B超下不同层次穴位埋线对女性腹型肥胖及排便功能的近期疗效及安全性观察

Short-term curative effect and safety on female abdominal obesity and defecation function treated with acupoint embedding therapy at different layers under B ultrasound

目的:探讨B超下不同层次穴位埋线对女性腹型肥胖及排便功能的近期疗效和安全性。方法:将102例女性腹型肥胖患者随机分为深埋线组(34例,脱落1例)、浅埋线组(34例,脱落3例)和假埋线组(34例,脱落6例),3组共完成92例。在B超引导下,深埋线组将线体埋置在脂肪层+肌肉层,浅埋线组将线体埋置在脂肪层,假埋线组无线体埋置。埋线穴位为中脘、关元、关门_((双))、天枢_((双))、带脉_((双))、水道_((双))。每2周埋线1次,治疗4次。记录3组患者治疗前后腹型肥胖指标[腰围(WC)、体脂率(BFR)、体质量指数(BMI)、腹部皮下脂肪厚度(ASFT)]和排便功能指标[周自主排便次数(SBMs)、Bristol粪便性状评分(BSS)]的变化,评价各组的安全性(针刺痛评分和接受性评分)。结果:治疗后深、浅埋线组的WC、BFR、BMI、ASFT均较治疗前降低(P<0.05),且深埋线组较浅埋线组降低更明显(P<0.05)。治疗后深、浅埋线组的SBMs、BSS均较治疗前增加(P<0.05),且深埋线组增加较浅埋线组更为明显(P<0.05)。治疗后假埋线组的腹型肥胖指标和排便功能指标与本组治疗前比较差异无统计学意义(P>0.05)。深、浅埋线组针刺痛评分均大于假埋线组(P<0.05)。3组接受性评分均大于2分,组间比较差异均无统计学意义(P>0.05)。结论:B超下深、浅层穴位埋线均可改善女性腹型肥胖且安全;深层穴位埋线对腹型肥胖及排便功能的改善优于浅层埋线。

Objective To investigate the short-term effect and safety on female abdominal obesity and defecation function in treatment with acupoint embedding therapy at different abdominal layers under B ultrasound.Methods A total of 102 female patients with abdominal obesity were randomly divided into 3 groups,i.e.a deep embedding group(34 cases,1 case dropped out),a shallow embedding group(34 cases,3 cases dropped out)and a sham-embedding group(34 cases,6 cases dropped out).Finally,92 cases were included in the three groups.Under B ultrasound,in the deep embedding group,the absor-bable surgical suture were embedded in subcutaneous fat layer and muscle layer.In the shallow embedding group,the absorbable surgical suture was embedded in the fat layer and in the sham-embedding group,no suture was embedded.The acupoints for embedding therapy included Zhongwan(CV12),Guanyuan(CV4),bilateral Guanmen(ST22),bilateral Tianshu(ST25),bilateral Daimai(GB26)and bilateral Shuidao(ST28).The acupoint embedding therapy was exerted once every two weeks,for 4 times totally.Before and after treatment,the changes in abdominal obesity indicators(waist circumference[WC],body fat rate[BFR],body mass index[BMI],abdominal subcutaneous fat thickness[ASFT])and defecation function indicators(spontaneous bowel movement times[SBMs]and Bristol stool scale[BSS])were observed and the safety indicators were assessed.Results After treatment,WC,BFR,BMI and ASFT were lower than those before treatment in both the deep embedding group and the shallow embedding group(P<0.05),those values in the deep embedding group were reduced more obviously as compared with the shallow embedding group(P<0.05).SBMs and BSS after treatment were increased as compared with those before treatment in both the deep embedding group and the shallow embedding group(P<0.05)and the increase in the deep embedding group was more obvious than in the shallow embedding group(P<0.05).The abdominal obesity indicators and defecation function indicators after treatment were not different statistically as compared with those before treatment in the sham-embedding group(P>0.05).The pain score of acupuncture in either the deep embedding group or the shallow embedding group was higher than in the sham-embedding group(P<0.05).The acceptance was more than 2 points in all of the three groups and there was no statistical significance among groups(P>0.05).Conclusion Acupoint embedding therapy in both the deep and the shallow subcutaneous layers under B ultrasound may regulate the indicators of female abdominal obesity safely.The acupoint embedding therapy in the deep layer is more effective on abdominal obesity and defecation improvement as compared with that exerted in the shallow layer.