引气归元针刺治疗脾肾两虚型单纯性肥胖的疗效及对胰岛素抵抗、淋巴管功能相关指标的影响

Curative effect of Yinqi Guiyuan acupuncture on simple obesity of dual deficiency of the spleen-kidney and its influence on insulin resistance and lymphatic function

目的观察引气归元针刺治疗脾肾两虚型单纯性肥胖的疗效及对胰岛素抵抗(IR)、淋巴管功能相关指标的影响。方法将110例单纯性肥胖患者按照随机数字表法分为2组,治疗组55例予引气归元针刺治疗,对照组55例予常规针刺治疗,2组疗程均为4周。比较2组治疗前后中医证候评分变化;比较2组治疗前后肥胖相关指标变化;比较2组治疗前后空腹血糖(FPG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)水平变化;比较2组治疗前后淋巴管功能相关指标血清血管内皮生长因子-C(VEGF-C)、Delta样配体4(DLL4)、肾上腺髓质素(ADM)水平变化。结果2组治疗后形体肥胖、疲乏无力、腰膝酸软、四肢发冷评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后腰围、体质量指数(BMI)、肥胖度、体脂百分率均较本组治疗前降低(P<0.05),治疗后治疗组BMI、肥胖度、体脂百分率均低于对照组(P<0.05)。2组治疗后FPG、FINS、HOMA-IR水平均较本组治疗前降低(P<0.05),治疗后治疗组FINS、HOMA-IR水平均低于对照组(P<0.05)。2组治疗后VEGF-C、DLL4、ADM水平均较本组治疗前降低(P<0.05),治疗后治疗组VEGF-C、DLL4、ADM水平均低于对照组(P<0.05)。结论引气归元针刺治疗脾肾两虚型单纯性肥胖,可有效降低中医证候评分,减轻肥胖程度,改善IR,其机制可能与抑制淋巴管新生、改善淋巴管功能有关。

Objective To explore the clinical efficacy of Yinqi Guiyuan acupuncture on simple obesity of dual deficiency of the spleen-kidney and its influence on insulin resistance(IR)and lymphatic function.Methods Totally 110 patients with simple obesity of dual deficiency of the spleen-kidney were randomized 1∶1 to receive routine acupuncture treatment(control group)or Yinqi Guiyuan acupuncture(treatment group)for 4 weeks.The traditional Chinese medicine(TCM)syndrome scores,and the levels of obesity-related indexes,fasting plasma glucose(FPG),fasting insulin(FINS)and homeostasis model assessment of insulin resistance(HOMA-IR),serum vascular endothelial growth factor-C(VEGF-C),Delta-like ligand 4(DLL4)and adrenomedullin(ADM)were included as comparisons between groups before and after treatment.Results After treatment,the TCM syndromes scores(physical obesity,fatigue and weakness,soreness and weakness of waist and knees,and cold limbs)in the two groups were significantly lower than those before treatment(P<0.05),and the decrease in the treatment group was more obvious(P<0.05).After treatment,the levels of waist circumference,body mass index(BMI),obesity degree and body fat percentage in the two groups were significantly lower than those before treatment(P<0.05),and the levels of BMI,obesity degree and body fat percentage in the treatment group were significantly lower than those in the control group(P<0.05).After treatment,the levels of FPG,FINS and HOMA-IR in the two groups were lower than those before treatment(P<0.05),FINS and HOMA-IR were more pronounced in the treatment group(P<0.05).After treatment,the levels of VEGF-C,DLL4 and ADM in the two groups were significantly lower than those before treatment(P<0.05),the improvement in the treatment group was more obvious than that in the control group(P<0.05).Conclusion Forpatients with simple obesity of dual deficiency of the spleen-kidney,Yinqi Guiyuan acupuncture can effectively reduce the TCM syndrome score,decrease obesity degree and IR.Its mechanism may be related to inhibiting lymphatic neogenesis and improving lymphatic function.