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1.贵州中医药大学针灸推拿学院,贵阳 550025
2.成都中医药大学针灸推拿学院
3.贵州中医药大学第一附属医院康复科,贵阳 550001
4.贵州中医药大学第一附属医院针灸科,贵阳 550001
晏明熙,贵州中医药大学博士研究生。E-mail:435294123@qq.com
✉崔瑾,教授。E-mail:516260179@qq.com
收稿:2024-05-17,
网络首发:2024-09-30,
纸质出版:2024-12-12
移动端阅览
晏明熙, 朱敏, 全菲, 等. 脂肪层穴位埋线治疗腹型肥胖:随机对照试验[J]. 中国针灸, 2024,44(12):1370-1376.
YAN Mingxi, ZHU Min, QUAN Fei, et al. Acupoint thread-embedding at fat layer for abdominal obesity: a randomized controlled trial[J]. Chinese Acupuncture & Moxibustion, 2024, 44(12): 1370-1376.
晏明熙, 朱敏, 全菲, 等. 脂肪层穴位埋线治疗腹型肥胖:随机对照试验[J]. 中国针灸, 2024,44(12):1370-1376. DOI: 10.13703/j.0255-2930.20240517-k0005.
YAN Mingxi, ZHU Min, QUAN Fei, et al. Acupoint thread-embedding at fat layer for abdominal obesity: a randomized controlled trial[J]. Chinese Acupuncture & Moxibustion, 2024, 44(12): 1370-1376. DOI: 10.13703/j.0255-2930.20240517-k0005.
目的:
2
观察脂肪层穴位埋线治疗腹型肥胖的临床疗效及对糖脂代谢的影响。
方法:
2
将96例腹型肥胖患者随机分为穴位埋线组(48例,脱落3例)和假穴位埋线组(48例,脱落3例)。在生活方式干预的基础治疗上,穴位埋线组于中脘、气海、关元及双侧梁门、丰隆、脾俞等穴行穴位埋线治疗,线体埋置在脂肪层;假穴位埋线组取穴及操作同穴位埋线组,但不埋入线体。两组均每2周1次,治疗12周,共6次。分别于治疗前后及治疗结束后12周(随访)测量及计算两组患者腰围、体质量、体质量指数(BMI)、腰臀比(WHR)和腰围身高比(WHtR),观察两组患者食欲视觉模拟量表(VAS)评分;分别于治疗前后测量两组患者腹部内脏脂肪面积(VFA)、皮下脂肪面积(SFA),检测并计算糖脂代谢指标[空腹血糖(FBG)、空腹胰岛素(FINS)、稳态模型胰岛素抵抗(HOMA-IR)指数及总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)含量],检测血清瘦素、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)含量;并于治疗结束后2周评定临床疗效。
结果:
2
治疗后及随访时,穴位埋线组患者腰围、体质量、BMI、WHR、WHtR和食欲VAS评分较治疗前降低(
P
<
0.01);治疗后,假穴位埋线组患者腰围、体质量、BMI、WHtR和食欲VAS评分较治疗前降低(
P
<
0.01)。除治疗后体质量外,穴位埋线组患者治疗后及随访时腰围、体质量、BMI、WHR、WHtR低于假穴位埋线组(
P
<
0.01,
P
<
0.05);治疗后,穴位埋线组患者食欲VAS评分低于假穴位埋线组(
P
<
0.01)。治疗后,两组患者腹部VFA、SFA较治疗前减少(
P
<
0.01,
P
<
0.05);穴位埋线组患者血清FBG、FINS、HOMA-IR指数及TC、TG、LDL-C、瘦素、TNF-α、IL-6含量较治疗前降低(
P
<
0.01),血清HDL-C较治疗前升高(
P
<
0.01);假穴位埋线组患者血清FBG、HOMA-IR指数较治疗前降低(
P
<
0.01,
P
<
0.05)。治疗后,穴位埋线组患者腹部SFA少于假穴位埋线组(
P
<
0.01),血清FINS、HOMA-IR指数及TC、LDL-C、瘦素、TNF-α、IL-6含量低于假穴位埋线组(
P
<
0.05,
P
<
0.01)。穴位埋线组总有效率为82.2%(37/45),高于假穴位埋线组的15.6%(7/45,
P
<
0.01)。
结论:
2
脂肪层穴位埋线可有效改善腹型肥胖患者肥胖程度,减少腹部脂肪堆积,抑制食欲,改善糖脂代谢,减轻炎性反应,且具有持续性效应。
Objective
2
To observe the clinical efficacy of acupoint thread-embedding at fat layer for abdominal obesity and its effects on glucose and lipid metabolism.
Methods
2
Ninety-six patients with abdominal obesity were randomly divided into an acupoint embedding group (48 cases
3 cases dropped out) and a sham embedding group (48 cases
3 cases dropped out). Both groups received lifestyle interventions as basic treatment. The acupoint embedding group underwent thread-embedding at Zhongwan (CV 12)
Qihai (CV 6)
Guanyuan (CV 4)
and bilateral Liangmen (ST 21)
Fenglong (ST 40)
and Pishu (BL 20)
with the thread implanted in the fat layer. The sham embedding group followed the same acupoint selection and procedure but without catgut implantation. Both groups were treated once every two weeks for 12 weeks
for a total of six treatments. Waist circumference
body weight
body mass index (BMI)
waist-to-hip ratio (WHR)
and waist-to-height ratio (WHtR) were measured
and appetite was assessed using the visual analogue scale (VAS) before and after treatment and at 12 weeks after treatment completion (follow-up) in the two groups. Visceral fat area (VFA) and subcutaneous fat area (SFA) at abdomen were measured
and blood glucose and lipid metabolism markers
including fasting blood glucose (FBG)
fasting insulin (FINS)
homeostasis model assessment of insulin resistance (HOMA-IR) index
total cholesterol (TC)
triglycerides (TG)
high-density lipoprotein cholesterol (HDL-C)
low-density lipoprotein cholesterol (LDL-C)
leptin
tumor necrosis factor-α(TNF-α)
and interleukin-6 (IL-6)
were also tested before and after treatment in the two groups. Clinical efficacy was evaluated two weeks after treatment completion.
Results
2
After treatment and at follow-up
the waist circumference
body weight
BMI
WHR
WHtR
and appetite VAS scores in the acupoint embedding group were decreased compared to those before treatment (
P
<
0.01). In the sham embedding group
waist circumference
body weight
BMI
WHtR
and appetite VAS score were also reduced after treatment compared to those before treatment (
P
<
0.01). Except for body weight after treatment
the acupoint embedding group showed lower waist circumference
body weight
BMI
WHR
and WHtR values after treatment and at follow-up compared to the sham embedding group (
P
<
0.01
P
<
0.05). Additionally
the appetite VAS score in the acupoint embedding group was lower than that in the sham embedding group after treatment (
P
<
0.01). Both groups showed a reduction in abdominal VFA and SFA after treatment compared to those before treatment (
P
<
0.01
P
<
0.05). In the acupoint embedding group
serum FBG
FINS
HOMA-IR index
TC
TG
LDL-C
leptin
TNF-α
and IL-6 levels were decreased compared to those before treatment (
P
<
0.01)
while HDL-C level was increased (
P
<
0.01). In the sham embedding group
serum FBG and HOMA-IR index were decreased compared to those before treatment (
P
<
0.01
P
<
0.05). After treatment
the abdominal SFA in the acupoint embedding group was lower than that in the sham embedding group (
P
<
0.01). Additionally
the acupoint embedding group had lower levels of serum FINS
HOMA-IR index
TC
LDL-C
leptin
TNF-α
and IL-6 compared to the sham embedding group (
P
<
0.05
P
<
0.01). The total effective rate in the acupoint embedding group was 82.2% (37/45)
which was significantly higher than 15.6% (7/45) in the sham embedding group (
P
<
0.01).
Conclusion
2
The acupoint catgut embedding at fat layer could effectively reduce the obesity severity in patients with abdominal obesity
decrease abdominal fat accumulation
suppress appetite
improve glucose and lipid metabolism
reduce inflammatory responses
and has a sustained effect.
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