陈秋教授自拟代综方联合穴位埋线治疗脾虚湿阻型肥胖症的临床疗效研究
发布时间：2018-08-28 07:14
【摘要】：目的探讨陈秋教授自拟代综方联合穴位埋线治疗脾虚湿阻型肥胖症的临床疗效。方法选取2014年11月—2015年11月在成都中医药大学附属医院内分泌科门诊和肥胖门诊就诊的脾虚湿阻型肥胖症患者74例,采用随机数字表法分为对照组(n=38)和观察组(n=36)。在接受基础治疗的同时,对照组患者采用代综方+二甲双胍治疗,观察组患者采用代综方+穴位埋线治疗,药物治疗周期均为12周。比较两组患者治疗前后的体格检查指标、相关实验室检测指标、中医证候积分及临床疗效。结果治疗前两组患者身高、体质量、腰围、臀围、大腿围、BMI、腰高比比较,差异无统计学意义(P0.05)。治疗后观察组患者体质量、腰围、BMI、腰高比低于对照组,差异有统计学意义(P0.05);而两组患者臀围、大腿围比较,差异无统计学意义(P0.05)。治疗前两组患者总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)比较,差异无统计学意义(P0.05)。治疗后观察组患者TG低于对照组,LDL-C高于对照组,差异有统计学意义(P0.05);而两组患者TC、HDL-C比较,差异无统计学意义(P0.05)。治疗前和治疗后,两组患者胰岛素(Ins)比较,差异均无统计学意义(P0.05);不同时间点比较,差异有统计学意义(P0.05);治疗方法与时间在Ins上不存在交互作用(P0.05)。治疗后两组患者Ins与治疗前比较,差异均有统计学意义(P0.05);不同时间点比较,差异有统计学意义(P0.05);治疗方法与时间在Ins上存在交互作用(P0.05)。治疗前两组患者胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(ISI)、胰岛β细胞功能(HOMA-β)比较,差异无统计学意义(P0.05)。治疗后两组患者HOMA-IR、ISI比较,差异无统计学意义(P0.05);观察组患者HOMA-β低于对照组,差异有统计学意义(P0.05)。治疗前两组患者中医证候积分比较,差异无统计学意义(P0.05);治疗后观察组患者中医证候积分低于对照组,差异有统计学意义(P0.05)。观察组患者西医临床疗效、中医证候疗效均优于对照组,差异有统计学意义(P0.05)。治疗前和治疗后,两组患者红细胞计数(RBC)、白细胞计数(WBC)、血红蛋白(Hb)、血小板计数(PLT)、ALT、AST、血肌酐(SCr)、血尿素氮(BUN)、尿酸(UA)比较,差异均无统计学意义(P0.05)。结论代综方联合穴位埋线治疗可明显改善脾虚湿阻型肥胖症患者的临床症状,减轻体质量,增加胰岛素敏感性,改善胰岛素抵抗,疗效显著。
[Abstract]:Objective to investigate the clinical effect of Professor Chen Qiu's self-made comprehensive prescription combined with acupoint embedding on spleen deficiency dampness obstruction obesity. Methods from November 2014 to November 2015, 74 obese patients with spleen deficiency and dampness obstruction were selected from the Endocrinology Department and Obesity outpatient Clinic of affiliated Hospital of Chengdu University of traditional Chinese Medicine. They were randomly divided into control group (n = 38) and observation group (n = 36). At the same time, the patients in the control group were treated with metformin, while the patients in the observation group were treated with catgut embedding at the acupoint of the treatment group. The treatment period was 12 weeks. The physical examination indexes, laboratory indexes, TCM syndromes score and clinical efficacy were compared between the two groups before and after treatment. Results there was no significant difference in height, body mass, waist circumference, hip circumference, thigh circumference and waist height ratio between the two groups before treatment (P0.05). After treatment, the observation group patients' body weight, waist circumference, waist height ratio was lower than the control group, the difference was statistically significant (P0.05), while the two groups of patients hip circumference, thigh circumference, the difference was not statistically significant (P0.05). There was no significant difference in total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) between the two groups before treatment (P0.05). After treatment, the TG of the observation group was lower than that of the control group, and the difference was statistically significant (P0.05), while the TC,HDL-C of the two groups had no statistical significance (P0.05). Before and after treatment, there was no significant difference in insulin (Ins) between the two groups (P0.05); at different time points, the difference was statistically significant (P0.05); there was no interaction between treatment methods and time on Ins (P0.05). After treatment, the difference of Ins between the two groups was statistically significant (P0.05); at different time points, the difference was statistically significant (P0.05); the treatment method and time had interaction on Ins (P0.05). There was no significant difference in insulin resistance index (HOMA-IR), insulin sensitivity index (ISI),) 尾 cell function (HOMA- 尾) between the two groups before treatment (P0.05). There was no significant difference in HOMA-IR,ISI between the two groups after treatment (P0.05), while the HOMA- 尾 in the observation group was lower than that in the control group (P0.05). Before treatment, there was no significant difference in TCM syndrome score between the two groups (P0.05); after treatment, the TCM syndrome score of the observation group was lower than that of the control group, and the difference was statistically significant (P0.05). The clinical curative effect of western medicine and syndromes of TCM in the observation group were better than those in the control group, the difference was statistically significant (P0.05). Before and after treatment, there was no significant difference in erythrocyte count, (RBC), leukocyte count, (WBC), hemoglobin, (Hb), platelet count, (PLT) alt AST, serum creatinine, (SCr), urea nitrogen, (BUN), uric acid (UA) between the two groups (P0.05). Conclusion the clinical symptoms, body weight, insulin sensitivity and insulin resistance of obesity patients with spleen deficiency and dampness obstruction can be obviously improved by the combination of Daizhuangfang and acupoint embedding therapy.
【作者单位】： 成都中医药大学临床医学院;成都中医药大学附属医院内分泌科;
【基金】：国家中医药管理局中医药标准化项目(SATCM-2015-BZ[204])——代谢综合征中医临床诊疗指南的修订
【分类号】：R249;R259
[Abstract]:Objective to investigate the clinical effect of Professor Chen Qiu's self-made comprehensive prescription combined with acupoint embedding on spleen deficiency dampness obstruction obesity. Methods from November 2014 to November 2015, 74 obese patients with spleen deficiency and dampness obstruction were selected from the Endocrinology Department and Obesity outpatient Clinic of affiliated Hospital of Chengdu University of traditional Chinese Medicine. They were randomly divided into control group (n = 38) and observation group (n = 36). At the same time, the patients in the control group were treated with metformin, while the patients in the observation group were treated with catgut embedding at the acupoint of the treatment group. The treatment period was 12 weeks. The physical examination indexes, laboratory indexes, TCM syndromes score and clinical efficacy were compared between the two groups before and after treatment. Results there was no significant difference in height, body mass, waist circumference, hip circumference, thigh circumference and waist height ratio between the two groups before treatment (P0.05). After treatment, the observation group patients' body weight, waist circumference, waist height ratio was lower than the control group, the difference was statistically significant (P0.05), while the two groups of patients hip circumference, thigh circumference, the difference was not statistically significant (P0.05). There was no significant difference in total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) between the two groups before treatment (P0.05). After treatment, the TG of the observation group was lower than that of the control group, and the difference was statistically significant (P0.05), while the TC,HDL-C of the two groups had no statistical significance (P0.05). Before and after treatment, there was no significant difference in insulin (Ins) between the two groups (P0.05); at different time points, the difference was statistically significant (P0.05); there was no interaction between treatment methods and time on Ins (P0.05). After treatment, the difference of Ins between the two groups was statistically significant (P0.05); at different time points, the difference was statistically significant (P0.05); the treatment method and time had interaction on Ins (P0.05). There was no significant difference in insulin resistance index (HOMA-IR), insulin sensitivity index (ISI),) 尾 cell function (HOMA- 尾) between the two groups before treatment (P0.05). There was no significant difference in HOMA-IR,ISI between the two groups after treatment (P0.05), while the HOMA- 尾 in the observation group was lower than that in the control group (P0.05). Before treatment, there was no significant difference in TCM syndrome score between the two groups (P0.05); after treatment, the TCM syndrome score of the observation group was lower than that of the control group, and the difference was statistically significant (P0.05). The clinical curative effect of western medicine and syndromes of TCM in the observation group were better than those in the control group, the difference was statistically significant (P0.05). Before and after treatment, there was no significant difference in erythrocyte count, (RBC), leukocyte count, (WBC), hemoglobin, (Hb), platelet count, (PLT) alt AST, serum creatinine, (SCr), urea nitrogen, (BUN), uric acid (UA) between the two groups (P0.05). Conclusion the clinical symptoms, body weight, insulin sensitivity and insulin resistance of obesity patients with spleen deficiency and dampness obstruction can be obviously improved by the combination of Daizhuangfang and acupoint embedding therapy.
【作者单位】： 成都中医药大学临床医学院;成都中医药大学附属医院内分泌科;
【基金】：国家中医药管理局中医药标准化项目(SATCM-2015-BZ[204])——代谢综合征中医临床诊疗指南的修订
【分类号】：R249;R259
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