穴位埋线+辨证分型综合干预肥胖症20例临床观察

Clinical Observation on 20 Cases of Obesity Treated by Acupoint Catgut Embedding plus Syndrome Differentiation and Comprehensive Intervention

[目的]观察穴位埋线+辨证分型综合干预肥胖症疗效。[方法]使用前瞻性设计方法,对20例住院及门诊患者使用穴位埋线+辨证分型综合干预。穴位埋线,主穴:中脘、天枢、水道、曲池、足三里,配穴:多食善饥、肝阳上亢、便秘、月经不调、血脂高、少寐等相应配穴;局部肥胖多在局部埋线。辨证食疗:改变膳食结构与数量,纠正不良的膳食行为,合理搭配饮食,注意饮食营养,以均衡饮食为主,坚持三低饮食(低能量、低碳水化合物,低脂肪饮食),脾虚湿阻,健脾利湿;胃肠积热:健脾和胃,清热通便;肝气郁结:条达肝气、除满消痞;气血亏虚:补气养血;脾肾阳虚:温肾健脾,益精填髓。健康指导:改变不良生活方式,顺应自然规律,规律作息,劳逸适度;运动指导:每日主动运动量一般消耗热量300kcal,约走一万步。心理疏导:指导患者正确面对,积极配合;鼓励参加社交活动,宣泄不良情绪,短时期内下决心选择全素食,坚持足够时间进行减肥。关心、鼓励患者,帮助患者避免不良情绪刺激以舒缓脏腑运行功能。自我管理:协助患者坚持自我管理,积极参与治疗、应对疾病,引导自我健康活动。连续干预28d为1疗程。观测体质量、体质量指数、腰围、不良反应。干预1疗程(28d),判定疗效。[结果]体质量、体质量指数、腰围均明显降低(P<0.01)。[结论]穴位埋线+中医特色护理干预肥胖症,疗效满意,无严重不良反应,值得推广。

[[Objective] To observe the effect of catgut implantation at acupoint and syndrome differentiation and comprehensive intervention on obesity. [Methods] Applying the treatment with acupoint catgut embedding and syndrome differentiation on 20 inpatients and outpatients based on prospective design. Acupoint catgut embedding： main acupoints： Zhongwan, Tianshu, Shuidao, Quchi, Zusanli, and acupoints relating to liver Yang hyperactivity, constipation, menstruation, high blood lipid, and less sleep. Local obesityapplied the local catgut. Syndrome differentiation diet： changing the diet structure and quantity, correcting unhealthy dietary behavior, matching diet rationally, paying attention to diet nutrition, taking a balanced diet mainly, implementing the three low diet （low energy, low carbohydrate, low fat diet）, treating spleen deficiency dampness with invigorating spleen and dampness, treating gastrointestinal heat with nvigorating spleen and stomach and clearing heat and defecation;treating deficiency of Qi and blood with nourishing Qi; treating Yang deficiency of spleen and kidney with warming the kidney, strengthening the spleen and tonifying the kidney essence. Health guidance： change the unhealthy way of life, conform to the law of nature, build disciplinary daily schedule. Exercise guidance：advise the patients to do daily active exercise of general consumption of heat 300kcal and walk ten thousand steps. Psychological guidance： guiding the patient to face correctly and actively cooperate and encourage them participating in social activities, releasing the bad mood, choosing the whole vegetarian diet in a short period of time and keeping enough time to lose weight. Professions should take care and encourage patients and help them avoid bad emotional stimulation in order to relieve the function of Zangfu organs. Self management： help patients with self-management, active participation in treatment and responding to diseases and guide self-health activities. The continuous intervention of 28 days was 1 course of treatment.Observing the body mass, body mass index,waist circumference and adverse reactions. The 1 course of treatment （28d） was intervened to determine the curative effect. [Results] body mass,body mass index and waist circumference were significantly reduced（P〈0.01）. [Conclusion] Acupoint catgut embedding plus TCM characteristic nursing intervention has a satisfactory effect and no serious side effects. It is worth promoting.