针灸治疗女性肥胖伴发更年期综合征疗效观察

Observation on the efficacy of female obesity complicated with climacteric syndrome treated by acupuncture and moxibustion

目的:观察针灸治疗肥胖伴发更年期综合征的疗效及其影响因素。方法:将151例女性肥胖伴发更年期综合征患者依据"辨证施治"基本原理,取曲池、中脘、天枢、大横、足三里、上巨虚、三阴交、内庭等穴,据证施以补泻手法,结合耳穴贴压饥点、神门、交感、内分泌、胃。隔日治疗1次,治疗3个月,观察针灸治疗前后症状、体征、肥胖指标、Kupperman指数、自主神经功能指数(Y值)、雌二醇(E2)、促卵泡成熟激素(FSH)的变化。结果:肥胖伴发更年期综合征患者肥胖指标、Kupperman指数、FSH水平异常升高,而E2水平异常低下。针灸治疗后,患者肥胖指标、Kupperman指数、FSH水平均显著下降(均P<0.01),而E2水平均显著回升(P<0.05)。结论:针灸疗法对肥胖伴发更年期综合征患者疗效显著,且这一临床疗效与证型及肥胖等级密切相关。从愈显率看,减肥疗效由高至低为:肝郁气滞型>肝郁脾虚型>脾肾阳虚型>肝肾阴虚型>阴阳两虚型;轻度肥胖>中度肥胖>重度肥胖。

REN Bin-bin , LIU Ztli-chent4, XU Bin （Provincial-Ministerial Level Key Laboratory of Acupuncture and Medicine of the Ministry of Education, Nanjing University of CM, Nanjing 210029, Jiangsu Province, China） ABSTRACT Objective To observe the efficacy of acupuncture and moxibustion on female obesity complicated with climacteric syndrome and its impact factors. Methods （）ne hundred and fifty-one cases of female obesity complicated with climacteric syndrome were treated according to the basic principle as ＂pattern/syndrome differen tiation＂. Accordingly, the reinforcing or reducing technique was applied at Quchi （LI 11）, Zhongwan （CV 12）, Tianshu （ST 25）, I）aheng （SP 15）, Zusanli （ST 36）, Shangjuxu （ST 37）, Sanyinjiao （SP 6）, Netting （ST 44）, etc. The auricular point sticking was applied at Hunger Point, Ear-shenmen, Sympathetic Nerve, Endocrine and Stomach. The treatment was given once every two days. The duration of treatment was 3 months. The changes in the symptoms, physical signs, obesity index, Kupperman index, the vegetative equilibrium index （Value Y）, estradiol （E2） and follicle stimulating hormone （FSH） were observed before and after treatment. Results The obesity patients complicated with climacteric syndrome presented unusually high level of obesity index, Kupperman index and FSH levels and unusually low level of E2. After treatment, the obesity index, Kupperman index and FSH levels were all reduced significantly （all P〈O. 01 ） while E2 level was increased significantly （P〈O. 05）. Conclusion Acupuncture and moxibustion achieve the significant efficacy on obesity complicated with climacteric syndrome, which is closely related with the pattern/syndrome of the disorder and obesity grade. For the effective and curative rate of obesily index, the efficacy of liver qi stagnation pattern/syndrome is better than that at liver stagnation and spleen deficiency pattern/syndrome than spleen and kidney yang deficiency pattern/syndrome than liver and kidney yin deficiency pattern/syndrome than yin and yank deficiency pattern/syndrome; the effieacy of mild obesity is better than that at moderate obesity than severe obesity.