针灸治疗不同性别重度肥胖并发高脂血症患者疗效观察

Effect of acupuncture and moxibustion on severe obesity complicated with hyperlipidemia in different genders

目的:观察针灸治疗重度肥胖并发高脂血症患者的临床疗效,并探讨针灸对不同性别患者的临床综合疗效、脂质指标以及肥胖相关指标的作用差异。方法:纳入264例重度肥胖并发高脂血症患者,其中男性组106例、女性组158例,根据其临床症状和体征,将两组患者分为胃肠腑热型、脾虚湿阻型、痰湿内阻型、肝郁脾虚型、脾肾阳虚型及阴虚夹瘀型,采用针灸疗法辨证施治。观察针灸治疗前后两组患者的综合疗效以及各项肥胖指标[体质量(W)、肥胖度(A)、体质量指数(BMI)、体脂率(F)]、血脂指标[总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)]的变化。结果:男性组总有效率为91.5%(97/106),高于女性组的85.4%(135/158),但组间差异无统计学意义((49)>0.05)。治疗后两组患者W、A、BMI及F均低于治疗前(均P<0.01),且男性组患者W、A、BMI及F治疗前后差值均高于女性组(均P<0.05)。治疗后两组患者TC、TG、LDL-C均低于治疗前,HDL-C均高于治疗前(均(49)<0.05),且男性组患者TC、TG、LDL-C及HDL-C治疗前后差值均优于女性组(均P<0.05)。结论:针灸对重度肥胖并发高脂血症患者具有减肥和调脂双重作用,在减重和降脂中男性组的改善优于女性组,对于高脂血症的治疗与预防有重要意义。

Objective To explore the effect of acupuncture and moxibustion on severe obesity complicated with hyperlipidemia in different genders and their comprehensive effect, lipid indexes, and obesity indexes. Methods A total of 264 patients of severe obesity complicated with hyperlipidemia were assigned into a male group（106 cases） and a female group（158 cases）.According to their clinical symptoms and patterns, acupuncture and moxibustion differentiation therapies were applied for stomach and intestine heat type, spleen deficiency and dampness resistance type, phlegm-dampness internal resistance type, liver depression and spleen deficiency type, spleen and kidney yang deficiency type and yin deficiency and blood stasis type.The obesity indexes were weight（W）, obesity degree（A）, body mass index（BMI） and body fat percentage（F）; the blood lipid indexes were total cholesterol（TC）,triglyceride（TG）,low density lipoprotein（LDL-C） and high density lipoprotein（HDL-C）. The comprehensive effect, obesity and blood lipid indexes were observed.Results The total effective rate of the male group was 91.5%（97/106）, and the total effective rate of the female group was 85.4%（135/158）, without statistical significance（P〉0.05）. After treatment, the obesity indexes of W, A, BMI and F and the blood lipid levels of TC, TG, LDL-C decreased, the levels of HDL-C increased compared with those before treatment in the two groups（P〈0.05, P〈0.01）. The different values before and after treatment of the above all indexes in the male group were higher than those in the female group（all P〈0.05）. Conclusion Acupuncture and moxibustion can both improve the obesity and blood lipid indexes for the patients with obesity complicated with hyperlipidemia. The effect is better for male than for female. The methods can prevent and treat hyperlipidemia.