脂肪层穴位埋线治疗腹型肥胖:随机对照试验  

Acupoint thread-embedding at fat layer for abdominal obesity:a randomized controlled trial

作　　者：晏明熙 朱敏 全菲 陈盼碧 崔瑾 YAN Mingxi;ZHU Min;QUAN Fei;CHEN Panbi;CUI Jin(School of Acupuncture-Moxibustion and Tuina,Guizhou University of TCM,Guiyang 550025,China;School of Acupuncture-Moxibustion and Tuina, Chengdu University of TCM;Department of Rehabilitation,First Affiliated Hospital of Guizhou University of TCM,Guiyang 550001,China;Department of Acupuncture-Moxibustion,First Affiliated Hospital of Guizhou University of TCM,Guiyang 550001,China)

机构地区：[1]贵州中医药大学针灸推拿学院,贵阳550025 [2]成都中医药大学针灸推拿学院 [3]贵州中医药大学第一附属医院康复科,贵阳550001 [4]贵州中医药大学第一附属医院针灸科,贵阳550001

出　　处：《中国针灸》2024年第12期1370-1376,共7页Chinese Acupuncture & Moxibustion

基　　金：国家重点研发项目结转经费项目:3416-416230019。

摘　　要：目的:观察脂肪层穴位埋线治疗腹型肥胖的临床疗效及对糖脂代谢的影响。方法:将96例腹型肥胖患者随机分为穴位埋线组(48例,脱落3例)和假穴位埋线组(48例,脱落3例)。在生活方式干预的基础治疗上,穴位埋线组于中脘、气海、关元及双侧梁门、丰隆、脾俞等穴行穴位埋线治疗,线体埋置在脂肪层;假穴位埋线组取穴及操作同穴位埋线组,但不埋入线体。两组均每2周1次,治疗12周,共6次。分别于治疗前后及治疗结束后12周(随访)测量及计算两组患者腰围、体质量、体质量指数(BMI)、腰臀比(WHR)和腰围身高比(WHtR),观察两组患者食欲视觉模拟量表(VAS)评分;分别于治疗前后测量两组患者腹部内脏脂肪面积(VFA)、皮下脂肪面积(SFA),检测并计算糖脂代谢指标[空腹血糖(FBG)、空腹胰岛素(FINS)、稳态模型胰岛素抵抗(HOMA-IR)指数及总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)含量],检测血清瘦素、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)含量;并于治疗结束后2周评定临床疗效。结果:治疗后及随访时,穴位埋线组患者腰围、体质量、BMI、WHR、WHtR和食欲VAS评分较治疗前降低(P<0.01);治疗后,假穴位埋线组患者腰围、体质量、BMI、WHtR和食欲VAS评分较治疗前降低(P<0.01)。除治疗后体质量外,穴位埋线组患者治疗后及随访时腰围、体质量、BMI、WHR、WHtR低于假穴位埋线组(P<0.01,P<0.05);治疗后,穴位埋线组患者食欲VAS评分低于假穴位埋线组(P<0.01)。治疗后,两组患者腹部VFA、SFA较治疗前减少(P<0.01,P<0.05);穴位埋线组患者血清FBG、FINS、HOMA-IR指数及TC、TG、LDL-C、瘦素、TNF-α、IL-6含量较治疗前降低(P<0.01),血清HDL-C较治疗前升高(P<0.01);假穴位埋线组患者血清FBG、HOMA-IR指数较治疗前降低(P<0.01,P<0.05)。治疗后,穴位埋线组患者腹部SFA少于假穴位埋线组(P<0.01),�Objective To observe the clinical efficacy of acupoint thread-embedding at fat layer for abdominal obesity and its effects on glucose and lipid metabolism.Methods Ninety-six patients with abdominal obesity were randomly divided into an acupoint embedding group(48 cases,3 cases dropped out)and a sham embedding group(48 cases,3 cases dropped out).Both groups received lifestyle interventions as basic treatment.The acupoint embedding group underwent thread-embedding at Zhongwan(CV 12),Qihai(CV 6),Guanyuan(CV 4),and bilateral Liangmen(ST 21),Fenglong(ST 40),and Pishu(BL 20),with the thread implanted in the fat layer.The sham embedding group followed the same acupoint selection and procedure but without catgut implantation.Both groups were treated once every two weeks for 12 weeks,for a total of six treatments.Waist circumference,body weight,body mass index(BMI),waist-to-hip ratio(WHR),and waist-to-height ratio(WHtR)were measured,and appetite was assessed using the visual analogue scale(VAS)before and after treatment and at 12 weeks after treatment completion(follow-up)in the two groups.Visceral fat area(VFA)and subcutaneous fat area(SFA)at abdomen were measured,and blood glucose and lipid metabolism markers,including fasting blood glucose(FBG),fasting insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR)index,total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),leptin,tumor necrosis factor-α(TNF-α),and interleukin-6(IL-6),were also tested before and after treatment in the two groups.Clinical efficacy was evaluated two weeks after treatment completion.Results After treatment and at follow-up,the waist circumference,body weight,BMI,WHR,WHtR,and appetite VAS scores in the acupoint embedding group were decreased compared to those before treatment(P<0.01).In the sham embedding group,waist circumference,body weight,BMI,WHtR,and appetite VAS score were also reduced after treatment compared to those before treatment(P<0.01).Except

关 键 词：腹型肥胖 穴位埋线 脂肪层 糖脂代谢 炎性反应 随机对照试验 

分 类 号：R246.1[医药卫生—针灸推拿学]