电阻抗法分析化痰消积方结合PGLA埋线、易医脐针治疗腹型肥胖的临床疗效及对脂联素、内脂素水平的影响

Electrical Impedance Analysis of Clinical Efficacy of Huatan Xiaoji Formula(化痰消积方)Combined with PGLA Thread Embedding and Yiyi Umbilical Needle in Treatment of Abdominal Obesity and Its Impact on Adiponectin and Visfatin

目的评价电阻抗法分析化痰消积方结合聚乙交酯丙交酯(Poly ethyl acetate lactide,PGLA)埋线、易医脐针治疗腹型肥胖的临床疗效及对脂联素、内脂素水平的影响。方法研究共纳入96例腹型肥胖患者,均来源自于2019年1月—2021年1月医院中医科。按照治疗方式的不同分为PGLA埋线组(32例)、埋线+脐针组(32例)、观察组(32例),PGLA埋线组采用PGLA埋线治疗,埋线+脐针组在PGLA埋线治疗的同时,采用易医脐针治疗,观察组在埋线+脐针组治疗的基础上,口服化痰消积方治疗。3组分别治疗12周。观察3组入组前、治疗8周后胃热湿阻证中医证候积分变化,采用生物电阻抗原理测量内脏脂肪面积(Visceral fat area,VFA)、体脂含量(Body fat,BF)、体脂率(Body fat rate,PBF),并测量腰围(Waist circle,WC),计算身体质量指数(Body Mass Index,BMI)。采用全自动分析生化仪检测甘油三酯(Triglyceride,TG)、总胆固醇(Total cholesterol,TC)、高密度脂蛋白胆固醇(High-density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(Low-density lipoprotein cholesterin,LDL-C)水平,脂联素和内脂素水平,比较治疗疗效。结果观察组治疗总有效率高于PGLA埋线组、埋线+脐针组(P<0.05);埋线+脐针组治疗后中医证候积分低于PGLA埋线组,观察组治疗后中医证候积分低于PGLA埋线组、埋线+脐针组(P<0.05);埋线+脐针组治疗后VFA、BF、PBF、WC、BMI水平低于PGLA埋线组,观察组治疗后VFA、BF、PBF、WC、BMI水平低于PGLA埋线组、埋线+脐针组(P<0.05);埋线+脐针组治疗后血脂指标TG、TC、LDL-C水平低于PGLA埋线组,HDL-C水平高于PGLA埋线组。观察组治疗后血脂指标TG、TC、LDL-C水平低于PGLA埋线组、埋线+脐针组,HDL-C水平高于PGLA埋线组、埋线+脐针组(P<0.05);埋线+脐针组治疗后脂联素水平高于PGLA埋线组,内脂素水平低于PGLA埋线组。观察组治疗后脂联素水平高于PGLA埋线组、埋线+脐针组,内脂素水平低于PGLA埋线组、埋线+脐针组(P<0.05)。结论化痰消积方结合PGLA埋线、易医脐针治疗可降低腹型肥胖患者的中医证候积分,改善脂肪的沉积和分布、脂肪代谢因子和血脂指标,提高整体治疗疗效,值得进一步研究探讨。

Objective To evaluate the clinical efficacy of Huatan Xiaoji Formula(化痰消积方)combined with poly ethyl ace-tate lactide(PGLA)catgut embedding and Yi medical umbilical needle in the treatment of abdominal obesity and its influence on the levels of adiponectin and adiponectin.Methods A total of 96 patients with abdominal obesity were enrolled in this study,all of whom were recruited from the Department of Traditional Chinese Medicine of the hospital from January 2019 to January 2021.According to the different methods of treatment,the patients were divided into the PGLA catgut embedding group(32 cases),the catgut embedding+umbilical needle group(32 cases)and the observation group(32 cases).The PGLA catgut embedding group used PGLA catgut embedding therapy.The catgut embedding+umbilical needle group used PGLA catgut embedding and Yi medical umbilical needle therapy.The observation group used Huatan Xiaoji Formula orally on the basis of the PGLA catgut embedding and Yi medical umbilical needle therapy.The three groups were treated for 12 weeks respectively.The changes of TCM syndrome scores of the three groups were observed before admission and after 8 weeks of treatment.The visceral fat area(VFA),body fat content (BF)and body fat rate(PBF)of visceral fat area were measured by bioelectrical impedance.Waist circle(WC)was measured and body mass index(BMI)was calculated.The levels of triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),adiponectin and endolipotin were measured by automatic analytical biochemical analyzer.The therapeutic efficacy was evaluated.Results The total effective rate in the observa-tion group was higher than that in the PGLA catgut embedding group and PGLA catgut embedding+umbilical needle group(P<0.05).The score of TCM syndrome after treatment in the catgut embedding+umbilical needle group was lower than that in the PGLA catgut embedding group,and the score of TCM syndrome in the observation group was lower than that in the PGLA catgut embedding group and the catgut embedding+umbilical needle group(P<0.05).The levels of VFA,BF,PBF,WC and BMI in the catgut embedding+umbilical needle group were lower than those in the PGLA catgut embedding group,and the levels of VFA,BF,PBF,WC and BMI in the observation group were lower than those in the catgut embedding+umbilical needle group(P<0.05).After treatment,the levels of TG,TC and LDL-C in the catgut embedding+umbilical needle group were lower than those in PGLA catgut embedding group,while the HDL-C level was higher than that in the PGLA catgut embedding group.After treatment,the levels of TG,TC and LDL-C in the observation group were lower than those in the PGLA catgut embedding group and the catgut embedding+umbilical needle group,while the HDL-C level was higher than that in the PGLA catgut embedding group and the catgut embedding+umbilical needle group(P<0.05).The level of adiponectin in the catgut embedding+umbili-cal needle group was higher than that in the PGLA catgut embedding group,and the level of endoadiponectin was lower than that in the PGLA catgut embedding group.After treatment,the adiponectin level in the observation group was higher than that in the PGLA catgut embedding group and the catgut embedding+umbilical needle group,and the adiponectin level was lower than that in the PGLA catgut embedding group and the catgut embedding+umbilical needle group(P<0.05).Conclusion Huatan Xiaoji Formula combined with PGLA catgut embedding and Yi medical umbilical needle treatment can reduce the TCM syndrome score of patients with abdominal obesity,improve the deposition and distribution of fat,adipose metabolic factors and blood lipid inde-xes,and improve the overall therapeutic effect,and is worthy of further study and discussion.