基于MRI及氢质子磁共振波谱评估针灸对腹型肥胖患者减脂塑形的疗效及肝脏脂肪分布的影响  

Evaluate the efficacy of acupuncture and moxibustion on fat reduction and liver fat distribution in patients with abdominal obesity based on MRI and 1 H-magnetic resonance spectroscopy

作　　者：简雪平 朱嘉骏 郭建徕 聂斐[1] 黄文泉[1] JIAN Xueping;ZHU Jiajun;GUO Jianlai;NIE Fei;HUANG Wenquan(Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine,Nanchang,Jiangxi,330006,China)

机构地区：[1]江西中医药大学附属医院,江西南昌330006

出　　处：《当代医学》2025年第1期81-84,共4页Contemporary Medicine

基　　金：江西省中医药管理局科技计划项目(2023B1049)。

摘　　要：目的基于MRI及氢质子磁共振波谱(1H-magnetic resonance spectroscopy,1H-MRS)评估针灸对腹型肥胖患者减脂塑形的疗效及肝脏脂肪分布的影响。方法选取2022年1月至2023年8月江西中医药大学附属医院收治的120例腹型肥胖患者作为研究对象,按照随机数字表法分为常规组与针灸组,每组60例。常规组给予盐酸二甲双胍片治疗,针灸组在常规组基础上联合电针和穴位埋线治疗,两组均于治疗前后进行MRI和1H-MRS检查。比较两组临床指标、血脂指标、腹部脂肪MRI数据[皮下脂肪组织(subcutaneous adipose tissue,SAT)、腹腔内脂肪组织(visceral adipose tissue,VAT)、总脂肪体积(total fat volume,TFV)、V/S]、1H-MRS检查数据[肝内脂质含量(intrahepatic content of lipid,IHCL)]及不良反应发生情况。结果治疗后,两组体质量均轻于治疗前,两组体重指数(body mass index,BMI)及针灸组腰臀比均小于治疗前,两组腰围均短于治疗前,且针灸组体质量轻于常规组,BMI、腰臀比均小于常规组,腰围短于常规组,差异有统计学意义(P<0.05)。治疗后,两组甘油三酯、总胆固醇水平及针灸组高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平均低于治疗前,且针灸组甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平均低于常规组,差异有统计学意义(P<0.05)。治疗后,两组VAT、TFV、V/S、IHCL及针灸组SAT均小于治疗前,且针灸组VAT、SAT、TFV、V/S、IHCL均小于常规组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论基于MRI及1H-MRS评估分析显示,针灸能显著增强腹型肥胖患者减脂塑形的疗效,对其VAT、SAT、IHCL均有明显降低作用,且不良反应率较低,安全性较高。Objective To evaluate the efficacy of acupuncture and moxibustion on fat reduction and liver fat distribution in patients with abdominal obesity based on MRI and 1H-magnetic resonance spectroscopy(1H-MRS)spectroscopy.Methods 120 patients with abdominal obesity admitted to the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from January 2022 to August 2023 were selected as the research subjects,they were divided into the routine group and the acupuncture group according to the random number table method,with 60 cases in each group.The routine group was treated with metformin hydrochloride tables,and the acupuncture group was treated with electroacupuncture and acupoint catgut embedding on the basis of the conventional group,MRI and 1H-MRS were performed in the two groups before and after treatment.The clinical indexes,blood lipid indexes,abdominal fat MRI data(subcutaneous adipose tissue[SAT],visceral adipose tissue[VAT],total fat volume[TFV],V/S),1H-MRS examination data(intrahepatic content of lipid[IHCL])and adverse reactions were compared between the two groups.Results After treatment,the body mass of the two groups were lighter than that before treatment,body mass index(BMI)ratio of the two groups and waist-to-hip in the acupuncture group were lower than those before treatment,and the waist circumference of the two groups were shorter than that before treatment;the body mass in the acupuncture group was lighter than that in the routine group,BMI and waist-to-hip ratio were lower than those in the routine group,and the waist circumference was shorter than that in the routine group,the differences were statistically significant(P<0.05).After treatment,the levels of triglyceride and total cholesterol of the two groups and the levels of high-density lipoprotein cholesterol and low-density lipoprotein cholesterol in the acupuncture group were lower than those before treatment,and the levels of triglyceride,high-density lipoprotein cholesterol and low-density lipoprotein cholesterol in the

关 键 词：MRI 氢质子磁共振波谱 腹型肥胖 肝脏脂肪 

分 类 号：R245[医药卫生—针灸推拿学]