针灸治疗重度肥胖并发高脂血症患者的疗效比较  

Comparison of therapeutic effects of acupuncture and moxibustion on patients with severe obesity complicated with hyperlipidemia

作　　者：黄迪迪 刘志诚[1] 徐斌[2] HUANG Di-di;LIU Zhi-cheng;XU Bin(Nanjing University of Chinese Medicine,Nanjing 210023,China)

机构地区：[1]南京中医药大学,南京210023 [2]南京中医药大学第二临床医学院针药结合教育部重点实验室,南京210023

出　　处：《中华中医药杂志》2020年第1期490-493,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81303019,No.30873307)。

摘　　要：目的:观察针灸治疗重度肥胖并发高脂血症患者作用疗效,并分析影响针灸疗效的因素。方法:纳入201例重度肥胖病发高脂血症患者,根据其临床症状和体征,采用针灸疗法辨证施治。观察针灸治疗前后重度肥胖并发高脂血症患者的综合疗效以及各项肥胖指标(体质量、胖肥度、体质量指数及体脂百分率)、脂质指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)]、空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素敏感性指数(ISI)、胰岛素抵抗指数(Homa-IR)、胰岛β细胞功能指数(Homa-β)、空腹瘦素水平(FLP)的变化特点。分析不同性别、年龄段、病程及诱发因素对针灸治疗重度肥胖伴高脂血症患者疗效影响。结果:重度肥胖并发高脂血症患者治疗后肥胖指标、脂质指标及FPG、FINS、ISI、Homa-IR、Homa-β、FLP较治疗前均改善(P<0.01);男性的针灸效果明显优于女性,18~30岁患者效果最佳有效率为89.29%,病程及诱发因素与针灸疗效间无明显关系。结论:针灸对重度肥胖并发高脂血症患者具有减肥和调脂双重作用,能够纠正患者胰岛素及瘦素抵抗,减少脂肪合成,在减重和降脂中男性组改善率优于女性组,对于高脂血症的治疗与预防有重要意义。Objective:To observe the effects of acupuncture and moxibustion on severe obesity complicated with hyperlipidemia,and analyze the factors which influence the therapeutic effect.Methods:A total of 201 cases of severe obesity complicated with hyperlipidemia.According to their clinical symptoms and patterns,acupuncture and moxibustion therapies are applied.Recording the obesity index weight,obesity degree,body mass index,and body fat percentage,the blood lipid index [total cholesterol (TC),triglyceride (TG),low density lipoprotein (LDL-C),high density lipoprotein (HDL-C)] and the fasting plasma glucose (FPG),fasting insulin (FINS) insulin sensitivity index (ISI),insulin resistance index (Homa-IR),β-cell function index (Homa-β),fasting leptin (FLP).To analyze the effects of different genders,ages,pathogenesis and inducing factors on the treatment of severe obesity with hyperlipidemia.Results:After treatment,obesity index,lipid index and FPG,FINS,ISI,Homa-IR,Homa-β and FLP were all improved compared with before treatment (P<0.01).The acupuncture effects of male was significantly better than that of female,and the effective rate was 89.29% for patients aged 18~30 years,and there was no significant relationship between the course and the induction factors.Conclusion:Acupuncture has the weight loss and lipid dual function in patients with severe obesity complicated with hyperlipidemia,can correct patients with insulin and leptin resistance,reduce fat synthesis.The effect of weight loss and lipid-lowering in male is better than that of female group,it has important significance for the treatment and prevention of hyperlipidemia.

关 键 词：针灸 重度肥胖 高脂血症 疗效 临床 

分 类 号：R246.1[医药卫生—针灸推拿学]