针灸温阳通络法治疗高脂血症的临床研究

发布时间：2018-08-25 15:36

【摘要】：目的：探讨针灸温阳通络法治疗高脂血症的临床疗效,为临床提供治疗该病的新思路和客观依据。方法：采用随机数字表法,将符合纳入标准的90例高脂血症(hyperlipidemia, HLP)患者分为3组,空白组30例、对照组30例、治疗组30例。空白组：予单纯改变生活方式；对照组：予每日口服10mg阿托伐他汀钙片;治疗组：予针刺脾俞(双)、肾俞(双)命门、中脘、三阴交双、足三里双,临症加减,结合麦粒灸脾俞、肾俞、命门治疗,针刺及麦粒灸均每日1次,每周6次,周日休息。均以2周为1个疗程,4个疗程后进行前后对照研究。疗程结束后,评定三组患者的临床疗效,观察中医症状量化积分和血脂4项、丙氨酸转氨酶(alanine aminotransferase, ALT)、谷草转氨酶(aspartate transaminase, AST)、肌酸激酶(creatine kinase, CK)和体重指数(body mass index, BMI)等指标,采用SPSS19.0统计软件对收集数据进行统计学分析。结果：本研究总共完成87例治疗,空白组脱失0例,对照组脱失1例,治疗组脱失2例。1、治疗前三组患者的性别、年龄、病程、各抽血检测成分、中医症状量化积分、中医证型及基本情况差异无统计学意义,具可比性。2、4个疗程后临床疗效评定,空白组临床痊愈0例,显效0例,有效8例,无效22例,总有效率为26.67%；对照组临床痊愈2例,显效11例,有效14例,无效2例,总有效率为93.10%：治疗组临床痊愈1例,显效8例,有效16例,无效3例,总有效率为89.29%,经检验,对照组与治疗组疗效均明显优于空白组,对照组与治疗组具有同等疗效。3、4个疗程后中医临床疗效评定,空白组临床痊愈1例,显效1例,有效18例,无效10例,总有效率为66.67%；对照组临床痊愈0例,显效1例,有效15例,无效13例,总有效率为55.17%;治疗组临床痊愈1例,显效9例,有效18例,无效0例,总有效率为100%,经检验,治疗组明显优于空白组与对照组,空白组与对照组具有同等疗效。4、对比三组血脂检测指标,治疗后空白组总胆固醇(total cholesterol, TC)、甘油三酯(triglyeeride, TG)均有降低,高密度脂蛋白胆固醇(high-density lipoproteincholesterol, HDL-c)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)疗效不明显；治疗后对照组及治疗组各血脂检测指标均有降低,说明三种疗法高脂血症均有疗效；经统计学分析,针灸温阳通络法及阿托伐他汀钙片治疗高脂血症明显优于单纯改变生活方式,针灸温阳通络法与阿托伐他汀钙片治疗两者具有同等的疗效。5、对比三组BMI,三组治疗前后BMI均有显著下降。空白组与对照组在降BMI方面无明显差异,治疗组则明显优于空白组与对照组。6、对比三组ALT、AST、CK,治疗后对照组ALT、AST、CK归显升高,空白组及治疗组治疗前后无明显差异,说明针灸温阳通络法在治疗高脂血症上具有更好的安全性。7、对比三组中医症状量化积分,治疗组在中医症状量化积分总分上较空白组与对照组降低更明显,差异有统计学意义,说明针灸温阳通络法在治疗各型高脂血症上具有更好地改善症状的优势。结论：根据本研究得出,针灸温阳通络法及口服阿托伐他汀钙片治疗高脂血症具有同等疗效,且明显优于单纯改变生活方式。在对ALT、AST、CK的影响方面,阿托伐他汀钙片组对其升高程度明显高于针灸温阳通络法组及单纯改变生活方式组。在降低体重指数、改善中医证候方面,针灸温阳通络法较单纯改变生活方式及口服阿托伐他汀钙片治疗更有效。运用针灸温阳通络法治疗高脂血症具有安全、有效、无毒副作用等优点,值得进一步研究推广。
[Abstract]:Objective: To explore the clinical effect of acupuncture and moxibustion warming yang and dredging collaterals in the treatment of hyperlipidemia, and to provide a new idea and objective basis for clinical treatment of the disease.Methods: 90 patients with hyperlipidemia (HLP) were divided into three groups according to the inclusion criteria by random number table method, 30 cases in blank group, 30 cases in control group and 30 cases in treatment group. The control group was given 10 mg of atorvastatin calcium tablets orally daily; the treatment group was given acupuncture at Spleen Shu (Shuang), Shenshu (Shuang) Mingmen, Zhongwan, Sanyinjiaoshuang, Zusanli Shuang, plus or minus the symptoms, combined with wheat grain moxibustion at Spleen Shu, Shenshu, Mingmen, acupuncture and wheat grain moxibustion once a day, six times a week, and rest on Sunday. After four courses of treatment, the clinical efficacy of the three groups was evaluated, and the symptoms of TCM, blood lipids, ALT, AST, creatine kinase (CK) and body mass index (BMI) were observed. Results: 87 cases were treated with SPSS19.0 statistical software. There were 0 cases of loss in blank group, 1 case in control group and 2.1 cases in treatment group. Before treatment, the sex, age, course of disease, component of blood test, quantitative integral of TCM symptoms, TCM syndrome types and basic conditions of the three groups were poor. There was no significant difference in clinical efficacy. 2,4 courses after clinical evaluation, blank group clinical recovery 0 cases, markedly effective 0 cases, effective 8 cases, ineffective 22 cases, the total effective rate was 26.67%; control group clinical recovery 2 cases, markedly effective 11 cases, effective 14 cases, ineffective 2 cases, the total effective rate was 93.10%: treatment group clinical recovery 1 case, markedly effective 8 cases, effective 16 cases, ineffective 3 cases, the total effective rate was 93.10%. The total effective rate was 89.29%. The control group and the treatment group were significantly better than the blank group. The control group and the treatment group had the same curative effect. 3,4 courses later, the blank group was cured in 1 case, markedly effective in 1 case, effective in 18 cases, ineffective in 10 cases, the total effective rate was 66.67%; the control group was cured in 0 cases, markedly effective in 1 case, effective in 15 cases. 13 cases were ineffective, the total effective rate was 55.17%; 1 case was cured in the treatment group, 9 cases were markedly effective, 18 cases were effective, 0 cases were ineffective, the total effective rate was 100%. The treatment group was obviously better than the blank group and the control group, the blank group and the control group had the same effect. Triglyeeride (TG) was decreased, high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-C) was not significantly effective; after treatment, the control group and the treatment group, all the blood lipid detection indicators were reduced, indicating that the three treatment of hyperlipidemia are all. Statistical analysis shows that acupuncture and moxibustion Wenyang Tongluo method and atorvastatin calcium tablets in the treatment of hyperlipidemia is significantly better than simply changing lifestyle, acupuncture and moxibustion Wenyang Tongluo method and atorvastatin calcium tablets treatment both have the same effect. 5, compared with three groups of BMI, three groups of BMI before and after treatment were significantly reduced. There was no significant difference in ALT, AST, CK between the treatment group and the control group. Compared with the three groups, ALT, AST, CK in the control group increased significantly after treatment. There was no significant difference between the blank group and the treatment group before and after treatment. It showed that acupuncture and moxibustion warming Yang and dredging collaterals method had better safety in the treatment of hyperlipidemia. The total score of symptoms quantification in the treatment group was lower than that in the blank group and the control group, and the difference was statistically significant, indicating that the acupuncture-moxibustion-warming-yang-dredging-collaterals method has a better advantage in improving symptoms in the treatment of various types of hyperlipidemia. Conclusion: According to this study, the acupuncture-moxibustion-warming-yang-dredging-collaterals method and oral atorvastatin calcium tablets The effect of atorvastatin calcium tablets on ALT, AST and CK was higher than that of acupuncture and moxibustion with Warming Yang and dredging collaterals and simple change of life style. Acupuncture and moxibustion warming Yang and dredging collaterals are safe, effective and non-toxic in the treatment of hyperlipidemia.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.1

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