陆氏健脾和胃针刺法治疗代谢综合征的随机对照研究  

Randomized Controlled Study on the Treatment of Metabolic Syndrome with Lu′s Spleen-invigorating and Stomach-harmonizing Acupuncture Method

作　　者：黄丽[1] 王秋月 张小晋[1] 范轶斌 丁鲁 金珠[1] 吴焕淦[2] HUANG Li;WANG Qiuyue;ZHANG Xiaojin;FAN Yibin;DING Lu;JIN Zhu;WU Huangan(The Seventh People′s Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China;Shanghai Research Institute of Acupuncture and Meridian,Shanghai 200030,China)

机构地区：[1]上海中医药大学附属第七人民医院,上海200137 [2]上海市针灸经络研究所,上海200030

出　　处：《世界中医药》2024年第14期2166-2170,共5页World Chinese Medicine

基　　金：国家重点基础研究发展计划“973计划”项目(2015CB554501);国家中医药领军人才“岐黄学者”;上海市卫生健康委员会面上项目(202040002);上海市浦东新区卫生健康委员会优秀青年医学人才培养项目(PWRq2023-47)。

摘　　要：目的:观察陆氏健脾和胃针刺法治疗代谢综合征(MetS)的临床疗效。方法:选取2020年3月至2022年3月于上海市第七人民医院就诊的MetS患者90例作为研究对象,按照随机数字表法分为观察组和对照组,每组45例。对照组采用健康宣教及常规药物治疗,观察组在此基础上加用陆氏健脾和胃针刺法。比较2组患者治疗前后体质量、腰围、体质量指数(BMI)、血脂、血糖、血压的变化。结果:意向性治疗(ITT)分析结果显示,2组患者各时间点体质量、腰围及BMI均较治疗前显著降低(P<0.05),且观察组各时间点体质量、腰围及BMI显著低于对照组(P<0.05);2组患者治疗后血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)均较治疗前下降(P<0.05),高密度脂蛋白胆固醇(HDL-C)明显上升(P<0.05),治疗后观察组TC、TG、HDL-C变化幅度较对照组更显著(P<0.05);2组患者治疗后空腹血糖(FBG)、糖化血红蛋白(HbA1c)及胰岛素抵抗指数(HOMA-IR)均比治疗前降低(P<0.05),治疗后观察组FPG、HbA1c及HOMA-IR值均比对照组降低明显(P<0.05)。2组患者治疗前后血压指标无明显变化(P>0.05),针刺期待值与临床疗效无明显相关性(P>0.05)。结论:陆氏健脾和胃法针刺法能有效降低MetS患者的体质量、腰围、BMI,改善血脂、血糖水平,并且具有良好的远期疗效。Objective:To observe the clinical efficacy of Lu′s spleen-invigorating and stomach-harmonizing acupuncture method in the treatment of metabolic syndrome(MetS).Methods:Ninety MetS patients who visited the Seventh People′s Hospital of Shanghai from March 2020 to March 2022 were enrolled and randomly divided into an observation group and a control group according to a random number table,with 45 patients in each group.The control group received health education and conventional drug treatment,while the observation group additionally received Lu′s spleen-invigorating and stomach-harmonizing acupuncture method.Changes in weight,waist circumference,body mass index(BMI),blood lipids,blood glucose,and blood pressure were compared before and after treatment in both groups.Results:Intent-to-treat(ITT) analysis showed that weight,waist circumference,and BMI significantly decreased at each time point in both groups compared to those before treatment(P<0.05).The weight,waist circumference,and BMI in the observation group were lower than those in the control group at each time point(P<0.05).After treatment,both groups showed significant decreases in serum total cholesterol(TC) and low-density lipoprotein cholesterol(LDL-C)(P<0.05),and significant increases in high-density lipoprotein cholesterol(HDL-C) compared to those before treatment(P<0.05).The changes in TC,triglycerides(TG),and HDL-C were more significant in the observation group than in the control group(P<0.05).Fasting blood glucose(FBG),glycated hemoglobin(HbA1c),and homeostasis model assessment of insulin resistance(HOMA-IR) decreased significantly in both groups after treatment(P<0.05),with greater reductions in the observation group than in the control group(P<0.05).There were no significant changes in blood pressure indicators before and after treatment in either group(P>0.05),and the expectation of acupuncture efficacy was not significantly correlated with clinical outcomes(P>0.05).Conclusion:Lu′s spleen-invigorating and stomach-harmonizing acupuncture me

关 键 词：针刺 代谢综合征 陆氏针灸 流派传承 随机对照试验 经络 辨证 健脾和胃 远期 疗效 

分 类 号：R245[医药卫生—针灸推拿学]