本文關(guān)鍵詞：代綜方合穴位埋線對肥胖�。ㄆ⑻摑褡栊停┭装Y因子、氧化應(yīng)激的初步觀察　出處：《成都中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 代綜方 穴位埋線 脾虛濕阻型 肥胖病 臨床觀察

【摘要】：目的：探討代綜方合并穴位埋線干預(yù)脾虛濕阻型肥胖病患者的臨床療效,觀察代綜方口服合并穴位埋線后肥胖患者的療效,比較治療前后患者的體重、體重指數(shù)、腰圍、體重指數(shù)的變化；觀察干預(yù)前后對患者高胰島素血癥的影響,并分析干預(yù)措施對肥胖病患者慢性炎癥因子、氧化應(yīng)激、microRNA29的影響。方法：選擇符合標(biāo)準(zhǔn)的肥胖病患者,共67例,隨機(jī)分為對照組和治療組。對照組,共計(jì)34例,在生活方式干預(yù)的基礎(chǔ)上,口服二甲雙胍850mg,一日兩次及中藥湯劑代綜方,1日1劑,連續(xù)12周；治療組,共計(jì)33例,在生活方式干預(yù)的基礎(chǔ)上,口服湯劑代綜方及穴位埋線治療,穴位埋線主穴有兩組：①天樞、中脘、關(guān)元、足三里、豐隆、梁丘②脾俞、胃俞、腎俞、上巨虛、下巨虛。交替選穴,3周埋線1次,連12周。進(jìn)行臨床12周的觀察,記錄觀察患者的年齡、身高,體重、腰圍、大腿圍,糖耐量試驗(yàn)數(shù)值、胰島素釋放實(shí)驗(yàn)數(shù)值、血脂以及IL-6、TNF-α、SOD、ox-LDL (Elisa檢測法)；mir-29 (RT-PCR檢測法)等指標(biāo)的變化。對實(shí)驗(yàn)結(jié)果采用統(tǒng)計(jì)軟件進(jìn)行分析,探討療效機(jī)理,分析病理機(jī)制。結(jié)果：1.對照組及治療組體重的均值分別降低了2.2kg和7kg, BMI分別降低了0.65和2.7,腰圍分別降低了3.2cm和5.5cm、臀圍降低了5.6cm和7.8cm,組間比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),兩組治療后與基線水平比較均有顯著差異(P0.01)；2.兩組治療前后CHOL與基線水平比較差異無統(tǒng)計(jì)學(xué)意義(P0.05),兩組TG、LDL-C組內(nèi)、組間比較差異有統(tǒng)計(jì)學(xué)意義(P0.05),兩組組內(nèi)HDL-C升高有統(tǒng)計(jì)學(xué)意義(P0.05),組間比較無統(tǒng)計(jì)意義(P0.05)。3.兩組1hINS、hINS顯著降低(P0.01), OhINS、3hINS降低有統(tǒng)計(jì)學(xué)意義(P0.05); OhINS、1hINS、2hINS、3hINS組間比較差異無統(tǒng)計(jì)學(xué)意義；兩組HOMA-IR、ISI有顯著改善(P0.01),組間相比計(jì)較差異無統(tǒng)計(jì)學(xué)意義(P0.05),兩組HOMA-β組間、組內(nèi)比較差異具有統(tǒng)計(jì)學(xué)意義：4.兩組IL-6、TNF-α顯著降低、SOD顯著升高(P0.01), ox-LDL降低有統(tǒng)計(jì)學(xué)意義(P0.05)5.兩組均可下調(diào)microRNA-29水平的表達(dá),下調(diào)數(shù)值差異具有統(tǒng)計(jì)學(xué)意義(P0.05)；治療組下調(diào)水平多于對照組,但差異不具有統(tǒng)計(jì)學(xué)意義(P0.05)。7.mir-29與BMI、HOMA-IR正相關(guān)；8.試驗(yàn)過程中,兩組患者肝腎功、血常規(guī)等安全性指標(biāo)未見明顯異常,不良反應(yīng)發(fā)生率低。結(jié)論：在隨機(jī)試驗(yàn)中代綜方及穴位埋線對超重及肥胖患者均有明顯減重、減腰圍的療效,調(diào)節(jié)血脂,顯著改善胰島素抵抗、增加胰島素敏感性,并改善肥胖病導(dǎo)致的低度炎癥反應(yīng)及氧化應(yīng)激：抑制mir-29水平的表達(dá)；無明顯不良反應(yīng)。
[Abstract]:Objective: to investigate the clinical effect of combined acupoint catgut implantation in treating obesity patients with spleen deficiency and dampness obstruction, observe the curative effect of Daizhuangfang combined with acupoint catgut embedding, and compare the body weight of patients before and after treatment. Body mass index, waist circumference, body mass index; The effects of intervention on hyperinsulinemia were observed, and the effects of intervention on chronic inflammatory factors and oxidative stress in obese patients were analyzed. Methods: 67 obese patients were randomly divided into two groups: control group (n = 34) and control group (n = 34) based on lifestyle intervention. Metformin 850 mg orally, twice in 1st and traditional Chinese medicine decoction, 1 dose on 1st, for 12 weeks; Treatment group, a total of 33 cases, on the basis of lifestyle intervention, oral decoction comprehensive formula and acupoint catgut embedding treatment, the main acupoint embedding points have two groups: 1 day armature, Zhongwan, Guan Yuan, Zusanli, Fenglong, Liang Qiu 2 spleen Shu. Weishu, Shenshu, Shangjuxu, Xia Juxu. Alternate selection of acupoints for 3 weeks embedding thread once for 12 weeks. Clinical observation for 12 weeks, recorded the patient's age, height, weight, waist circumference, thigh circumference. Glucose tolerance test, insulin release test, serum lipids and IL-6 TNF- 偽 SODX ox-LDL Elisa assay; The results of the experiment were analyzed by statistical software, and the mechanism of curative effect was discussed. Results: 1. The average body weight of the control group and the treatment group decreased by 2.2 kg and 7 kg, respectively, and the BMI decreased by 0.65 and 2.7 kg, respectively. The waist circumference and hip circumference decreased by 3.2 cm and 5.5 cm, respectively, and the hip circumference decreased by 5.6 cm and 7.8 cm, respectively. The difference between the two groups was statistically significant (P 0.05). There was significant difference between the two groups after treatment and baseline level (P 0.01). 2. There was no significant difference between CHOL and baseline before and after treatment in the two groups (P 0.05). The increase of HDL-C in the two groups was statistically significant (P 0.05), but there was no statistical significance between the two groups (P 0. 05. 3. 1hINS decreased significantly (P 0. 01)). The decrease of 3hins in OhINS was significantly lower than that of P0.05; There was no significant difference in 3hins between the groups of OhINS 1hINS 2hINS and 3hINS. The HOMA-IRISI of the two groups was significantly improved (P 0.01), and there was no significant difference between the two groups (P 0.05), and there was no significant difference between the two groups (P 0.05), and there was no significant difference between the two groups in terms of HOMA- 尾. The difference between the two groups was statistically significant. The level of IL-6 TNF- 偽 in the two groups was significantly lower than that in the control group and SOD was significantly increased (P0.01). The expression of microRNA-29 was down-regulated in both groups, and the down-regulation was statistically significant (P 0.05). The down-regulation level in the treatment group was higher than that in the control group, but the difference was not statistically significant (P 0.05) .7.mir-29 was positively correlated with BMIHOMA-IR. 8. In the course of the experiment, the safety indexes such as liver and kidney function and blood routine were not obviously abnormal in the two groups. Conclusion: in the random trial, the patients with overweight and obesity have significant weight loss, the effect of reducing waist circumference, the regulation of blood lipid, and the improvement of insulin resistance. Increase insulin sensitivity and improve the low inflammatory response and oxidative stress caused by obesity: inhibit the expression of mir-29; There was no obvious adverse reaction.
【學(xué)位授予單位】：成都中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R246.1

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