针叩联合耳针对阴虚夹瘀型肥胖并发高脂血症“脂肪-胰岛内分泌轴”的调节  

Effect of Combined Therapy of Acupuncture, Tapping and Auricular Needling on Fatty-insulin Endocrine Axis in Obesity Complicated with Hyperlipidaemia Patients with Yin-deficiency and Blood-stasis Pattern

作　　者：王鸣[1] 刘志诚[1] 徐斌[1] 

机构地区：[1]南京中医药大学第二临床医院,南京210029

出　　处：《世界科学技术-中医药现代化》2015年第10期2049-2055,共7页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家自然科学基金委面上项目(30873307):针刺不同穴位影响肥胖大鼠下丘脑GS活动及AMPK表达的研究;负责人:徐斌

摘　　要：目的:观察"针叩联合耳针"对阴虚夹瘀型肥胖并发高脂血症患者"脂肪-胰岛内分泌轴"功能的调节作用。方法:本研究共纳入108例阴虚夹瘀型肥胖并发高脂血症患者,随机分为"针叩联合耳针"组和"针叩"组,各54例。针叩耳针组采用针刺和叩刺联合耳针施治,"针叩组"采用针刺和叩刺联合施治,并与正常组52例患者作对比。观察两组患者治疗前后"脂肪-胰岛内分泌轴"指标、脂质指标、肥胖指标、植物神经功能指数(Y值)的变化和临床减肥降脂疗效。结果:"针叩耳针组"与"针叩组"患者治疗前的肥胖指标、FINS、FPG、Homa-IR、FLP、TG、TC、LDL-C及Y值均显著高于正常组(P<0.01),而HDL-C、ISI却显著低于正常组(P<0.01)。治疗后两组患者均取得了较为满意的减肥和降脂疗效,"脂肪-胰岛内分泌轴"指标(FINS、FPG、Homa-IR、FLP)均显著下降(P<0.05),ISI显著上升(P<0.05)。"针叩联合耳针"组在调整"脂肪-胰岛内分泌轴"水平、血脂水平及植物神经功能水平上的效果显著优于"针叩组"(P<0.05)。结论:阴虚夹瘀型肥胖并发高脂血症患者存在"脂肪-胰岛内分泌轴"功能紊乱,"针叩联合耳针"及"针叩治疗"均对其功能具有良性的调整作用,且"针叩联合耳针"治疗的疗效更显著。This study was aimed to observe effect of combined therapy of acupuncture, tapping and auricular needling on fatty-insulin endocrine axis in obesity complicated with hyperlipidaemia patients with yin-deficiency and blood-stasis pattern. A total of 108 patients with obesity complicated with hyperlipidaemia of yin-deficiency and blood-stasis pattern were randomly divided into the treatment group of combined therapy of acupuncture, tapping and auricular needling, and the acupuncture and tapping group, with 54 cases in each group. The comparison was made to 52 patients in the normal group. Observations were made on changes of fatty-insulin endocrine axis index, lipid index, obesity index, vegetative nerve function index（Y value） and clinical weight-reducing and lipid-reducing effect. The results showed that the pretreatment obesity index, fasting insulin（FINS）, fasting plasma glucose（FPG）, insulin resistance index（Homa-IR）, fasting leptin（FLP）, triglyceride（TG）, total cholesterol（TC）, low density lipoprotein（LDL-C） and Y value of patients in both groups were significantly higher than those of the normal group（P〈0.01）. However, the high density lipoprotein（HDL-C） and insulin sensitivity index（ISI） were significantly lower than those of the normal group（P〈0.01）. After treatment, both groups received satisfied effects on weight-reducing and lipid-reducing. The fatty-insulin endocrine axis indexes（FINS, FPG, Homa-IR and FLP） were significantly reduced（P〈0.05）; and ISI was significantly increased（P〈0.05）. The combined therapy of acupuncture, tapping and auricular needling had better regulation effects on the fattyinsulin endocrine axis level, lipid level and vegetative nerve function level compared with the acupuncture and tapping group（P〈0.05）. It was concluded that patients with obesity complicated with hyperlipidaemia of yindeficiency and blood-stasis pattern had dysfunction of the fatty-insulin endocrine axis. The combined therapy of acupuncture

关 键 词：肥胖 高脂血症 针刺 耳针 脂肪-胰岛内分泌轴 

分 类 号：R245[医药卫生—针灸推拿学]