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1.常州市第七人民医院,江苏 常州 213011
2.南京中医药大学 无锡附属医院,江苏 无锡 214177
3.江西省中医院,南昌 330019
4.江苏省中医院,南京 210029
商德俊,主任中医师,从事推拿针灸临床工作,E-mail:sdjyeb@163.com
* 陶琦,主任中医师,从事推拿针灸临床工作,E-mail:qwertyuiop753956@163.com
收稿日期:2020-10-20,
网络出版日期:2020-12-11,
纸质出版日期:2021-12-05
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商德俊,杜建明,梁启军等.加味小承气汤联合穴位埋线治疗食源性肥胖胃热湿阻证的临床疗效[J].中国实验方剂学杂志,2021,27(23):131-136.
SHANG De-jun,DU Jian-ming,LIANG Qi-jun,et al.Clinical Efficacy of Modified Xiao Chengqitang Combined with Acupoint Catgut Implantation in Treating Diet-induced Obesity Syndrome of Stomach Heat Dampness Obstruction[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(23):131-136.
商德俊,杜建明,梁启军等.加味小承气汤联合穴位埋线治疗食源性肥胖胃热湿阻证的临床疗效[J].中国实验方剂学杂志,2021,27(23):131-136. DOI: 10.13422/j.cnki.syfjx.20210333.
SHANG De-jun,DU Jian-ming,LIANG Qi-jun,et al.Clinical Efficacy of Modified Xiao Chengqitang Combined with Acupoint Catgut Implantation in Treating Diet-induced Obesity Syndrome of Stomach Heat Dampness Obstruction[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(23):131-136. DOI: 10.13422/j.cnki.syfjx.20210333.
目的
2
观察加味小承气汤联合穴位埋线治疗食源性肥胖(DIO)胃热湿阻证的临床疗效与安全性。
方法
2
将172例患者按随机数字表法分为对照组84例和观察组88例。两组患者均给予饮食和运动的生活方式调整,并进行穴位埋线,10 d进行1次,间隔5 d再行1次埋线,共埋6次。观察组服用加味小承气汤颗粒剂,10 g/次,分早晚2次温开水冲服;对照组服用加味小承气汤颗粒剂模拟剂,10 g/次,温开水冲服,2次/d。两组疗程均为4个月。测量治疗前后体质量指数(BMI),脂肪百分率(F%),肥胖度、腰臀比(WHR),采用彩色多普勒超声检查仪测量腹部脂肪厚度、肝前脂肪厚度(AHF),肾周脂肪囊厚度(PRF),并计算内脏脂肪指数(UVI);检测治疗前后空腹血糖(FBG),甘油三酯(TG),总胆固醇(TC),高密度脂蛋白胆固醇(HDL-C),低密度脂蛋白胆固醇(LDL-C),空腹胰岛素(FINS),瘦素(LP),脂联素(APN),并计算胰岛素抵抗指数(HOMA-IR);进行安全性评价。
结果
2
观察组患者BMI,F%,肥胖度和WHR均低于对照组(
P
<
0.05,
P
<
0.01);观察组患者皮下脂肪厚度,AHF,PRF和UVI均低于对照组(
P
<
0.01);观察组患者TG,TC,LDL-C和FINS均低于对照组(
P
<
0.01);观察组患者LP和HOMA-IR均低于对照组(
P
<
0.01),APN高于对照组(
P
<
0.01);观察组的临床疗效总有效率为(71/80)88.75%,高于对照组的(57/75)76.00%(
χ
2
=4.374,
P
<
0.05)。
结论
2
加味小承气汤联合穴位埋线治疗胃热湿阻型DIO,可调节LP,APN等因子,改善糖、脂等能量代谢,能有效控制肥胖情况,且安全,值得临床使用。
Objective
2
To observe the clinical efficacy and safety of modified Xiao Chengqitang combined with acupoint catgut implantation in treating diet-induced obesity (DIO) syndrome of stomach heat dampness obstruction.
Method
2
One hundred and seventy-two patients were randomly divided into control group(84 cases) and observation group(88 cases). Both groups of patients received diet and exercise lifestyle adjustments, and acupoint catgut implantation was performed, 10 days for 1 time, 5 days intervals and then catgut implantation again, for a total of 6 times. Patients in observation group took modified Xiao Chengqitang granular powder, 10 g/time, with lukewarm boiled water in morning and evening. Patients in control group took modified Xiao Chengqitang granular powder simulant, 10 g/time, with lukewarm boiled water, 2 times/day. The treatment courses continued 4 months in two groups. Then the body mass index (BMI), fat percentage (F%), obesity, waist to hip ratio (WHR) were measured before and after treatment. Color Doppler ultrasonography was used to measure abdominal fat thickness, prehepatic fat thickness (AHF), perirenal fat thickness (PRF), and visceral fat index (UVI). Fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), fasting insulin (FINS), leptin (LP), and adiponectin (APN) were detected before and after treatment, and the homeostasis model assessment of insulin resistance (HOMA-IR) index was calculated. In addition, safety evaluation was also conducted.
Result
2
The BMI, F%, obesity degree and WHR in observation group were all lower than those in control group (
P
<
0.05 or
P
<
0.01). Subcutaneous fat thickness, AHF, PRF and UVI in observation group were lower than those in control group (
P
<
0.01). The TG, TC, LDL-C and FINS levels in observation group were lower than those in control group (
P
<
0.01). The LP and HOMA-IR were also lower than those in control group (
P
<
0.01), while the APN was higher than that in control group (
P
<
0.01). The total effective rate in clinical application was (71/80) 88.75% in the observation group, higher than (57/75) 76.00% in the control group (
χ
2
=4.374,
P
<
0.05).
Conclusion
2
Modified Xiao Chengqitang combined with acupoint catgut implantation in treating DIO syndrome of stomach heat dampness obstruction can adjust LP, APN and other factors, improve energy metabolism such as sugar and fat, and effectively control obesity with high safety, so it is worthy of clinical use.
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