本文關(guān)鍵詞： 基本證型 辨證論治 單純性肥胖 臨床療效　出處：《南京中醫(yī)藥大學(xué)》2016年博士論文　論文類型：學(xué)位論文

【摘要】：目的探討單純性肥胖的臨床基本證型以及針灸辨證施治的臨床療效及作用機制。為臨床辨證論治個性化治療提供依據(jù)。方法：首先對單純性肥胖基本證型進行分析,按統(tǒng)一設(shè)計調(diào)查表登記,并根據(jù)臨床常見證型癥狀表現(xiàn)進行辨證分型,總結(jié)出常見證型的分布。其次,針灸辨證施治的臨床研究,隨機選取臨床最常見的三種證型共計70例,其中陰陽平和型26例,脾虛濕阻型20例,胃腸實熱型24例。70名患者被隨機分為二組,每組35例,分為用辨證取穴電針組和電針組。結(jié)果：(1)肥胖患者中,女性225例,占62.5%；男性135例,占37.5%；最多見的證型是陰陽平和型106例,占29.44%；脾虛濕阻型84例,占23.33%；胃腸實熱證69例,占19.16%；肝郁氣滯型57例,占15.83%；脾胃虛弱型27例,占7.50%；脾腎陽虛型17例,占4.72%。肝郁氣滯型以女性多見,多并發(fā)婦科疾病,男性多并發(fā)脂肪肝等�。黄⑽柑撊鹾推⒛I陽虛以中老年患者為多見,其他證型以青年為主。(2)辨證治療電針組治療后,FAT、VFA、體重指數(shù)、臀圍、腰圍都降低。治療前后對比P0.01,差異有極顯著性。治療后電針組病人FAT、VFA、體重指數(shù)、上臂圍、小腿圍、大腿圍、臀圍、腰圍都降低,治療前后對比,P0.05差異有顯著性。辨證論治電針組與電針組比較,腰圍、臀圍、體重指數(shù)、FAT及VFA下降值比較具有顯著差異性(P0.05)。(3)辨證取穴組總有效率高于電針組,兩組總有效率比較P0.01,差異有極顯著性。結(jié)論：(1)單純性肥胖臨床常見證型主要是陰陽平和型,脾虛濕阻型,胃腸實熱型。(2)辨證論治療效優(yōu)于單純電針組。
[Abstract]:Objective to explore the clinical basic syndrome types of simple obesity and the clinical curative effect and mechanism of acupuncture and moxibustion treatment based on differentiation of symptoms and signs, and to provide the basis for individualized treatment based on differentiation of symptoms and signs. Methods:. At first, the basic syndromes of simple obesity were analyzed. According to the unified design of questionnaire registration, and according to the clinical symptoms of common syndromes, summed up the distribution of common syndrome types. Secondly, the clinical study of acupuncture and moxibustion syndrome differentiation. A total of 70 cases of the three most common syndromes were randomly selected, including 26 cases of Yin and Yang mild type, 20 cases of spleen deficiency and dampness obstruction type, and 24 cases of gastrointestinal solid heat type .70 cases were randomly divided into two groups, 35 cases in each group. Results among the obese patients, 225 cases were female (62.5%). There were 135 males (37.5%); The most common syndromes were Yin and Yang mild type in 106 cases (29.44%). Spleen deficiency and dampness obstruction in 84 cases (23.33%); There were 69 cases (19.16%) with gastrointestinal heat syndrome. There were 57 cases with stagnation of qi in liver, accounting for 15.83%. The spleen and stomach were weak in 27 cases (7.50%); There were 17 cases with deficiency of spleen and kidney yang (4.72%). The type of stagnation of liver-qi was more common in women, more complicated with gynecological diseases, and more complicated with fatty liver in men. Deficiency of spleen and stomach and deficiency of spleen and kidney yang were more common in middle-aged and elderly patients, and other syndromes were mainly in youth. 2) after treatment of electroacupuncture group, FATV VFA, body mass index and hip circumference were found in electroacupuncture group. After treatment, the patients in electroacupuncture group had lower FATV, body mass index, upper arm circumference, calf circumference, thigh circumference, hip circumference and waist circumference. Before and after treatment, there was significant difference between the two groups. Compared with electroacupuncture group, waist circumference, hip circumference and body mass index were compared between syndrome differentiation group and electroacupuncture group. The total effective rate of acupoint differentiation group was higher than that of electroacupuncture group, and the total effective rate of the two groups was higher than that of electroacupuncture group (P0.01). Conclusion the common syndromes of simple obesity are Yin and Yang type, spleen deficiency and dampness obstruction type, gastrointestinal solid heat type. Conclusion the curative effect of differentiation of symptoms and signs is better than that of simple electroacupuncture group.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：博士
【學(xué)位授予年份】：2016
【分類號】：R246.1

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