穴位埋线治疗单纯性肥胖病临床研究
摘要
肥胖病是因机体内脂肪细胞数目增多或体积增大,脂肪堆积过多,使体重超过标准体重20%以上的病理状态,无明显内分泌代谢病因可寻者称之为单纯性肥胖病。自1997年WHO明确宣布肥胖为一种疾病以来,现代医学在该病治疗上尚无突破性进展。中医针灸及相关疗法治疗肥胖病疗效确切,其中穴位埋线法以简、便、廉、验、安全可靠、无毒副作用、患者痛苦少、依从性好等特点,在肥胖病的治疗领域具有比较大的优势,是目前研究的重点之一。
目的:本课题对穴位埋线治疗单纯性肥胖病进行临床研究,旨在通过前瞻性随机对照试验研究,证明穴位埋线治疗单纯性肥胖病的有效性、安全性及可推广性,为穴位埋线治疗本病提供循证医学依据。
方法:诊断标准根据2001年国际生命科学学会“中国肥胖问题工作组”提出的“中国成年人体重指数分类的建议”制定。将60例患者随机分为2组,其中治疗组30例,对照组30例。治疗组采用穴位埋线治疗,主穴取中脘、关元、天枢(双)、足三里(双),脾虚湿阻型配水分、脾俞(双);胃热湿阻型配丰隆(双)、胃俞(双);肝郁气滞型配肝俞(双)、膈俞(双);脾肾阳虚型配肾俞(双)、气海;阴虚内热型配肾俞(双)、肝俞(双),每2周埋线1次。对照组采用电针治疗,取穴同治疗组,每周3次,隔天一次,每次30分钟,以上两组均以4周为一个疗程,共治疗3个疗程。
结果:治疗组30人,痊愈21人,显效3人,有效2人,无效4人,总有效率86.67%;对照组30人,痊愈23人,显效2人,有效2人,无效3人,总有效率90.00%。经统计学处理差异无显著性意义(P＞0.05)。肥胖指标方面,两组体重、体重指数、腰围、臀围、腰臀比治疗后较治疗前均有下降,两组比较下降程度无差别。症状积分方面,两组治疗后均有下降,治疗组较对照组症状改善明显(P＜0.01)。
结论:穴位埋线治疗单纯性肥胖病具有确切的疗效,是一种使用方便、疗效快捷、无毒副作用、适于推广应用的方法。
Obesity is a pathological state that the body fat overacummulates 20% than the average.Those occurred not after confirmed endocrinopathy is named as simply obesity.Many researches in traditional Chinese medicine have been done before those effective methods were summarized in recent years.Among those methods,acupoints catgut implantation is one of the focus.
Objective:This subject is to prove the validity,security and propagability of acupoints catgut-embedding therapy,and provide the proof based on evidence for the treatment of obesity by forward looking randomly control test research.
Method:The diagnostic criteria is based on the International Chinese Workgroup on Obesity in 2001.60 cases were divided into two group randomly, and there were 30-case in treat group,30-case in control group.The main acupoints include Zhongwan,Guangyuan,Zusanli,Tianshu.Others were selected based on differention of symptoms and signs.The cases of treat group took the acupoints catgut implantation every two weeks;the cases of control group took the electrical acupuncture three times each week.Evaluate the total efficiency after 12 weeks.
Result:After the treating courses,in treat group,there were 21-case cured,3-case significantly improved,2-case in effect,4-case non-effective among 30-case,and the total effective rate was 86.67%.In control group,there were 23-case cured,2-case significantly improved,2-case in effect,3-case non-effective among 30-case,and the total effective rate was 90.00%.There were no significant difference between the two groups(p＞0.05).
Those obesity index such as body weight,body mass index(BMI),waist and hip line,waist hip rate(WHR)decreased significantly after the courses of treatment at the same degree.The syndrome integral of two groups decreased after the treatment,and the treat group decreased obviously(p＜0.01).
Conclusion:Acupoints catgut implantation possess definite curative effect in the treatment of obesity,and it is a sort of effective.By comparation, this method is more simple,time-saving,economic,has less pain.
目的:本课题对穴位埋线治疗单纯性肥胖病进行临床研究,旨在通过前瞻性随机对照试验研究,证明穴位埋线治疗单纯性肥胖病的有效性、安全性及可推广性,为穴位埋线治疗本病提供循证医学依据。
方法:诊断标准根据2001年国际生命科学学会“中国肥胖问题工作组”提出的“中国成年人体重指数分类的建议”制定。将60例患者随机分为2组,其中治疗组30例,对照组30例。治疗组采用穴位埋线治疗,主穴取中脘、关元、天枢(双)、足三里(双),脾虚湿阻型配水分、脾俞(双);胃热湿阻型配丰隆(双)、胃俞(双);肝郁气滞型配肝俞(双)、膈俞(双);脾肾阳虚型配肾俞(双)、气海;阴虚内热型配肾俞(双)、肝俞(双),每2周埋线1次。对照组采用电针治疗,取穴同治疗组,每周3次,隔天一次,每次30分钟,以上两组均以4周为一个疗程,共治疗3个疗程。
结果:治疗组30人,痊愈21人,显效3人,有效2人,无效4人,总有效率86.67%;对照组30人,痊愈23人,显效2人,有效2人,无效3人,总有效率90.00%。经统计学处理差异无显著性意义(P＞0.05)。肥胖指标方面,两组体重、体重指数、腰围、臀围、腰臀比治疗后较治疗前均有下降,两组比较下降程度无差别。症状积分方面,两组治疗后均有下降,治疗组较对照组症状改善明显(P＜0.01)。
结论:穴位埋线治疗单纯性肥胖病具有确切的疗效,是一种使用方便、疗效快捷、无毒副作用、适于推广应用的方法。
Obesity is a pathological state that the body fat overacummulates 20% than the average.Those occurred not after confirmed endocrinopathy is named as simply obesity.Many researches in traditional Chinese medicine have been done before those effective methods were summarized in recent years.Among those methods,acupoints catgut implantation is one of the focus.
Objective:This subject is to prove the validity,security and propagability of acupoints catgut-embedding therapy,and provide the proof based on evidence for the treatment of obesity by forward looking randomly control test research.
Method:The diagnostic criteria is based on the International Chinese Workgroup on Obesity in 2001.60 cases were divided into two group randomly, and there were 30-case in treat group,30-case in control group.The main acupoints include Zhongwan,Guangyuan,Zusanli,Tianshu.Others were selected based on differention of symptoms and signs.The cases of treat group took the acupoints catgut implantation every two weeks;the cases of control group took the electrical acupuncture three times each week.Evaluate the total efficiency after 12 weeks.
Result:After the treating courses,in treat group,there were 21-case cured,3-case significantly improved,2-case in effect,4-case non-effective among 30-case,and the total effective rate was 86.67%.In control group,there were 23-case cured,2-case significantly improved,2-case in effect,3-case non-effective among 30-case,and the total effective rate was 90.00%.There were no significant difference between the two groups(p＞0.05).
Those obesity index such as body weight,body mass index(BMI),waist and hip line,waist hip rate(WHR)decreased significantly after the courses of treatment at the same degree.The syndrome integral of two groups decreased after the treatment,and the treat group decreased obviously(p＜0.01).
Conclusion:Acupoints catgut implantation possess definite curative effect in the treatment of obesity,and it is a sort of effective.By comparation, this method is more simple,time-saving,economic,has less pain.
引文
[1]裴海成,刘志民,邱明才等.实用肥胖病治疗学,北京:人民军医出版社,2006年4月,第1版:8.
[2]廖二元,超楚生.内分泌学,北京:人民卫生出版社,2001年12月,第一版:1678.
[3]孙玉安,段文若,李德爱等.实用内分泌代谢疾病药物治疗学,北京:人民卫生出版社,2003年9月,第一版:383.
[4]同[1]。
[5]MacDougald OA,Cheng SH,Fan HY,et al.Regulated expression of the obese gene product(leptin)in white adipose tissue and 3T3-L1 adipocytes.Proc Nal Acad Sci USA,1995,92:9034-9037.
[6]Sinha MK.Human leptin:the hormone of adipose tissue.Eur Jendocrinol,1997.136:461-464.
[7]徐淑静,徐明彤,傅祖植.肥胖基因和度素.中华内分泌代谢杂志,2003;(1):61-63.
[8]同[1]。
[9]盛建辉,胡滨,李建中等.穴位埋线减肥663例体会.中国现代医学临床杂志,1998;11(4):162.
[10]牛胜田.世界卫生组织编.肥胖的防治,北京:人民卫生出版社,2001:11.
[11]张爱珍.临床营养学,北京:人民卫生出版社,2001;6:85-57.
[12]同[1]。
[13]裴海成,王朝迅.中国肥胖防治的研究和健康教育亟待加强.中华医学杂志,2003;83:1465-1466.
[14]焦东海,沈学敏,高雅萍等.大黄提取片治疗单纯性肥胖的临床研究.中国中西医结合杂志,1998;18(4):241.
[15]杜岁增.减肥降脂胶囊治疗单纯性肥胖症100例临床观察,实用中医杂志,1991:(8):485.
[16]马永泽,刘小渭.复方山楂减肥汤对肥胖者生化指标的影响.中医药研究,2002:18(5):28-29.
[17]黄洪林,付志红.丹杞降脂方治疗单纯性肥胖症的临床观察.中国中医药杂志信息,1999:(10):49.
[18]温木生.试论穴位埋线疗法的综合性效应及治疗机理.针灸学报,1991;(4):7-9.
[19]任晓艳.穴位埋线的源流及其机理探讨.中国医药学报,2004;19(12):757-759.
[20]王素玲.穴位埋线治疗肥胖100例观察.实用中医内科杂志,2006;20(1):97.
[21]吴卫平.穴位埋线治疗单纯性肥胖80例.浙江中医杂志,2006;41(2):72.
[22]齐凤军,程井军.穴位埋线减肥60例临床观察.针灸临床杂志,2006;22(7):34-35.
[23]盛建辉,胡滨,李建中等.穴位埋线减肥663例体会.中国现代医学临床杂志,1998;11(4):162.
[24]曹春,王飞.穴位埋藏法治疗单纯性肥胖.中国自然医学杂志,2002;4(3):178-179.
[25]郑卫国.穴位埋药线结合点穴推拿治疗肥胖症96例.中国针灸推拿,2005;25(6):376.
[26]熊健,左珊珊.穴位埋线治疗单纯性肥胖25例临床观察.中医药导报,2006;12(9):34-35,72.
[27]陈千里,张泽胜.耳穴贴压配合穴位埋线治疗单纯性肥胖症83例.上海针灸推拿,2005:24(2):24.
[28]许姿妙.穴位埋线治疗肥胖症100例临床观察[J].中国针灸,2002;22(2):95-96.
[29]王倩,丛莘,熊家轩.穴位埋线治疗肥胖型高血脂症52例疗效观察.新中医,2005:37(6):64-65.
[30]许倩,陈云慧,杨岚等.穴位埋线治疗单纯性肥胖症78例.河北中医,2006;28(3):196.
[31]李志湘,黄泽春,李细珍等.中医方法治疗单纯性肥胖症.中国美容医学,2006;15(5):573.
[32]丛莘,金庆文,李莉芳等.穴位埋线治疗单纯性肥胖症疗效观察.针灸临床杂志,2006:22(12):38-39.
[33]龙志江,章薇,娄必丹.穴位埋线加耳压疗法治疗单纯性肥胖症68例总结.湖南中医杂志,2004;20(3):6-7.
[34]丁敏,马彦平,王艳君等.穴位埋线治疗单纯性肥胖症65例临床观察.现代中西医结合杂志,2006;15(24):3337-3338.
[35]杨涛,欧挂珍.穴位埋线为主治疗单纯性肥胖症60例.上海针灸杂志,2003;22(2):35.
[36]杨福霞.穴位埋线治疗单纯性肥胖症的临床研究.中国针灸,2006;25(4):237-239.
[37]闰润虎,白洁,杨文波等.穴位埋线结合耳压治疗单纯性肥胖病.中国临床康复,2006:10(11):8-10.
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[2]廖二元,超楚生.内分泌学,北京:人民卫生出版社,2001年12月,第一版:1678.
[3]孙玉安,段文若,李德爱等.实用内分泌代谢疾病药物治疗学,北京:人民卫生出版社,2003年9月,第一版:383.
[4]同[1]。
[5]MacDougald OA,Cheng SH,Fan HY,et al.Regulated expression of the obese gene product(leptin)in white adipose tissue and 3T3-L1 adipocytes.Proc Nal Acad Sci USA,1995,92:9034-9037.
[6]Sinha MK.Human leptin:the hormone of adipose tissue.Eur Jendocrinol,1997.136:461-464.
[7]徐淑静,徐明彤,傅祖植.肥胖基因和度素.中华内分泌代谢杂志,2003;(1):61-63.
[8]同[1]。
[9]盛建辉,胡滨,李建中等.穴位埋线减肥663例体会.中国现代医学临床杂志,1998;11(4):162.
[10]牛胜田.世界卫生组织编.肥胖的防治,北京:人民卫生出版社,2001:11.
[11]张爱珍.临床营养学,北京:人民卫生出版社,2001;6:85-57.
[12]同[1]。
[13]裴海成,王朝迅.中国肥胖防治的研究和健康教育亟待加强.中华医学杂志,2003;83:1465-1466.
[14]焦东海,沈学敏,高雅萍等.大黄提取片治疗单纯性肥胖的临床研究.中国中西医结合杂志,1998;18(4):241.
[15]杜岁增.减肥降脂胶囊治疗单纯性肥胖症100例临床观察,实用中医杂志,1991:(8):485.
[16]马永泽,刘小渭.复方山楂减肥汤对肥胖者生化指标的影响.中医药研究,2002:18(5):28-29.
[17]黄洪林,付志红.丹杞降脂方治疗单纯性肥胖症的临床观察.中国中医药杂志信息,1999:(10):49.
[18]温木生.试论穴位埋线疗法的综合性效应及治疗机理.针灸学报,1991;(4):7-9.
[19]任晓艳.穴位埋线的源流及其机理探讨.中国医药学报,2004;19(12):757-759.
[20]王素玲.穴位埋线治疗肥胖100例观察.实用中医内科杂志,2006;20(1):97.
[21]吴卫平.穴位埋线治疗单纯性肥胖80例.浙江中医杂志,2006;41(2):72.
[22]齐凤军,程井军.穴位埋线减肥60例临床观察.针灸临床杂志,2006;22(7):34-35.
[23]盛建辉,胡滨,李建中等.穴位埋线减肥663例体会.中国现代医学临床杂志,1998;11(4):162.
[24]曹春,王飞.穴位埋藏法治疗单纯性肥胖.中国自然医学杂志,2002;4(3):178-179.
[25]郑卫国.穴位埋药线结合点穴推拿治疗肥胖症96例.中国针灸推拿,2005;25(6):376.
[26]熊健,左珊珊.穴位埋线治疗单纯性肥胖25例临床观察.中医药导报,2006;12(9):34-35,72.
[27]陈千里,张泽胜.耳穴贴压配合穴位埋线治疗单纯性肥胖症83例.上海针灸推拿,2005:24(2):24.
[28]许姿妙.穴位埋线治疗肥胖症100例临床观察[J].中国针灸,2002;22(2):95-96.
[29]王倩,丛莘,熊家轩.穴位埋线治疗肥胖型高血脂症52例疗效观察.新中医,2005:37(6):64-65.
[30]许倩,陈云慧,杨岚等.穴位埋线治疗单纯性肥胖症78例.河北中医,2006;28(3):196.
[31]李志湘,黄泽春,李细珍等.中医方法治疗单纯性肥胖症.中国美容医学,2006;15(5):573.
[32]丛莘,金庆文,李莉芳等.穴位埋线治疗单纯性肥胖症疗效观察.针灸临床杂志,2006:22(12):38-39.
[33]龙志江,章薇,娄必丹.穴位埋线加耳压疗法治疗单纯性肥胖症68例总结.湖南中医杂志,2004;20(3):6-7.
[34]丁敏,马彦平,王艳君等.穴位埋线治疗单纯性肥胖症65例临床观察.现代中西医结合杂志,2006;15(24):3337-3338.
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