耳穴贴压治疗单纯肥胖症的作用及机理研究
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摘要
Body Mass Index(BMI)>30kg/m2为肥胖。过重及肥胖是常见糖尿病或高血压等疾病最大的潜在危险因素,并可对个人心理产生不良影响,如造成个体自卑、缺失自信心、情绪低落、忧郁焦虑的负面情绪等,并产生偏差的体型意识及自我价值混淆甚至产生心理精神上疾病。因此预防和及时治疗肥胖症,对提高民众的健康水平对台湾具有重大的现实意义和社会意义。
     目前肥胖的治疗尚无有效的方法。饮食及运动是预防此病的方法。减肥药物疗效不肯定且有较多的副作用,易反弹。手术治疗是唯一有效治愈肥胖及代谢症候群的治疗方式。中医通过辨证治疗、辨病治疗、单味药治疗以及针灸推拿疗法治疗单纯性肥胖症,效果显著,副作用小,反弹率低。
     耳穴贴压是目前中医热门的减肥疗法。耳穴贴压对于单纯性肥胖的治疗有显著的效果,临床医家对于肥胖的选穴约有25个穴位,耳穴贴压的耳穴有:肝、脾、肾、肺、胃、三焦、口、丘脑、大肠、饥点、渴点、内分泌、皮质下和肛门等。多与消化系统和内分泌为主,肥胖乃是阴阳失去平衡,经络和脏腑功能失常所致。但存在取穴点多,手法操作复杂,机理不明等缺点,本论文为推广运用耳穴减肥的实际效果及操作可行性,采用神门、饥点、胃三个穴位进行研究耳穴贴压减肥的效果,并运用人体经络良导性及心律变异等指标探索耳穴贴压减肥的可能机理。
     [研究目的]:
     通过观察实验组单纯性肥胖症之女性以耳穴贴压减肥过程中与对照组比较,经一个月耳穴贴压疗护后,探讨减肥过程中身体组成(体重、BMI、腰围、臀围)、经络的良导性与自律神经系统改变(心率变异度值变化之差异)的现象与机理。为临床耳穴贴压减肥简化操作穴位和步骤提供科学的依据,并对耳穴的贴压减肥机理提供一定的实验支持。
     [研究方法]:
     1.研究对象:将60位身体质量指数(body mass index,BMI)大于30合乎台湾卫生署肥胖症标准妇女,由研究者收案后以随机分派各30人成为实验组与对照组。各组流失率考虑在3%(经验值)。
     2.分组设计:
     于台湾东部诊所与大学为收案地点,由中西医师协同判定单纯肥胖症者,并邀请志愿加入为研究对象,将收案对象随机分配分为实验组和对照组,给予两组前测,测定身体组成、良导络及心律变异,进行基线值的确认。实验组将接受耳穴贴压疗护介入措施,王不留行籽耳豆贴片贴于饥点、神门和胃点,七天一疗程,周一更换对耳耳穴疗护,并与前测同一时段测定身体组成、良导络及心律变异,比避免经络的子午流注的变异,共计一个月,对照组则不给予任何介入措施。
     3.耳穴贴压方式与使用
     将王不留行籽与剪好0.5×0.5公分的胶布,分别贴压在单耳的于饥点、神门和胃点之耳穴,于每日三餐进食前15分钟由研究者电话通知,请研究对象轮流贴压每个穴位15下,默数0001至0015,计一分钟,三穴计时间三分钟,需记录下压痛时间,每周一至研究室更换至另一耳。对照组不进行任何的干预。
     4.检测指标及方法
     测量各项指针流程如下:
     (1)请志愿受测者于填写受测者基本资料调查表、健康调查表及签写受测者同意书。测量前36小时请勿饮酒;测量前24小时禁止摄取咖啡及含咖啡因之产品;测量前一晚请勿熬夜;测量前4小时请勿进食;测量中除实验人员提供之饮食外,请勿进食其他食品
     (2)身高体重之测量
     受测者先如厕,避免膀胱积尿等,并将身上所有重物拿下,穿着短袖上衣和短裤,脱去鞋袜,依照SP-901型。自动身高体重测量计之双脚站立位置,轻松站直,按下测量按钮,即可读出身高、体重值,共测量三次,取两次接近值的平均。
     (3)身体组成:
     1.腰臀围之测量
     研究对象仅着下身衣物,双手下垂双脚拢站立,以标准皮尺于自然呼气终期,测量其腰围及臀围(以公分量至小数以下一位)。腰臀围比值=腰围/臀围。测量时受测者闭目,测量者为同一人,每次测量3次,取其平均值,测量之结果不让售测者知道。
     2、良导络值的测量:
     2.1开始检测前,请受测者休息5分钟后再开始测验。
     2.2请受测者露出测量部位,且脱鞋袜、卸除身上可导电之物品。
     2.3检测前,不可刺激代表测定点部位之皮肤。如洗手、搓手或烘手脚取暖保温等。
     2.4请受测者抓握手握导子,并请抓握力道自始至终都均等。因为抓握力道大,电流量也较大;抓握力道小,电流量也较小。但测验期间,左右手交不交换握棒均无差。
     2.5依照右列顺序进行测验:左手手部良导点H1至H6→右手手部良导点H1至H6→左脚脚部良导点Fl至F6→右脚脚部良导点F1至F6。
     2.6检测时,探测导子须全面性平整地贴至测量部位的皮肤表面上(如图6)。
     2.7检测手部时,检测者之非测手手心向上,食(或中)指与大拇指之指腹分别对称、平行地挟住受测者手腕之最小围两侧,并注意探测导子不可处碰到检测者。
     2.8如代表测定点之部位的皮肤有伤口时,会增加其电流量,故将会稍微移动测量部位。
     3.心律变异之测定:
     前测及后测各量测一次,量测时需将腕式生理监视器--心律大师(ANSWatch(?))适当佩戴于受测者左手腕上,量测高度约略与心脏位置同高,量测时间大约6-7分钟,在量测过程中受测者不得有任何的移动,以确保量测数据的质量与客观性。
     [研究结果]:
     1、前测年龄、身高、体重、身体质量指数、腰围、臀围差异比较
     结果表明:两组年龄、身体质量指数、腰围、臀围、均无显著差异。
     2、前测之组间心律变异与良导络值差异比较
     实验组与对照组前测在安静收缩压、安静舒张压、安静心跳率与平均R-R波间期、HF%、LF/HF的比值方面均无显著差异。
     3、后测之组间变量差异比较
     接受耳穴贴压干预治疗后,实验组在体重、身体质量指数、腰围、臀围的减少百分比与对照组相比均有统计上显著差异(P<0.05)。而心率变异值在实验组、对照组前后测则未达统计上差异(P>0.05)。
     [研究结论]:
     耳穴贴压能显著改善单纯肥胖症女性的小肠经、大肠经、三焦经、脾经、肾经、膀胱经、胆经、胃经的良导值平衡。
     耳穴贴压神门、饥点、胃点,每天餐前按压15下,持续时间四周能显著改善单纯肥胖症女性的身体组成,包括减轻体重、减少臀围、腰围及身体质量指数。
     耳穴贴压神门、饥点、胃点能显著改善单纯肥胖症女性的小肠经、大肠经、三焦经、脾经、肾经、膀胱经、胆经、胃经的良导值平衡。
     耳穴贴压对于单纯肥胖症女性R-R波间期、代表心脏副交感神经活动状态的HF%、代表心脏交感神经活动状态的LF及代表交感神经与副交感神经两大系统的衡状态LF/HF比值,实验组与对照组无显著差异。但有降低副交感神经的倾向。
     本论文尝试以三个耳穴穴位验证是否可以有效的改善单纯肥胖症女性的肥胖指标:因为中外医家对于肥胖的选穴约有25个穴位,耳穴贴压的耳穴常用的有:肝、脾、肾、肺、胃、三焦、口、丘脑、大肠、饥点、渴点、内分泌、皮质下和神门等。多与消化系统和内分泌为主,肥胖乃是阴阳失去平衡,经络和脏腑功能失常所致,本病病机有脾虚、痰湿阻滞、阳气不足、蒸发乏力及体内痰水潴留。本研究,选定神门、饥点、胃三个穴位。研究结果发现,相较于对照组,身体质量指数显著降低2.1%,体重降低2.3%、腰围降低3.7%、臀围减少2.0%,显示贴压三个耳穴对于女性单纯肥胖症有改善身体组成的成效,有利于未来的推广。
     本论文的创新点:
     (1)本文采用耳穴贴压法对神门、饥点、胃三个穴位的减肥作用进行研究,达到了简化穴位操作减肥的目的,有助于临床的推广运用。
     (2)首次运用以科学仪器良导络MEAD检测耳穴贴压对于经络良导性的影响,为耳穴贴压减肥的机理提供科学的实证思路。
     (3)首次运用简易的手持式心律大师仪器替代复杂的心律变异测量仪器,为未来此类研究的提供有益参考。
Overweight and obesity is a common diabetes or high blood pressure and other diseases of potential risk factors, especially the incidence of cardiovascular disease, diabetes, diabetes, certain cancers and other diseases or mortality, and overweight overweight have a close relationship. Obesity on the individual psychological aspects will also be the impact will cause the individual self-esteem,lack of self-confidence, depression,negative emotions of depression,anxiety, confusion and bias of body awareness and self-worth,and thus social maladjustment, and psychological spirit with the disease.World Health Organization(WHO) definition,BMI (Body Mass lndex)>30kg/m2as obese.The purpose of this study to explore the palliative care month ear taping and pressing on body composition (weight, BMI,waist circumference, hip circumference), ryodoraku values and heart rate variability values change differences.
     Research purposes
     The experimental method was adopted in this topic, through the observation of the experimental group with simple obesity women compared with the control group to explore the scientific evidence included the phenomenon and mechanism of body composition, weight loss process, the meridians and autonomic nervous system changes. Since this study belongs to the short-term treatment experiments, the research focus is to explore the changes of parameters after the ear acupoint application therapy.
     Research hypothesis
     Hypothesis1:After the ear acupoint application therapy,the body composition (weight, waist circumference, body mass index) were significantly different between the experimental group and control group.
     Hypothesis2:After the ear acupoint application therapy,the body composition (weight, waist circumference, body mass index) were significantly different within the experimental group and control group
     Hypothesis3After the ear acupoint application therapy,Ryodoraku values were significantly different between the experimental group and control group.
     Hypothesis4;After the ear acupoint application therapy,Ryodoraku values were significantly different within the experimental group and control group.
     Hypothesis5:After the ear acupoint application therapy,the heart rate variability were significantly different between the experimental group and control group. Hypothesis6:After the ear acupoint application therapy,the heart rate variability were significantly different within the experimental group and control group.
     3.Study Design This study adopts a quasi-experimental (Quasi-Experiment) design,experimental design are as follows:
     O1, x O2O3O4,O5
     O6O7O8O9of O10、
     Ol experimental group pre-test
     O6control group pre-test
     X:Intervention
     O2,O3,O4,O7,O8,O9of,O10, is the data sampling every other week
     Record measured with four weeks of treatment four times in two groups included weight, waist circumference, body mass index, mean values and heart rate variability power spectral analysis of the composition changes.the ear acupoint application therapy Auricular pressure intervention in the experimental group,no intervention control group.The indicators include the following:
     (A) body composition:waist circumference,hip circumference, weight,body mass index (BMI)
     (B) Ryodoraku values:12meridians resistance value
     (C) the value of heart rate variability:time domain parameters, frequency domain parameters,
     Object of Study
     60women which body mass index (body mass index,BMI) greater than30in line with the Taiwan Department of Health obesity standards randomized by the researchers enrolled30people into experimental group and control group.The loss rate is considered in3%(empirical value)
     Subjects aged between40-50years old women, according to Cohen(1988), statistical power analysis to estimate the number of samples in this study, the use of the PASS8.0statistical software to estimate each at least25cases when the Power up to0.80,.Research sample must amtch the standards as follows.
     (1) age40-50years old women
     (2) BMI>30km/m2
     (3) waist circumference>80cm
     (4) clear consciousness for voluntary participation in the pilot scheme and signed consent The study exclusion criteria are as follows:
     (a) endocrine disorders (thyroid,gonads, pituitary dysfunction)
     (b) heart disease (heart rate is not the whole, myocardial infarction, heart failure, patients fitted with pacemakers).
     (c) immune and allergic diseases
     (d) of the abdomen and limbs,the appearance of the wound,or wound stammer traces greater than3cm.
     (e) pregnant and lactating women
     (f) six months postpartum
     (g) within three months, never to drugs (Western medicine) to control body weight.
     (h) adverse reactions to Auricular pressure
     (i) the poor treatment adherence
     (j) within three months, never exercise and diet to control weight.
     The method of auricular point sticking
     In this study, the experimental group auricular pressure means the Cowherb seeds will Cut a0.5×0.5cm tape are put pressure on the monaural shenmen,stomach point and the hungry points, three meals a day before consumption, in turn affixed to pressure each point3min,every Monday to the Laboratory of change to the other ear. The control group without any intervention.
     This study selected the ear position and function are as follows:
     (1)stomach point:located in a cavity of the ear, the helix feet disappear at. The main function of gastric digestion of the stomach,Bu Zhong Yi Qi and co-co spleen attending indigestion, bloating and stomach cramps and other stomach problems.Located in helix feet endpoint. Stomach is postnatal and said Mizutani sea, Wang stomach with food and fertilizer to stimulate the stomach hole of nerve impulses to nerve conduction will be walking along the fans, by blocking the hypothalamic hunger message against the excitement of the spleen and stomach function.thus suppress the appetite and eliminate hunger, to achieve weight control effect, taking the stomach hole Kin spleen and stomach, with deficiency of liver qi,Heweijiangni and help to transport and dampness function.
     (2) hunger point:located outside of the bottom of the hole of the external nose, about when the midpoint of the external nose and adrenal online.With anti-hunger to the control diet, the treatment of obesity, hyperthyroidism,nervous drink.
     (3) shenmen:shenmen points in the ear triangular fossa, helix up and down the foot of the bifurcation slightly above. From its anatomical structure, the innervation of the triangular fossa is extremely rich,almost all disposable auricular nerve has a branch of the triangular fossa, ear branch from the vagus nerve of the trigeminal nerve auriculotemporal nerve, the facial nerve in the ear nerves, as well as the greater occipital nerve,lesser occipital nerve, sympathetic.these nerves form a plexus in the triangular fossa endothelium.Its main function is antispasmodic and analgesic, sedative, heat-inflammatory and anti-allergy, lowering blood pressure, such as cough and asthma. Attending a variety of pain,withdrawal syndrome, cardiovascular disease,neurasthenia, schizophrenia, as well as a variety of inflammatory diseases, allergic diseases and neuroendocrine diseases, weakened stomach and intestines, inhibiting strong appetite,limit the intake of the diet.
     The use of instruments
     (A) Ryodoraku:MEAD Meridian Energy analyzer, including hardware detection of the host (Figure4-2),the RS-232,Transmission signal cable, power cable, rod detection module, the sodium ion conductive cotton
     (B) Automatic height and weight scales:the SP-901type.
     (C) Heart rate variability (HRV) Master
     Rhythm master instrument Taiwan made,a wrist physiological Monitor,the style number is TS-0411.Taiwan scientifically(shares)(Taiwan Scientific Corp.) develope after years of study, combined with Figure team of domestic and international medical research, animal and human trials to confirm the heart rate variability and autonomic nervous system activity by wrist radial artery blood pressure waveform measured.Electrocardiogram (ECG) measurement of myocardial release of the waves, the Rhythm master of measurement is the description of the blood pressure wave pressure;and scored physiological piezoelectric sensor, rhythm master wrist radial artery blood pressure waveform converted to voltage,and then filtering, amplification and analysis of the calculation process can be accurately measured have related to HRV and autonomic nervous activity indices;in physiology, the ECG of the measured radio signal (drive signal of heart to fight blood) for the upstream pointer, while the The Rhythm master, measurement of blood pressure signals (signals) of the cardiac output and blood,compared with the downstream pointer, and both measured heart rate variability from the conciliation heart rate,autonomic nervous system.To prove (to endorse the amendment No.5,200,277), the Department of Health medical equipment inspection and registration (DOH medical device system number001525)such as the Department of Health approved the GMP, ISO13485,and EU CEMark approved. Determination of heart rate variability analysis of the various ingredients, including low-frequency power (Ln LF), high-frequency power (Ln HF), total power (LnTP), low frequency power normalization unit (the LF), low frequency high frequency ratio (Ln LF/HF) to evaluate the autonomic nervous system activity.
     Blood pressure measurement range and accuracy:50-180mmHg (+/-6mmHg)
     Heartbeat measurement range and accuracy:30-250times/min (+/-1beats/min)
     HRV measurement range and accuracy:0-999ms,(+/-5%)
     HF%measurement range and accuracy:0-100%(+/-5%)
     LF%measurement range and accuracy:0-100%(+/-5%)
     LF/HF measurement range and accuracy:0-999(+/-5%)
     In the above HRV time domain analysis of the main parameters of the calculation for the5-minute heart rate variability of the mean and standard deviation measurements of the instrument wrist Rhythm masters used in this study, the final five minutes is the measurement of HR (average per minute heart rate) and HRV. Wrist-type rhythm master measurement parameters of HRV and the autonomic nervous activity by wrist radial artery blood pressure waveform measured in this way compared to the need to large hospitals, electrocardiogram (ECG)measurements to simple many.
     Experimental procedure and method
     In clinics and universities in eastern Taiwan, by Western doctors to determine synergistic simple obesity who were recruited location, and invited to volunteer for the study, enrolled subjects were randomly assigned into the experimental group and control group, giving two sets of pre-test measured body composition, Ryodoraku and heart rate variability, confirmation of baseline values.The experimental group will receive auricular acupressure palliative care interventions, the seed ear bean patch affixed to the hunger point, the shenmen and stomach point, a course of seven days, Monday to replace ear ear palliative care, with the former measuring the same period determination of body composition, Ryodoraku and heart rate variability, than to avoid the meridian Ziwuliuzhu the variation, for a total of one month, the control group did not receive any intervention.
     Measurement of the indicator process is as follows:
     (A)The volunteer subjects were completing the basic information of the subjects the questionnaire, health questionnaire and signed written consent subjects.And ask the subject to observe the following precautions:
     (1) Do not consume alcohol.before measurement of36hours
     (2) prohibit the intake of coffee and caffeinated products before measurement of24hours
     (3) Do not stay up all night before measuring
     (4) Do not eating and drinking before four hours
     (5) In addition to the diet provided by the laboratory personnel in the measurement, do not eat other food.
     (B) measurement of height and weight
     Subject to measured, first go to the toilet, to avoid the bladder plot of urine, and body of all heavy objects won, wearing short-sleeved shirt and shorts, take off his shoes and socks, in accordance with the SP-901.Automatic height and weight measurements count the feet standing position easily stand up straight, press the measurement button, you can read out the height, weight values, we measured three times, close to the value of the average take twice.
     (C)body composition:
     A waist-hip measurements
     Study only the lower body clothing, hands down feet rope standing, the final standard tape measure in the natural breath, measuring their waist circumference and hip circumference (cm amount to one less decimal).
     Waist:
     (1)side of the ribs under the most edge and the midpoint of the anterior superior iliac spine horizontal
     (2)Hip:on both sides of the greater trochanter horizontal (haffner,1998)
     (3)WHR (Waist-to-hip circumference Ratio, WHR)=waist/hip (4)when measured by measuring those who turn a blind eye, measuring the same person, each measured three times the mean value,the measurement results would not let the participants know.
     (D) the Ryodoraku the value of measurement:
     (1)equipment:Ryodoraku
     (2)calibration of instruments and viewing
     (3)test procedures
     1) prior to testing, subjects to rest for5minutes before starting the test.
     2) the subjects were exposed measurement site, and take off shoes and socks, removable body conductive items.
     3) pre-test, can not stimulate the representative determination of the point part of the skin. Such as hand washing, hand-wringing or drying hands and feet warm insulation.
     4) subjects were grasping hand derivation and grip strength throughout the Equalization. Grip strength, amount of current is also larger; grip strength is small, the amount of current is also smaller. Test period, Left and right do not exchange the grip stick was no difference.
     5) in accordance with the order:left hand Ryodoraku points H1to H6→right hand, the guide good point H1to the H6→left foot foot Ryodoraku point F1to F6→right foot foot Ryodoraku point F1to F6.
     6) detection of the derivation to be comprehensive and neatly paste measuring the skin surface.
     7) detect the hand,the detection of non-measured hand palm up,food or refers to the pulp of the thumb, respectively, symmetric the parallel Xiezhu on both sides of the smallest circumference measured by wrist, and note detection derivation can not be at the encounter detection.
     8) If on behalf of the determination of the point of the parts of the skin wound, it will increase the amount of current, and therefore will slightly move the measurement site.
     This detection system to detect the interface connected to computer software. After entering the basic data of the study participants, the participants adopted a sitting position and maintain a relaxed state, the clip grip on the right hand palm,test hand detection rod,in accordance with the subjects of his left hand too deep→The Algol→Shenmen→the Yanggu→Yang pool→Yang River meridian on behalf of the measurement point, and then measuring the right hand the same order in each meridian on behalf of the measuring point. Next to left foot of Bai→Taichong→clock→beam bone→the mound→Chongyang six meridians on behalf of the determination of point position,and then measured the right foot.Measured every meridian on behalf of the measuring point, when the computer screen after the test value, you can release the measure on behalf of the measuring point of a meridian.Hands, feet, a total of twenty-four meridians on behalf of the measuring point Ryodoraku values. This test program were conducted twice and the mean value for the final test data. Subjects in the two hours prior to testing should avoid excessive diet and vigorous exercise, in order to maintain the accuracy of measurement.
     (E) Determination of heart rate variability:
     Pretest and posttest measurements, measuring the wrist physiological monitor-Heart Rhythm Masters (ANSWatch(?)) properly worn on the subjects left wrist, the measurement height of roughly the same with the heart of the measurement about6to7minutes in the process of measurement, subjects may not have any mobile in order to ensure the quality and objectivity of the measurement data. According to the technical data provided by the rhythm master manual and the company, heart rate variability (HRV) based on the1996American and European standards [126] wrist radial artery retrieved five minutes the blood pressure pulse wave signal using time domain (Time Domain) and frequency domain (Frequency Domain) analysis of the two methods, human trials according to the hospital with electrocardiograph (ECG;the Agilent A3,the Patient Monitor) calibration accuracy of±5%. Rhythm master in the analysis process and in accordance with standards by the autonomic nervous system caused by an irregular heartbeat (such as:body movement, coughing, or arrhythmia (Cardiac Arrhythmia), etc.)excluded from HRV analysis outside, in order to improve heart rate variability parameters accuracy.
     Statistical methods
     IBM SPSS19.0statistical software.In addition to basic descriptive analysis of percentage, mean, standard deviation, The ALPHA=0.05.
     Results
     (A) pre-test age, height, weight, body mass index, waist circumference, hip circumference difference
     A total of60were enrolled, randomized to the experimental group and control group of30people,of which19were withdrawn from the total of full participation in the experimental group and25in the control group26. The average age of the experimental group was41.3years, average height157cm, weight83kg, body mass index of33.5, average waist circumference of97.2cm, Hip108.3cm in the control group the average age of41.2years, average height156.9cm, weight81.8kg, body mass index94.5,an average waist circumference94.5cm,Hip108.2cm,two groups of age, body mass index,waist circumference, hip circumference, were not significantly different.
     (B) heart rate variability between the pre-test group Ryodoraku values differences
     Experimental group and control group pre-test of cardiac autonomic nervous system activity status results. Shown in Table5, the two groups in a quiet systolic blood pressure, quiet and diastolic blood pressure, quiet heart rate and mean RR interval, there was no significant difference. HF%aspects of the state on behalf of the cardiac sympathetic nerve activity (the LF%) and parasympathetic activities on behalf of the cardiac sympathetic nerve activity, LF/HF ratio, the experimental group and control group were not significantly different.
     Individual meridians values, the12meridians of the experimental group mean Ryodoraku values were no significant differences with the control group.
     (C) Difference between the post-test group
     Percentage reduction of body weight, body mass index, waist circumference, hip circumference, after a month-long intervention to accept the percentage reduction of auricular pressure in the experimental group was significantly higher.
     Measured cardiac autonomic nervous activity in the experimental group and control group comparison results. After a one-month experimental period,on behalf of the state of the cardiac sympathetic nerve activity in a quiet systolic blood pressure, quiet and diastolic blood pressure, resting heart rate, mean RR wave interval,on behalf of the cardiac parasympathetic activity, HF%, LF and on behalf of the sympathetic and no significant differences in the parasympathetic balance of the two systems state of the LF/HF ratio aspect, the experimental group and control group.
     Ryodoraku values measured after the experimental group and control group results.After a month during the experiment, the experimental group posttest Ryodoraku values in the individual meridians, the experimental group group in addition to significant differences in the spleen, kidney meridian,bladder, gall bladder, stomach meridian,the rest of the meridian The Ryodoraku the value have no significant different from the control group.
     (D) Differences pretest and post within the group
     Experimental group and control group post-test body weight, body mass index, hip circumference, and waist circumference were significantly lower than the pre-test.Pretest and post cardiac autonomic nervous activity results in the experimental group.the experimental group group pre-test and posttest quiet systolic blood pressure, quiet and diastolic blood pressure, resting heart rate, mean RR wave interval,HF and the LF/HF of the ratio are showing no significant difference.
     The control results of the comparison group before the test and post cardiac autonomic
     nervous activity. Shown in Table Vll, quiet systolic blood pressure of the control group pretest and posttest, quiet and diastolic blood pressure, resting heart rate, mean RR wave interval and the LF/HF ratio, showing no significant difference.
     Compare the results of the experimental group before the test and post Ryodoraku value.By the small intestine, triple burner, large intestine by the terms of significantly reduced.The remaining nine meridian was not significant.
     The control results of the comparison group before the test and post Ryodoraku value. Individual meridians Ryodoraku values, lung, spleen, stomach with the bladder through the measurements of conductivity mean values were compared with the previous measurements up to a significant reduction.
     Conclusions
     Through the above analysis, the following conclusions:
     Auricular pressure Shenmen, hunger point, stomach point, a day before a meal to press15, the duration of four weeks can significantly improve the simple obesity of the female body composition, including weight loss, reduce hip, waist circumference and body mass index.
     Auricular pressure the shenmen,hunger point, stomach point to significant improvements in simple obesity of women small intestine, large intestine meridians, triple burner, spleen, kidney, bladder through the gall bladder, the stomach through the value of ryodoraku.
     Auricular pressure for simple obesity women RR wave of the cardiac parasympathetic activity HF, on behalf of the state of the cardiac sympathetic activity LF and on behalf of sympathetic and parasympathetic balance state of the two systems LF/HF ratio the experimental group and control group, no significant differences.But there is a tendency to lower parasympathetic.
     The paper innovation
     (A) Instruments Ryodoraku (the MEAD) detect the effect acupoint application therapy provide Meridian scientific empirical ideas.
     This study indicates that auricular acupressure shenmen,hunger point, stomach point can significantly improve the simple obesity, women's small intestine, large intestine, triple burner, spleen,kidney meridian,the bladder through the gall bladder, stomach Ryodoraku value balance. The Ryodoraku use ohms law principle, provide a more robust scientific basis for the determination of the meridian.In this study, an instrument MEAD prove this meridian more scientific ideas.
     (B)the use of simple handheld rhythm master; the instrument instead of complex heart rate variability measurement instruments, for the future of such studies provide a useful reference.
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