自拟益气固本方联合耳穴贴压对单纯性肥胖患者糖脂代谢及血清IGF-1、25(OH)D表达的干预作用

Intervention Effect of Self-made Yiqi Guben Prescription Combined with Auricular Point Sticking on Glucose and Lipid Metabolism and Serum IGF-1,25(OH)D Expression in Simple Obese Patients

目的:探讨自拟益气固本方联合耳穴贴压对单纯性肥胖患者糖脂代谢及血清胰岛素样生长因子-1(IGF-1)、25羟维生素D[25(OH)D]表达的干预作用。方法:选取2018年1月-2019年7月笔者医院接诊的102例单纯性肥胖患者作为研究对象,将符合标准患者按照1:1分配,依据就诊顺序排序1~102,每位患者赋予1位随机数,分为三组,每组34例。三组均予以综合干预(饮食、运动、心理等),在此基础上,对照A组予以自拟益气固本方,对照B组予以耳穴贴压治疗,观察组予以自拟益气固本方联合耳穴贴压治疗。对比三组临床疗效、不良反应发生率及治疗前后中医证候积分、体质量指数(BMI)、糖脂代谢指标[空腹血糖(FBG)、空腹胰岛素(FINS)、总胆固醇(TC)、甘油三酯(TG)]、血清炎性因子[C反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)]、血清IGF-1及25(OH)D水平。结果:观察组临床疗效94.12%,高于对照A、B组的73.53%、67.65%(P<0.05);疗程结束后,观察组中医证候积分、BMI低于对照A、B组(P<0.05),观察组FBG、FINS、TC、TG水平低于对照A、B组(P<0.05),观察组血清CRP、IL-6、TNF-α水平低于对照A、B组(P<0.05);疗程结束后,观察组血清IGF-1及25(OH)D水平高于对照A、B组(P<0.05);三组不良反应发生率相比无显著性差异(P>0.05)。结论:自拟益气固本方联合耳穴贴压治疗单纯性肥胖,疗效确切,能有效改善患者临床症状,减轻体重,降低炎症反应,提高血清IGF-1及25(OH)D水平,调节糖脂代谢紊乱,且安全性高。

Objective To investigate the intervention effect of Yiqi Guben prescription combined with auricular point sticking on the metabolism of glucose and lipid and the expression of serum insulin-like growth factor-1(IGF-1)and 25 hydroxyvitamin D[25(OH)D]in simple obesity patients.Methods From January 2018 to July 2019,102 patients with simple obesity in our hospital were selected as the research objects,patients who met the criteria were assigned according to 1:1,and were ranked from 1-102 according to the order of consultation,each patient was assigned a random number,and they were divided into three groups,with 34 cases each.All three groups were given comprehensive interventions(diet,exercise,psychology,etc),on this basis,control group A was given Yiqi Guben prescription,control group B was given auricular point sticking treatment,the observation group was treated with Yiqi Guben prescription and auricular point sticking.The clinical efficacy,incidence of adverse reactions,TCM syndrome score,body mass index(BMI),glucose and lipid metabolism indexes[fasting blood glucose(FBG),fasting insulin(FINS),total cholesterol(TC),triglycerides(TG)],serum inflammatory factors[C-reactive protein(CRP),interleukin 6(IL-6),tumor necrosis factor-α(TNF-α)],serum IGF-1,25(OH)D levels before and after treatment were compared in the three groups.Results The clinical effect of the observation group was 94.12%higher than that of the control groups A and B,73.53%and 67.65%(P<0.05).After the treatment course,the TCM syndrome points and BMI of the observation group were lower than those of the control groups A and B(P<0.05).After the treatment course,the levels of FBG,FINS,TC,and TG in the observation group were lower than those in the control A and B groups(P<0.05).After the treatment,the levels of CRP,IL-6 and TNF-αin the observation group were lower than those in the control group A and B(P<0.05).After the treatment course,the serum IGF-1,25(OH)D levels in the observ ation group were higher than those in the control A and B groups(P<0.05).Incidence of adverse reactions:There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion The self-made Yiqi Guben prescription combined with auricular acupressure for the first time is effective in treating simple obesity,it can effectively improve symptoms,reduce weight,reduce inflammatory response,increase serum IGF-1,25(OH)D levels,regulate glucose and lipid metabolism disorders,and have high safety.