本文選題：穴位埋線　切入點：單純性肥胖　出處：《廣州中醫(yī)藥大學(xué)》2016年博士論文

【摘要】：目的：肥胖癥是一種慢性代謝性疾病,它由多因素引起,與基因、環(huán)境、炎癥和生活方式等密切相關(guān)。隨著工業(yè)化的發(fā)展,經(jīng)濟的進步,肥胖癥在一些發(fā)達國家和地區(qū)廣泛流行。肥胖是心血管疾病、糖尿病、痛風、癌癥、高血壓等慢性疾病的重要危險因子,因此,治療肥胖成為公共衛(wèi)生事業(yè)的重要內(nèi)容：本研究旨在探討穴位埋線結(jié)合中藥治療脾虛痰濕型正常代謝性肥胖癥患者的臨床療效,為今后中醫(yī)藥治療肥胖癥奠定研究基礎(chǔ),同時提供更好的臨床治療策略。方法：臺灣宜森中醫(yī)診所,肥胖門診,符合病例選擇標準肥胖病例共60例。按隨機數(shù)字法,將其隨機分為治療組和對照組,各30例。其中治療組女25例,男5例,對照組女25例,男5例。治療組采用穴位埋線加基礎(chǔ)中藥治療,方用厚樸夏苓湯加減,埋線穴位選取為,主穴：帶脈、環(huán)跳、足三里、中脘、三陰交、肩骼。輔穴：胃俞、天樞、水分、豐隆、地機、脾俞、氣海、大橫、陰陵泉。每次治療選取7-10個穴位,進行穴位埋藥線。對照組單純采用中藥治療。觀察治療前后BMI、腰圍、臀圍及糖脂代謝指標。比較兩組療效差異。結(jié)果：本研究通過對60例脾虛痰濕證正常代謝性肥胖癥的患者進行觀察并收集資料分析,經(jīng)過統(tǒng)計學(xué)檢驗,在年齡、性別、病程、肥胖程度、觀察指標(包括BMI、體重、腰臀圍、糖脂代謝各指標)、中醫(yī)體質(zhì)上,差異無統(tǒng)計學(xué)意義,故具有可比性(P0.05)。穴位埋線結(jié)合中藥組和單用中藥組在治療后各項觀察指標與治療前比較,經(jīng)檢驗差異均有統(tǒng)計學(xué)意義(P0.05),可以認為兩組治療均對單純肥胖患者有效,能降低患者體重、腰臀圍和改善糖脂代謝狀況。治療組的總有效率為93%,對照組的總有效率為80%,經(jīng)統(tǒng)計學(xué)檢驗,p0.05,可以認為穴位埋線結(jié)合中藥組在療效方面優(yōu)于單用中藥組,而且在BMI、甘油三酯(TG)、總膽固醇(TC)、高密度脂蛋白(HDL-C)這些觀察指標上改善程度優(yōu)于單用中藥組(P0.05),其它觀察指標則無顯著性的差別(P0.05)。結(jié)論：加用穴位埋線之后,減肥效果明顯好于單用中藥,具體體現(xiàn)在：1、能顯著減少腰圍、臀圍,降低BMI指數(shù)；2、能有效改善內(nèi)分泌代謝狀態(tài),能降低甘油三酯、膽固醇,升高高密度脂蛋白。其機制可能與長效刺激穴位、增強機體代謝狀態(tài)、調(diào)節(jié)中樞食欲等有關(guān)。
[Abstract]:Objective: obesity is a chronic metabolic disease, which is caused by many factors and is closely related to gene, environment, inflammation and lifestyle.With the development of industrialization and economic progress, obesity is widespread in some developed countries and regions.Obesity is an important risk factor for chronic diseases such as cardiovascular disease, diabetes, gout, cancer, hypertension, etc.Treatment of obesity has become an important part of public health. The purpose of this study was to explore the clinical effect of acupoint catgut embedding combined with traditional Chinese medicine in the treatment of normal metabolic obesity with spleen deficiency and phlegm dampness, and to lay a foundation for the future treatment of obesity with traditional Chinese medicine.At the same time, to provide a better clinical treatment strategy.Methods: a total of 60 obese patients met the criteria of case selection in Taiwan Yisen TCM Clinic and Obesity Clinic.According to the method of random number, it was randomly divided into treatment group and control group, 30 cases each.In the treatment group, 25 cases were female, 5 cases were male, 25 cases were female and 5 cases were male in the control group.The treatment group was treated with acupoint catgut embedding plus basic Chinese medicine, and the treatment group was treated with Houpu Xia Ling decoction. The main points were selected as main points: with pulse, ring jump, Zusanli, Zhongwan, Sanyinjiao, shoulder ilium.Auxiliary points: Weishu, Tianshu, water, Fenglong, ground machine, spleen Yu, air sea, big transverse, Yin Lingquan.Each treatment selected 7-10 points, point embedding line.The control group was treated with traditional Chinese medicine only.BMI, waist circumference, hip circumference and glucose and lipid metabolism were observed before and after treatment.The difference of curative effect between the two groups was compared.Results: in this study, 60 cases of normal metabolic obesity with spleen deficiency and phlegm dampness syndrome were observed and analyzed. After statistical test, the indexes of age, sex, course of disease, degree of obesity, observation index (including BMI, body weight, waist-hip circumference) were observed.The indexes of glucose and lipid metabolism have no statistical significance in constitution of traditional Chinese medicine, so it is comparable to P0.05.The observation indexes of acupoint catgut embedding combined with traditional Chinese medicine group and single Chinese medicine group after treatment were compared with those before treatment. The difference was statistically significant (P 0.05). It can be concluded that the treatment of both groups is effective for simple obesity patients and can reduce the body weight of the patients.Waist hip circumference and improve glucose and lipid metabolism.The total effective rate of the treatment group was 93.The total effective rate of the control group was 80. By statistical test, p0.05, we can conclude that the acupoint catgut embedding combined with traditional Chinese medicine group is superior to the single Chinese medicine group in the curative effect.Moreover, in BMI, TGN, TCX, HDL-C), the improvement of these indexes was better than that of P0.05 in the single Chinese medicine group, but there was no significant difference in other observation indexes.Conclusion: the effect of catgut embedding at acupoint is better than that of traditional Chinese medicine alone. It can significantly reduce waist circumference hip circumference and BMI index. It can effectively improve endocrine metabolism state and reduce triglyceride and cholesterol.Elevated high density lipoprotein.The mechanism may be related to long-term stimulation of acupoints, enhancement of metabolic state and regulation of central appetite.
【學(xué)位授予單位】：廣州中醫(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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