發(fā)布時間：2018-05-18 09:50

  本文選題：單純性肥胖 + 針藥結(jié)合療法��； 參考：《廣西中醫(yī)藥大學》2017年碩士論文

【摘要】：目的:通過觀察針灸結(jié)合健脾溫腎中藥對脾腎陽虛型單純性肥胖的臨床療效,佐證以“健脾溫腎”理論指導治療肥胖癥的學術(shù)思想,為針灸臨床防治肥胖癥提供客觀的依據(jù)。方法:本研究采用隨機分組法將符合納入標準的脾腎陽虛證肥胖患者69例分成3組,其中針藥結(jié)合組23例,服用健脾溫腎中藥治療,每日1劑,同時接受針灸治療,取穴以脾經(jīng)、任脈為主,佐以灸法,隔日1次,10次為1個療程,治療3個療程,共2個月;中藥組23例,僅服用健脾溫腎中藥治療,每日1劑,療程2個月;針灸組23例,只接受針灸治療,隔日1次,療程2個月。觀察并記錄治療前后病例的身高、體重、體質(zhì)指數(shù)(BMI)、腰圍、臀圍、腰臀比(WHR)、中醫(yī)癥狀量化積分與療效及血脂的變化情況。全部數(shù)據(jù)以SPSS21.0統(tǒng)計軟件進行統(tǒng)計學分析。結(jié)果:(1)體重、BMI、WHR:3組在體重、BMI、WHR方面組內(nèi)治療前后有顯著性差異(P0.05),有統(tǒng)計學意義。(2)血脂:3組治療前血清總膽固醇(TC)、甘油三脂(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)值兩兩比較,差異無統(tǒng)計學意義(P0.05)。治療后TC、TG、LDL-C明顯值下降,HDL-C值升高,與治療前比較差異有統(tǒng)計學意義(P0.05);針藥結(jié)合組治療后TC、TG、LDL-C值下降明顯,與中藥組及針灸組比較差異顯著(P0.05),HDL-C值升高明顯,與中藥組及針灸組比較差異顯著(P0.05);(3)中醫(yī)癥狀積分:3組中醫(yī)證候積分治療前后具有統(tǒng)計學差異(P0.05),治療后針藥結(jié)合組較中藥組及針灸組積分降低,具有統(tǒng)計學差異(P0.05)。(4)中醫(yī)臨床療效評價:治療后對3組病例進行中醫(yī)癥狀療效評價,針藥結(jié)合組23例患者中,顯效8例,有效13例,無效2例,臨床總有效率為91.3%;中藥組22例患者中,顯效3例,有效10例,無效9例,臨床總有效率為59.1%,針灸組22例患者中顯效5例,有效12例,無效5例,臨床總有效率為77.2%,3組臨床癥狀和體征均有不同程度的改善;針藥結(jié)合組與中藥組、針灸組比較有顯著差異(P0.05)。結(jié)論:針灸結(jié)合健脾溫腎中藥方是治療單純性肥胖癥脾腎陽虛證的有效方法,療效高于單純中藥組、針灸組;基于“健脾溫腎”為理論治療肥胖癥的學術(shù)思想具有臨床指導意義,而基于此的針灸與中藥組方合理有效。
[Abstract]:Objective: To observe the clinical effect of acupuncture combined with Chinese herbal medicine of strengthening spleen and warm kidney on simple obesity of spleen and kidney yang deficiency type, to support the academic thought of "invigorating the spleen and warm kidney" theory in the treatment of obesity and providing objective basis for clinical prevention and treatment of obesity by Acupuncture. 69 cases of fat patients were divided into 3 groups, of which 23 cases were combined with acupuncture and medicine, 1 doses per day and acupuncture treatment, taking acupuncture and moxibustion, with moxibustion and moxibustion, 1 times a day, 10 times for 1 courses, 3 courses for 2 months, 23 cases of Chinese medicine group, only taking medicine of invigorating spleen and warm kidney, 1, course 2 months; acupuncture and moxibustion; acupuncture and moxibustion Group 23 cases, only received acupuncture and moxibustion, 1 times a day and 2 months of treatment. Observe and record the height, weight, body mass index (BMI), waist circumference, hip circumference, waist hip ratio (WHR), quantitative integration of TCM symptoms and changes of curative effect and blood lipid. All data were statistically analyzed by SPSS21.0 software. Results: (1) body weight, BMI, WHR:3 group There were significant differences (P0.05) before and after treatment in body weight, BMI, and WHR. (2) blood lipid: 3 groups of serum total cholesterol (TC), glycerol three fat (TG), high density lipoprotein (HDL-C), low density lipoprotein (LDL-C) value 22 compared, there was no statistical difference (P0.05). After treatment, TC, TG, LDL-C obviously decreased, HDL-C values were elevated. Compared with before treatment, there was significant difference (P0.05); the value of TC, TG and LDL-C decreased significantly after treatment in the combination group of acupuncture and medicine, compared with the traditional Chinese medicine group and the acupuncture group, the difference was significant (P0.05), the value of HDL-C increased obviously, and the difference was significant (P0.05) compared with the traditional Chinese medicine group and the acupuncture group (3) the TCM symptom integral: the 3 groups of TCM syndromes were statistically different before and after the treatment. (P0.05), after treatment, the integration of acupuncture and medicine group was lower than that of the traditional Chinese medicine group and the acupuncture group (P0.05). (4) the evaluation of the clinical efficacy of Chinese medicine: after treatment, the curative effect was evaluated in 3 groups of cases. Among the 23 patients with 23 cases, 8 cases were effective, 13 cases were effective, 2 cases were invalid, the total effective rate was 91.3%, and 22 patients of traditional Chinese medicine group were shown in the Chinese medicine group. 3 cases were effective, 10 cases were effective, 9 cases were invalid, the total effective rate was 59.1%, 5 of 22 patients in the acupuncture group, 12 effective and 5 ineffective, the total clinical effective rate was 77.2%. The 3 groups of clinical symptoms and signs were improved in different degrees. The ratio of acupuncture and medicine combined with traditional Chinese medicine group and acupuncture group was significantly different (P0.05). Conclusion acupuncture combined with Chinese traditional Chinese medicine of invigorating spleen and warming kidney It is an effective method to treat the spleen and kidney yang deficiency syndrome of simple obesity. The curative effect is higher than that of the traditional Chinese medicine group and the acupuncture group. Based on "strengthening the spleen and warming the kidney" as a theoretical treatment for obesity, the acupuncture and Chinese medicine based on this method are reasonable and effective.
【學位授予單位】：廣西中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R259

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