靳三针不同疗法治疗痰浊阻遏型高脂血症临床疗效观察

Clinical therapeutic effect of hyperlipidemia of turbid phlegm obstruction pattern/syndrome treated with the different Jin’s three-needle therapies

目的:通过比较靳三针不同疗法治疗痰浊阻遏型高脂血症临床疗效的差异,为临床针灸治疗高脂血症的方案优化提供新思路和理论依据。方法:将痰浊阻遏型高脂血症患者随机分为宣教组、电针组、穴位埋线组,每组30例。宣教组予常规的健康教育;电针组在宣教组的基础上加电针治疗,30 min/次,每周2次;穴位埋线组在宣教组的基础上加穴位埋线,取穴同电针组,每周治疗1次。3组均连续治疗8周。于入组前及治疗后检测肥胖指标[体质量、腰围、体质量指数(BMI)]、血脂指标[总胆固醇(TC)、总甘油三酯(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)]、胰岛素抵抗指标[空腹血糖(FBG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]。结果:治疗后,电针组和穴位埋线组体质量、腰围、BMI及TC、TG、LDL-C含量和FINS、HOMA-IR均较治疗前明显下降(P<0.05,P<0.01),HDL-C较治疗前明显上升(P<0.01),穴位埋线组FBG较治疗前明显下降(P<0.01)。治疗后与电针组比较,穴位埋线组LDL-C明显降低、HDL-C明显升高(P<0.05),在肥胖指标、胰岛素抵抗指标方面,两组比较差异无统计学意义(均P>0.05)。穴位埋线组总有效率为90.0%(27/30),电针组总有效率为83.3%(25/30),均明显优于宣教组的60.0%(18/30),差异有统计学意义(P<0.01,P<0.05)。结论:宣教基础上加用靳三针电针或穴位埋线对高脂血症患者异常的脂质代谢及胰岛素抵抗均有良性调节作用,且穴位埋线疗法在降糖和改善LDL-C、HDL-C水平方面优于电针疗法。

Objective To compare the differences in clinical effects on hyperlipidemia of turbid phlegm obstruction pattern/syndrome treated with the different Jin’s three-needle therapies so as to provide a new approach and theoretic evidence for the clinical optimal scheme of acupuncture on hyperlipidemia.MethodsA total of 90 patients were randomly divided into education group,electroacupuncture group and catgut embedding group(30 cases in each).The routine health education was given to the education group.On the base of the treatment as the education group,electroacupuncture was applied to the electroacupuncture group for 30 min each time,twice a week;and the catgut embedding was applied to the catgut embedding group at the same acupoints as the electroacupuncture group,once a week.The treatment was given consecutively for 8 weeks in each group.Before and after treatment,the obesity indices[weight,waistline,body mass index(BMI)],blood lipid indices[serum total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),high density lipoprotein cholesterol(HDL-C)]and insulin resistance indices[fasting blood glucose(FBG),fasting plasma insulin(FINS),homeostasis model assessment-estimated insulin resistance(HOMA-IR)]were observed in the three groups before and after treatment.ResultsAfter treatment,in the electroacupuncture group and the catgut embedding group,the results of the obesity indices,e.g.weight,waistline and BMI,the levels of blood lipid,e.g.TC,TG,LDL-C and the insulin resistance indices,e.g.FINS and HOMA-IR were all obviously decreased compared with those before treatment(P<0.05,P<0.01),and the level of HDL-C apparently increased than that before treatment(P<0.01).In the catgut embedding group,FBG was obviously decreased after treatment as compared with that before treatment(P<0.01).After treatment,the improvements in LDL-C and HDL-C in the catgut embedding group were superior to those in the electroacupuncture group(P<0.05).Regarding the obesity indices and insulin resistance indices,the differences were not statistically significant in comparison between the catgut embedding group and the electroacupuncture group(all P>0.05).The total effective rate was 90.0%in the catgut embedding group(27/30)and it was 83.3%(25/30)in the electroacupuncture group,either of them was better than 60.0%(18/30)in the education group,indicating the statistical significance(P<0.01,P<0.05).ConclusionOn the base of health education,either the catgut embedding therapy or electroacupuncture of Jin’s three-needle treatment achieves the positive regulation on the abnormal lipid metabolism and insulin resistance.The hypoglycemic effect and the improving effect in LDL-C and HDL-C of the catgut embedding therapy are superior to electroacupuncture.