(P0.05);(3)中医症状积分:3组中医证候积分治疗前后具有统计学差异(P0.05),治疗后针药结合组较中药组及针灸组积分降低,具有统计学差异(P0.05)。(4)中医临床疗效评价:治疗后对3组病例进行中医症状疗效评价,针药结合组23例患者中,显效8例,有效13例,无效2例,临床总有效率为91.3%;中药组22例患者中,显效3例,有效10例,无效9例,临床总有效率为59.1%,针灸组22例患者中显效5例,有效12例,无效5例,临床总有效率为77.2%,3组临床症状和体征均有不同程度的改善;针药结合组与中药组、针灸组比较有显著差异(P0.05)。结论:针灸结合健脾温肾中药方是治疗单纯性肥胖症脾肾阳虚证的有效方法,疗效高于单纯中药组、针灸组;基于“健脾温肾”为理论治疗肥胖症的学术思想具有临床指导意义,而基于此的针灸与中药组方合理有效。
[Abstract]:Objective: To observe the clinical effect of acupuncture combined with Chinese herbal medicine of strengthening spleen and warm kidney on simple obesity of spleen and kidney yang deficiency type, to support the academic thought of "invigorating the spleen and warm kidney" theory in the treatment of obesity and providing objective basis for clinical prevention and treatment of obesity by Acupuncture. 69 cases of fat patients were divided into 3 groups, of which 23 cases were combined with acupuncture and medicine, 1 doses per day and acupuncture treatment, taking acupuncture and moxibustion, with moxibustion and moxibustion, 1 times a day, 10 times for 1 courses, 3 courses for 2 months, 23 cases of Chinese medicine group, only taking medicine of invigorating spleen and warm kidney, 1, course 2 months; acupuncture and moxibustion; acupuncture and moxibustion Group 23 cases, only received acupuncture and moxibustion, 1 times a day and 2 months of treatment. Observe and record the height, weight, body mass index (BMI), waist circumference, hip circumference, waist hip ratio (WHR), quantitative integration of TCM symptoms and changes of curative effect and blood lipid. All data were statistically analyzed by SPSS21.0 software. Results: (1) body weight, BMI, WHR:3 group There were significant differences (P0.05) before and after treatment in body weight, BMI, and WHR. (2) blood lipid: 3 groups of serum total cholesterol (TC), glycerol three fat (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C) value 22 compared, there was no statistical difference (P0.05). After treatment, TC, TG, LDL-C obviously decreased, HDL-C values were elevated. Compared with before treatment, there was significant difference (P0.05); the value of TC, TG and LDL-C decreased significantly after treatment in the combination group of acupuncture and medicine, compared with the traditional Chinese medicine group and the acupuncture group, the difference was significant (P0.05), the value of HDL-C increased obviously, and the difference was significant (P0.05) compared with the traditional Chinese medicine group and the acupuncture group (3) the TCM symptom integral: the 3 groups of TCM syndromes were statistically different before and after the treatment. (P0.05), after treatment, the integration of acupuncture and medicine group was lower than that of the traditional Chinese medicine group and the acupuncture group (P0.05). (4) the evaluation of the clinical efficacy of Chinese medicine: after treatment, the curative effect was evaluated in 3 groups of cases. Among the 23 patients with 23 cases, 8 cases were effective, 13 cases were effective, 2 cases were invalid, the total effective rate was 91.3%, and 22 patients of traditional Chinese medicine group were shown in the Chinese medicine group. 3 cases were effective, 10 cases were effective, 9 cases were invalid, the total effective rate was 59.1%, 5 of 22 patients in the acupuncture group, 12 effective and 5 ineffective, the total clinical effective rate was 77.2%. The 3 groups of clinical symptoms and signs were improved in different degrees. The ratio of acupuncture and medicine combined with traditional Chinese medicine group and acupuncture group was significantly different (P0.05). Conclusion acupuncture combined with Chinese traditional Chinese medicine of invigorating spleen and warming kidney It is an effective method to treat the spleen and kidney yang deficiency syndrome of simple obesity. The curative effect is higher than that of the traditional Chinese medicine group and the acupuncture group. Based on "strengthening the spleen and warming the kidney" as a theoretical treatment for obesity, the acupuncture and Chinese medicine based on this method are 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】：2017
【分类号】：R259

【参考文献】