Wang Kaiyue, Liu Zhicheng, Xu Bin
Zhongguo Zhen Jiu. 2016 Mar;36(3):225-30.
To explore the efficacy on obesity of spleen deficiency and damp blockage pattern and hyperlipemia treated with warm needling therapy and auricular acupuncture and the effect mechanism of the combined treatment.
One hundred and ten patients of obesity of spleen deficiency and damp blockage pattern and hyperlipemia were randomized into an observation group and a control group, 55 cases in each one. Additionally, a healthy group (52 cases) was set up as the control. In the control group, the warm needling therapy was applied to Taibai (SP 3), Chongyang (ST 42), Yinlingquan (SP 9), Zusanli (ST 36), etc., once every two days. In the observation group, on the basic treatment as the control group, the auricular acupuncture was applied to Pi (CO₁₃), Wei (CO₄), Fei (CO₁₄), Shen (CO₁₀), etc., once every 2 to 3 days. The efficacy was evaluated after 3-month, treatment in the two groups. The observation was conducted on the obesity outcomes [body mass, obesity degree (A), body mass index (BMI), body fat percentage (F%)], blood-lipoids indicators [such as serum total cholesterol (TC), triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)], fat-islet endocrine axis outcomes [such as fasting plasma glucose (FPG) , fasting leptin (FLP), fasting insulin (FINS), insulin sensitivity index (ISI), insulin resistance index (Homa-IR) and insulin β cell function index (Homa-β)], as well as autonomic nerve function index (Y) before and after treatment in the patients of the two groups. The efficacy was assessed in the two groups.
The total effective rate was 96.4% (53/55) in the observation group, better than 87.3% (48/55, P < 0.01) in the control group. For the improvements of the obesity indices, the differences were not significant between the two groups (all P > 0.05). Before treatment, the levels of TC, TG, LDL-C, FLP, FPG, FINS and Homa-IR in the two groups were all significantly higher than those in the healthy group (all P < 0.01), and the levels of HDL, ISI, Homa-β and Y were significantly lower than those in the healthy group (all P < 0.01). After treatment, except Homa-β, the other indices were all improved significantly (all P < 0.01). The results in the observation group were better than those in the control group (all P < 0.01).
The patients of obesity of spleen deficiency and damp blockage pattern and hyperlipemia have the disturbances of lipid metabolism, "fat-islet endocrinal axis" function and automatic nerve function. The combined treatment of warm needling therapy and auricular acupuncture or simple warm needling therapy present the effects of weight reducing and lipid reducing. The effect of the combined treatment is better than simple warm needling therapy. The efficacy mechanism is probably relevant to the positive regulation of blood glucose, lipid metabolism, fat-islet endocrinal axis and automatic nerve function.
探讨温针疗法与耳针疗法联合治疗脾虚湿阻型肥胖症及高脂血症的疗效及作用机制。
将110例脾虚湿阻型肥胖症及高脂血症患者随机分为观察组和对照组，每组55例。另设健康组（52例）作为对照。对照组采用温针疗法针刺太白（SP 3）、冲阳（ST 42）、阴陵泉（SP 9）、足三里（ST 36）等穴位，每2天治疗1次。观察组在对照组基础治疗上，加用耳针疗法针刺脾（CO₁₃）、胃（CO₄）、肺（CO₁₄）、肾（CO₁₀）等穴位，每2至3天治疗1次。两组均治疗3个月后评价疗效。观察两组患者治疗前后肥胖指标[体重、肥胖度（A）、体重指数（BMI）、体脂百分比（F%）]、血脂指标[血清总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）]、脂-胰岛内分泌轴指标[空腹血糖（FPG）、空腹瘦素（FLP）、空腹胰岛素（FINS）、胰岛素敏感指数（ISI）、胰岛素抵抗指数（Homa-IR）及胰岛素β细胞功能指数（Homa-β）]以及自主神经功能指标（Y）的变化，并进行疗效评定。
观察组总有效率为96.4%（53/55），优于对照组的87.3%（48/55，P < 0.01）。在肥胖指标改善方面，两组差异无统计学意义（均P > 0.05）。治疗前，两组患者的TC、TG、LDL-C、FLP、FPG、FINS及Homa-IR水平均显著高于健康组（均P < 0.01），HDL、ISI、Homa-β及Y水平均显著低于健康组（均P < 0.01）。治疗后，除Homa-β外，其他指标均显著改善（均P < 0.01）。观察组各项指标改善情况均优于对照组（均P < 0.01）。
脾虚湿阻型肥胖症及高脂血症患者存在脂质代谢、“脂-胰岛内分泌轴”功能及自主神经功能紊乱。温针疗法与耳针疗法联合治疗或单纯温针疗法均有减肥降脂作用，联合治疗效果优于单纯温针疗法。其作用机制可能与对血糖、脂质代谢、脂-胰岛内分泌轴及自主神经功能的正向调节有关。
