基于辨证论治探讨针灸治疗肥胖合并高脂血症的疗效规律  

Exploring the Efficacy Pattern of Acupuncture in the Treatment of Obesity Combined with Hyperlipidemia Based on Discriminatory Treatment

作　　者：蒋星卓 陈栋[1] 陈子璐 李晓洁 徐斌[3] 刘志诚[3] 原萌谦 连晓阳 JIANG Xing-zhuo;CHEN Dong;CHEN Zi-lu;LI Xiao-jie;XU Bin;LIU Zhi-cheng;YUAN Meng-qian;LIAN Xiao-yang(Jiangsu Province Hospital of Chinese Medicine,Nanjing Jiangsu 210004,China;Jiangsu Health Vocational College,Nanjing 210029,China;Key Laboratory of Acupuncture and Medicine Research of Ministry of Education,Nanjing University of Chinese Medicine,Nanjing,Jiangsu,210023,China)

机构地区：[1]江苏省中医院,江苏南京210004 [2]江苏卫生健康职业学院,江苏南京210029 [3]南京中医药大学针药结合教育部重点实验室,江苏南京210009

出　　处：《时珍国医国药》2023年第4期905-908,共4页Lishizhen Medicine and Materia Medica Research

基　　金：国家自然科学基金(81873238;81904290)。

摘　　要：目的 观察针灸治疗肥胖合并高脂血症患者的临床疗效,并探讨不同证型针灸疗效的差异。方法 回顾纳入1188例肥胖合并高脂血症受试者,其中脾虚湿阻200例、肝郁脾虚198例、脾肾阳虚197例、痰湿内阻198例、胃肠腑热199例及阴虚夹瘀196例,采取辨证施治针灸疗法。观察治疗前后各组患者的肥胖指标、脂质指标的变化以评估疗效。结果 (1)针灸疗法可显著改善肥胖指标和脂质指标:减肥总有效率95.96%,降脂总有效率87.37%(均P<0.01);(2)肝郁脾虚患者总有效率、减肥及降脂总有效率均最高[93.5%(187/200),97%(196/200),93.5%(187/200)](P<0.01)。结论 针灸治疗肥胖合并高脂血症具有减肥降脂的双重疗效,且通过辨证施治对于不同证型的患者均有显著疗效,但对肝郁脾虚型疗效最显著。Objective To observe the clinical efficacy of acupuncture in the treatment of obese patients with hyperlipidemia and to investigate the differences in the efficacy of acupuncture in different evidence types.Methods 1188 obese patients with hyperlipi⁃demia,including 200 with spleen deficiency and dampness obstruction,198 with liver depression and spleen deficiency,197 with spleen and kidney Yang deficiency,198 with phlegm and dampness internal obstruction,199 with heat in the stomach and intes⁃tines,and 196 with Yin deficiency and stasis,were retrospectively enrolled.The changes of obesity index and lipid index in each group before and after treatment were observed to assess the efficacy.Results 1.Acupuncture therapy significantly improved the obesity index and lipid index:the total effective rate of weight loss was 95.96%,and the total effective rate of lipid reduction was 87.37%(all P<0.01);2.The patients with liver deficiency and spleen deficiency had the highest total effective rate,weight loss and lipid reduction[93.5%(187/200),97%(196/200),93.5%(187/200)](P<0.01).Conclusion Acupuncture treatment for obesity combined with hyperlipidemia has the dual efficacy of weight loss and lipid reduction,and it has significant efficacy for patients with different types of symptoms through evidence-based treatment,but it has the most significant efficacy for the type of liver-depression and spleen-deficiency.

关 键 词：肥胖 高脂血症 针灸 不同证型 辨证论治 

分 类 号：R245[医药卫生—针灸推拿学]