本文選題：電針 + 穴位埋線　； 參考：《南京中醫(yī)藥大學》2016年博士論文

【摘要】：目的：鑒于電針和埋線療法在治療單純性肥胖中的大量臨床運用,觀察對比分析常見電針、穴位埋線及兩者結(jié)合治療的療效差異,并進一步基于人體成分分析來比較三種療法對人體成分尤其是脂肪分布的影響,明確其在治療單純性肥胖中的安全性、作用機制及各自優(yōu)勢,便于臨床選擇。方法：采用隨機原則,將單純性肥胖患者分配到“電針組”35例,“埋線組”40例和“電針結(jié)合埋線組”33例,剔除不能嚴格接受治療安排的患者11例,最終符合研究要求的病例有97例,電針組31例,埋線組34,電針結(jié)合埋線組32例。選取主穴：中脘、天樞、水道、氣海、足三里、梁丘等,大腿肥胖明顯者加伏兔,小腿肥胖明顯者加豐隆,上肢肥胖明顯加曲池、肩髑穴。電針組腹部用2組穴,雙下肢各選用1組穴,使用頻率f1(為2Hz,10/100 Hz,3種頻率交替循環(huán)),強度以病人能耐受為度,留針30min,隔日1次,共治療6周；埋線組同樣穴位進行埋線,7-10天一次；電針結(jié)合埋線組在埋線基礎上加電針處理,每次埋線后的第4天針刺1次,隨后隔天一次,直至下次埋線。三組均治療6周。治療前及治療結(jié)束后由同一體檢醫(yī)生(并不提供對患者的治療)對每位患者測量身高,并采用InBody720人體成份分析儀采集數(shù)據(jù)(包含健康評估分值、BMI、WHR、BF%、 VFA%、BMR、蛋白質(zhì)、無機鹽、細胞內(nèi)液、細胞外液、節(jié)段性脂肪分布)。結(jié)果：1、三種療法的總有效率分別為77.42%、73.53%、90.62%,電針結(jié)合埋線組治療單純性肥胖患者的療效最佳(P0.05),其次為電針組,埋線組療效最差。2、三種療法均能降低各項肥胖指標BMI、WHR、BF%、VFA%等,其中電針結(jié)合埋線組降低幅度最大(P0.05)。3、三組對于軀干部位脂肪(主要在腹部)脂肪量的減少,均明顯高于對四肢脂肪的減少量,電針組對于下肢和軀干部位脂肪減少的作用強于埋線組(P0.05),而埋線結(jié)合電針組無論對于上肢、下肢還是軀干,其療效均優(yōu)于其余兩組(P0.05)。4、三種療法均能提高單純性肥胖患者低下的基礎代謝率,使人體脂肪含量減少而肌肉相對增多(P0.05)；并能升高健康評估分值,多數(shù)患者由原來的小于70分的弱體質(zhì),恢復到70-90的正常范圍之內(nèi)。5、三種療法在治療過程中并不影響患者其他成分如蛋白質(zhì)、無機鹽、細胞內(nèi)外水液的正常分布范圍,四項指標在治療前后無明顯改變,均在正常范圍內(nèi)(P0.05)。
[Abstract]:Objective: in view of the large amount of clinical application of electroacupuncture and catgut embedding therapy in the treatment of simple obesity, the curative effect of common electroacupuncture, acupoint catgut embedding and their combination were observed and analyzed. The effects of the three therapies on the distribution of body components, especially fat, were further compared based on the analysis of human body composition, and the safety, mechanism and advantages of the three therapies in the treatment of simple obesity were clarified, which was convenient for clinical selection. Methods: the patients with simple obesity were divided into "electroacupuncture group" (35 cases), "embedding group" (40 cases) and "electroacupuncture combined with catgut embedding group" (33 cases). Eleven patients who could not be treated strictly were excluded. There were 97 cases in accordance with the requirements of the study, 31 cases in the electroacupuncture group, 34 cases in the embedding group and 32 cases in the group of electroacupuncture combined with embedding thread. Main points: Zhongwan, Tianshu, waterway, Qihai, Zusanli, Liang Qiu, and so on. In the electroacupuncture group, two points were used in the abdomen and one point in each of the lower limbs was used. The frequency f _ 1 (10 / 100 ~ 100 Hz ~ +) was used alternately, the intensity of which was to be tolerated by the patient, the needle was kept for 30 minutes, once every other day for 6 weeks, and the same acupoint was implanted once for 7-10 days in the wire embedding group. The electroacupuncture combined with wire embedding group was treated with electroacupuncture on the basis of embedding wire. The acupuncture was needled once on the 4th day after each embedding, and then every other day until the next embedding. All the three groups were treated for 6 weeks. The height of each patient was measured before and after treatment by the same examining doctor (who did not provide treatment for the patient), and the data were collected by InBody720 anthropometric analyzer (including health assessment score, BMI-WHR BF, protein, inorganic salt, intracellular fluid). Extracellular fluid, segmental fat distribution. Results the total effective rates of the three treatments were 77.42 and 73.53, respectively. Electroacupuncture combined with catgut embedding group had the best curative effect on simple obesity patients (P 0.05), followed by electroacupuncture group, embedding thread group and embedding thread group. All three kinds of therapy could reduce BMIWHRBFFV FAA% and so on. Among them, electroacupuncture combined with embedding thread group had the largest decrease in the amount of fat in the trunk (mainly in the abdomen), which was significantly higher than that in the limbs, and the decrease of fat in the trunk was significantly higher in the three groups than in the extremities. The effect of electroacupuncture group on lower extremity and trunk fat loss was stronger than that on thread embedding group (P 0.05), but the combination of embedding wire group and electroacupuncture group was not only for upper limb, lower extremity and trunk, but also for upper limb, lower extremity and trunk. The therapeutic effect was better than that of the other two groups (P 0.05. 4). All the three treatments could increase the basal metabolic rate of simple obesity patients, decrease the fat content of human body and increase the muscle mass, and increase the score of health assessment. Most patients recovered from the original weak constitution of less than 70 points to within the normal range of 70-90. The three treatments did not affect the normal distribution of other components of the patient, such as protein, inorganic salt, and extracellular water, during the course of treatment. There was no significant change in the four indexes before and after treatment, all of them were within normal range (P 0.05).
【學位授予單位】：南京中醫(yī)藥大學
【學位級別】：博士
【學位授予年份】：2016
【分類號】：R246.1

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