基于“标本配穴”理论针灸干预疗法对单纯性肥胖患者血脂水平及胰岛素抵抗的影响
|
摘要
目的:探讨"基于"标本配穴"理论针灸干预疗法治疗单纯性肥胖患者的临床疗效,并研究分析对患者血脂水平及血清胰岛素抵抗的影响,为治疗有胰岛素抵抗及血脂异常的肥胖患者提供理论依据。方法:根据随机数字法将来医院进行治疗的90例患者分为针灸组和西药组,于患者接受治疗前及治疗2个疗程后分别测试患者空腹状态腰围、臀围、身高、体质量、空腹血糖(FPG)、空腹胰岛素(FINS)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C),并以此计算出腰臀围比(WHR)、体质量指数(BMI),胰岛素抵抗指数(IR),收集数据进行统计学比较分析。结果:两组患者经治疗后皆有一定的疗效,而针灸组在臀围比及体质量指数方面总有效率(90%、94%)与西药组(90%、92%)无明显差异,差异无统计学意义(P>0.05);两组治疗前后比较,血清指标中FPG水平无明显变化(P>0.05),TC、TG、LDL-C均较治疗前显著降低,HDL-C水平升高;治疗后,在TC、TG、LDL-C、HDL-C改善方面,针灸组与西药组无明显差异(P>0.05),而治疗前后胰岛素抵抗改善情况比较,针灸组(8.24±1.21、5.81±0.87)显著优于西药组(8.31±0.88、8.18±0.83),差异有统计学意义(P<0.05)。结论:在降低单纯性肥胖患者体质量及改善血脂方面,基于"标本配穴"理论的针灸疗法取得了西医减肥药同等的疗效,在改善胰岛素抵抗方面,针灸疗法显著胜于西药疗法,且"标本配穴"针灸疗法为无不良反应的绿色疗法,值得在临床进行推广。
Objective: To explore the effect of acupuncture therapy for treatment of simple obesity patients, and study the effects on blood lipid and insulin resistance to provide a theoretical basis. Methods: According to the method of random number in our hospital 90 cases were divided into acupuncture group and Western medicine group. Before and after two courses of treatment,we tested the fasting state of waist and hip circumference, height, body weight, fasting blood glucose(FPG), fasting insulin(FINS), total cholesterol(TC),triglyceride(TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C) and calculated the waist hip ratio(WHR), body mass index(BMI) and insulin resistance index(IR). The data was collected and statistically comparatively analyzed. Results: Two groups after treatment had certain curative effect, and the acupuncture grou's hip ratio and body mass index total effective rate(90%, 94%) and Western medicine group's(90%, 92%) had no obvious difference and the difference was not statistically significant(P>0.05). Before and after treatment, two groups had no significant changes in serum levels of FPG index(P>0.05). TC, TG and LDL-C were significantly lower than those before treatment. HDL-C level increased. After treatment, the improvements in the TC, TG, LDL-C and HDL-C of acupuncture group and Western medicine group had no significant difference(P>0.05). And the improvement of insulin resistance of the acupuncture group before and after treatment[(8.24±1.21)vs(5.81±0.87)] was significantly better than the western medicine group's [(8.31±0.88)vs(8.18±0.83)]. The difference was statistically significant(P<0.05). Conclusion: In reducing blood fat and improving body weight in simple obesity patients, based on Biao-Ben points compatibility theory,acupuncture made equal efficacy in improving insulin resistance and was better than western medicine therapy. And acupuncture therapy has no toxic side effect, worthy of clinical practice.
Objective: To explore the effect of acupuncture therapy for treatment of simple obesity patients, and study the effects on blood lipid and insulin resistance to provide a theoretical basis. Methods: According to the method of random number in our hospital 90 cases were divided into acupuncture group and Western medicine group. Before and after two courses of treatment,we tested the fasting state of waist and hip circumference, height, body weight, fasting blood glucose(FPG), fasting insulin(FINS), total cholesterol(TC),triglyceride(TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C) and calculated the waist hip ratio(WHR), body mass index(BMI) and insulin resistance index(IR). The data was collected and statistically comparatively analyzed. Results: Two groups after treatment had certain curative effect, and the acupuncture grou's hip ratio and body mass index total effective rate(90%, 94%) and Western medicine group's(90%, 92%) had no obvious difference and the difference was not statistically significant(P>0.05). Before and after treatment, two groups had no significant changes in serum levels of FPG index(P>0.05). TC, TG and LDL-C were significantly lower than those before treatment. HDL-C level increased. After treatment, the improvements in the TC, TG, LDL-C and HDL-C of acupuncture group and Western medicine group had no significant difference(P>0.05). And the improvement of insulin resistance of the acupuncture group before and after treatment[(8.24±1.21)vs(5.81±0.87)] was significantly better than the western medicine group's [(8.31±0.88)vs(8.18±0.83)]. The difference was statistically significant(P<0.05). Conclusion: In reducing blood fat and improving body weight in simple obesity patients, based on Biao-Ben points compatibility theory,acupuncture made equal efficacy in improving insulin resistance and was better than western medicine therapy. And acupuncture therapy has no toxic side effect, worthy of clinical practice.
引文
[1] 闫利敏,刘志诚,徐斌,等. 针灸治疗1527例肥胖并发高脂血症不同年龄疗效的探讨[J].时珍国医国药,2016,27(10):2431-2432.
[2] 郭霞.针灸减肥治疗单纯性肥胖患者的疗效及对超敏C反应蛋白、血脂水平的影响[J].光明中医,2017,32(2):248-249.
[3] 王凯悦,刘志诚,徐斌.电针治疗女性胃肠腑热型肥胖并发高脂血症患者疗效分析[J]. 针灸临床杂志,2015,4: 22.
[4] 庞婷婷,刘志诚,徐斌.温针灸联合耳针治疗女性脾肾阳虚型肥胖并发高脂血症临床观察[J].中国针灸,2015(6): 529.
[5] 王鸣,刘志诚,徐斌.温针灸联合耳针治疗脾虚湿阻型肥胖并发高脂血症患者临床疗效[J]. 世界华人消化杂志,2015,24: 3973.
[6] 危北海,贾葆鹏. 单纯性肥胖病的诊断及疗效评定标准[J].中国中西医结合杂志,1998,18(5):317-319.
[7] 李彩云,李月亭. 腹针治疗单纯性肥胖 56 例[J]. 中国民间疗法,2011,19(4): 16.
[8] 王华,杜元灏.针灸学[M].3版.北京:中国中医药出版社,2012:32-120.
[9] 梁凤霞,陈瑞,王华.针灸防治胰岛素抵抗及其相关性疾病的临床研究思路探讨[J]. 中国针灸,2012, 32(7):639-644.
[10] 张安仁,王文春,胡斌,等. 针灸结合行为疗法治疗老年单纯性肥胖病的临床研究[J].西南军医,2007,9(3):1-2.
[11] 黄玲玲,阳期望,王升旭.薄氏股针治疗单纯性肥胖症的临床观察[J]. 针灸临床杂志,2011,27(5): 14-17.
[12] Kahn SE,Hull RL,Utzschneider KM. Mechanisms link-ing obesity to insulin resistance and type 2 diabetes[J].Nature,2006,444(7121): 840-846.
[13] 周一帆.生活方式管理对青春期多囊卵巢综合征合并胰岛素抵抗的治疗效果观察[J].中国社区医师杂志,2017,33(18):144-146.
[14] 岳琳,岳新元. 限食干预对代谢综合征患者血脂及血清IL-6等指标水平的影响[J].国际检验医学杂志,2017,38(12):1652-1654.
[15] 刘英,孙贺,李霞.代谢综合征对冠心病患者颈动脉粥样硬化、血脂及血清脂联素水平的影响[J].中国医药导报,2015,12(6):71-74.
[16] 许银银,刘北忠.血清游离脂肪酸、同型半胱氨酸与代谢综合征的相关性研究[J].检验医学与临床,2015,12(21):3131-3132.
[17] 张苏皖,李素梅.糖尿病肾病与线粒体氧化应激[J].国际病理科学与临床杂志,2011,31(6):535-538.
[18] 陈爱娇,胡浙芳,冯丽君. 2型糖尿病患者膳食营养摄入与血清钙、糖代谢之间关系研究[J].浙江医学杂志,2017,39(12):993-996.
[19] 鲍喜静,李建英,彭一,等. 红花黄色素联合二甲双胍对早期糖尿病肾病患者氧化应激、胰岛素抵抗及肾功能的影响[J].河北医药杂志,2017,39(12):1780-1782.
[20] 贾军利,郝玉杰,王秀梅,等. 加味升降散联合针灸对肥胖相关性肾病患者胰岛素抵抗的影响[J].中医学报杂志,2017,32(7):1336.
[21] 李道平,孙丽云,宫化丽,等. 综合疗法治疗单纯性肥胖 67 例[J].针灸临床杂志,2001,17(9): 11.
[22] 刘志诚. 肥胖病的针灸治疗[M]. 北京: 人民卫生出版社,2008: 64.
[23] 王华,梁凤霞.“双固一通”针灸法与疾病防治[J].湖北中医杂志,2004,26(4): 3-6.
[24] 谢俊,陈泽斌,吴松,等. 标本配穴法电针对慢性心肌缺血大鼠心肌线粒体结构及线粒体DNA相关调控因子表达的影响[J].中华中医药杂志,2017,32(3):1251-1254.
[25] 王华,梁凤霞. 腧穴配伍研究思路和展望[J]. 中国针灸,2012,33(4): 359-362.
[26] Liang FX,Koya D. Acupuncture: is it effective for treatment of insu-lin resistance Diabetes[J].Obesity and Metabolism,2010,12(7):555-569.
[27] 梁凤霞,徐芬,王华,等.“标本配穴”针法刺对糖尿病大鼠下丘脑瘦素受体及 mRNA表达的影响[J]. 中华中医药杂志,2012,30(12): 2773-2775.
[28] 孙娜,黄志真,梁凤霞,等.“双固一通”针法对糖尿病大鼠血清TNF-α 的影响[J]. 湖北中医杂志,2006,28(4): 13-15.
[2] 郭霞.针灸减肥治疗单纯性肥胖患者的疗效及对超敏C反应蛋白、血脂水平的影响[J].光明中医,2017,32(2):248-249.
[3] 王凯悦,刘志诚,徐斌.电针治疗女性胃肠腑热型肥胖并发高脂血症患者疗效分析[J]. 针灸临床杂志,2015,4: 22.
[4] 庞婷婷,刘志诚,徐斌.温针灸联合耳针治疗女性脾肾阳虚型肥胖并发高脂血症临床观察[J].中国针灸,2015(6): 529.
[5] 王鸣,刘志诚,徐斌.温针灸联合耳针治疗脾虚湿阻型肥胖并发高脂血症患者临床疗效[J]. 世界华人消化杂志,2015,24: 3973.
[6] 危北海,贾葆鹏. 单纯性肥胖病的诊断及疗效评定标准[J].中国中西医结合杂志,1998,18(5):317-319.
[7] 李彩云,李月亭. 腹针治疗单纯性肥胖 56 例[J]. 中国民间疗法,2011,19(4): 16.
[8] 王华,杜元灏.针灸学[M].3版.北京:中国中医药出版社,2012:32-120.
[9] 梁凤霞,陈瑞,王华.针灸防治胰岛素抵抗及其相关性疾病的临床研究思路探讨[J]. 中国针灸,2012, 32(7):639-644.
[10] 张安仁,王文春,胡斌,等. 针灸结合行为疗法治疗老年单纯性肥胖病的临床研究[J].西南军医,2007,9(3):1-2.
[11] 黄玲玲,阳期望,王升旭.薄氏股针治疗单纯性肥胖症的临床观察[J]. 针灸临床杂志,2011,27(5): 14-17.
[12] Kahn SE,Hull RL,Utzschneider KM. Mechanisms link-ing obesity to insulin resistance and type 2 diabetes[J].Nature,2006,444(7121): 840-846.
[13] 周一帆.生活方式管理对青春期多囊卵巢综合征合并胰岛素抵抗的治疗效果观察[J].中国社区医师杂志,2017,33(18):144-146.
[14] 岳琳,岳新元. 限食干预对代谢综合征患者血脂及血清IL-6等指标水平的影响[J].国际检验医学杂志,2017,38(12):1652-1654.
[15] 刘英,孙贺,李霞.代谢综合征对冠心病患者颈动脉粥样硬化、血脂及血清脂联素水平的影响[J].中国医药导报,2015,12(6):71-74.
[16] 许银银,刘北忠.血清游离脂肪酸、同型半胱氨酸与代谢综合征的相关性研究[J].检验医学与临床,2015,12(21):3131-3132.
[17] 张苏皖,李素梅.糖尿病肾病与线粒体氧化应激[J].国际病理科学与临床杂志,2011,31(6):535-538.
[18] 陈爱娇,胡浙芳,冯丽君. 2型糖尿病患者膳食营养摄入与血清钙、糖代谢之间关系研究[J].浙江医学杂志,2017,39(12):993-996.
[19] 鲍喜静,李建英,彭一,等. 红花黄色素联合二甲双胍对早期糖尿病肾病患者氧化应激、胰岛素抵抗及肾功能的影响[J].河北医药杂志,2017,39(12):1780-1782.
[20] 贾军利,郝玉杰,王秀梅,等. 加味升降散联合针灸对肥胖相关性肾病患者胰岛素抵抗的影响[J].中医学报杂志,2017,32(7):1336.
[21] 李道平,孙丽云,宫化丽,等. 综合疗法治疗单纯性肥胖 67 例[J].针灸临床杂志,2001,17(9): 11.
[22] 刘志诚. 肥胖病的针灸治疗[M]. 北京: 人民卫生出版社,2008: 64.
[23] 王华,梁凤霞.“双固一通”针灸法与疾病防治[J].湖北中医杂志,2004,26(4): 3-6.
[24] 谢俊,陈泽斌,吴松,等. 标本配穴法电针对慢性心肌缺血大鼠心肌线粒体结构及线粒体DNA相关调控因子表达的影响[J].中华中医药杂志,2017,32(3):1251-1254.
[25] 王华,梁凤霞. 腧穴配伍研究思路和展望[J]. 中国针灸,2012,33(4): 359-362.
[26] Liang FX,Koya D. Acupuncture: is it effective for treatment of insu-lin resistance Diabetes[J].Obesity and Metabolism,2010,12(7):555-569.
[27] 梁凤霞,徐芬,王华,等.“标本配穴”针法刺对糖尿病大鼠下丘脑瘦素受体及 mRNA表达的影响[J]. 中华中医药杂志,2012,30(12): 2773-2775.
[28] 孙娜,黄志真,梁凤霞,等.“双固一通”针法对糖尿病大鼠血清TNF-α 的影响[J]. 湖北中医杂志,2006,28(4): 13-15.