基于“腘肉”探索《黄帝内经》肥胖分型的研究  

Study on the classification of obesity based on“Guo Rou”in the Huangdi Neijing

作　　者：朱绘 张佳[1,2,3,4,5] 欧阳卡妮 王景芝 张国红 肖明中 李晓东[1,2,3,4,5] ZHU Hui;ZHANG Jia;OUYANG Ka-ni;WANG Jing-zhi;ZHANG Guo-hong;XIAO Ming-zhong;LI Xiao-dong(Hubei University of Chinese Medicine,Wuhan 430065,China;Institute of Hepatology,Hubei Provincial Hospital of TCM,Hubei Provincial Key Laboratory of Traditional Chinese Medicine Liver and Kidney Research and Application,Wuhan 430061 China;Affiliated Hospital of Hubei University of Chinese Medicine,Wuhan 430060,China;Hubei Provincial Academy of TCM,Wuhan 430060,China;Hubei Shizhen Laboratory,Wuhan 430061,China;Wuchang District Shouyi Road Street Community Health Service Center,Wuhan 430061,China)

机构地区：[1]湖北中医药大学,湖北武汉430065 [2]湖北省中医院肝病研究所,中医肝肾研究及应用湖北省重点实验室,湖北武汉430061 [3]湖北中医药大学附属医院,湖北武汉430060 [4]湖北省中医药研究院,湖北武汉430060 [5]湖北时珍实验室,湖北武汉又430061 [6]武汉市武昌区首义路街社区卫生服务中心,湖北武汉430065

出　　处：《时珍国医国药》2025年第5期985-989,共5页Lishizhen Medicine and Materia Medica Research

基　　金：湖北省自然科学基金(2020CFA023)。

摘　　要：目的从现代客观化指标分析《黄帝内经》肥胖分型中膏人和脂人判别的科学性及临床结局差异,探索经典条文的科学内涵。方法纳入7638名于湖北省中医院肥胖专科就诊的超重/肥胖人群,测量相关人体测量学指标,应用China-PAR模型探讨不同分型人群心脑血管疾病的风险差异。结果脂人骨骼肌、双下肢去脂重量、基础代谢率以及水分含量更高(P<0.001);膏人体重、BMI、体脂率、内脏脂肪面积和双下肢体脂量更高(P<0.001),腹围更大(P=0.001),臀围更大(P=0.011)。在终身风险的预测上,脂人发生心脑血管病风险显著高于膏人(P<0.01)。结论基于“腘肉”的坚实与否对下肢脂肪、肌肉和水分进行膏人和脂人的判定的方式,或可作为肥胖分型指标应用于临床。Objective To analyze the scientific validity and clinical outcome differences between“Gao Ren(fat poeple with beer belly)”and“Zhi Ren(people with skinny builds)”in the obesity classifications of the Huangdi Neijing(Yellow Emperor's Canon of Medicine)using modern quantitative indicators,thereby exploring the scientific basis of classical textual descriptions.Methods A total of 7,638 overweight/obese individuals from the Obesity Clinic of Hubei Provincial Hospital of TCM was enrolled.Relevant anthropometric indicators were measured,the China-PAR model was applied to investigate differences in cardiovascular and cerebrovascular disease risks among different subtype groups.Results The“Zhi Ren”group exhibited higher skeletal muscle mass,lower limbs fat-free weight,basal metabolic rate,and body water content(P<0.001).The“Gao Ren”group demonstrated greater body weight,BMI,body fat percentage,visceral fat area,lower limbs fat-free weight(P<0.001),as well as larger waist circumference(P=0.001)and hip circumference(P=0.011).Lifetime risk prediction revealed significantly elevated cardiovascular and cerebrovascular disease risk in the“Zhi Ren”group compared to the“Gao Ren”group(P<0.01).Conclusion The classification of“Gao Ren”and“Zhi Ren”based on the firmness of“Guo Rou(flesh of the knee back)”,which reflects fat,muscle,and water content in lower limbs may serve as a clinically applicable biomarker system for obesity classification.

关 键 词：肥胖 腘肉 黄帝内经 膏人 脂人 

分 类 号：R221[医药卫生—中医基础理论]