化痰祛湿方联合揿针干预腹型肥胖的临床疗效

目的:从“体-病”结合角度探讨化痰祛湿方联合揿针干预腹型肥胖的疗效。方法:2021年3月至2021年7月,选取腹型肥胖受试者112例,按随机数字表法分为对照组、中药组、揿针组、联合组,对其给予12周持续干预,观测受试者干预前后的腰围、体质量、体质量指数(BMI)、甘油三脂、总胆固醇、高密度脂蛋白、低密度脂蛋白及体质量表、压力知觉量表、贝克抑郁量表等指标,建立数据库进行统计分析。结果:①干预后,联合组、中药组、揿针组的腰围、体质量、BMI均显著小于干预前(P<0.05);②联合组在主要疗效指标、次要疗效指标及情绪指标方面的改善均较为显著(P<0.05);③中药组在主要疗效指标、情绪指标方面的改善较为显著(P<0.05);④揿针组仅在主要疗效指标方面改善较为显著(P<0.05);⑤体质分析结果显示,腹型肥胖受试者中痰湿质占比为56.04%,最为多见。结论:化痰祛湿方联合揿针干预腹型肥胖具有较好的临床疗效,在腰围的改善方面效果尤为突出,由此可见“体-病”结合的干预更为有效。

Systematic review and Meta-analysis of acupuncture and acupoint catgut embedding for the treatment of abdominal obesity

OBJECTIVE:To systematically review and analyze the effect of acupuncture and acupoint catgut embedding in treatment of abdominal obesity to provide a more reasonable clinical treatment regimen.METHODS:Ten databases were searched as of August 2022:the English databases Pub Med,Embase,Cochrane Library,Web of Science,Wiley,and Scopus and the Chinese databases China National Knowledge Infrastructure Database,China Science and Technology Journal Database,Wanfang,and Sino Med/Chinese Biomedical Literature Database.Randomized controlled trials(RCTs)of acupuncture and acupoint catgut embedding as the main interventions to treat abdominal obesity were extracted.The investigators imported the citations into End Note version X9.1 for deduplication,screening,extraction,and integration.The risk of bias in the included RCTs was assessed according to the Cochrane Handbook.Rev Man 5.4 software was used to conduct a Meta-analysis of RCTs that met the inclusion criteria.RESULTS:Thirteen RCTs(1069 patients)were included in this study,and the data of eleven RCTs(966 patients)were include in the Meta-analysis.The results showed that acupoint catgut embedding can significantly change the weight and waist circumference of patients with abdominal obesity when compared to sham acupuncture or no treatment[mean difference(MD)=2.32,95%confidence interval(CI)(1.88,2.76),P<0.00001],[MD=3.47,95%CI(1.99,4.94),P<0.00001].The change in hip circumference after acupuncture was also significant[MD=0.89,95%CI(0.12,1.66),P=0.02].CONCLUSION:This study found that acupuncture and acupoint catgut embedding can effectively treat abdominal obesity,therefore,these interventions can be used as clinical supplements and alternative therapies.The diagnostic criteria of the existing studies and the intervention measures of the control group are not unified.It will be necessary to improve the clinical study protocols and expand the sample size to further validate the reliability of the results obtained of this study.

基于伏痰理论探讨广泛性焦虑障碍与肠道菌群的关系及治疗

广泛性焦虑障碍(generalized anxiety disorder, GAD),中医在治疗该疾病方面因疗效好且不良反应小备受学界关注。中医的伏痰理论历史悠久,且从伏痰辨治精神疾病是古今中医的共同认知,所以伏痰理论的运用可以为中医治疗与痰有关的疾病开创新的思路。本文试从伏痰理论出发,结合西医学的研究热点肠道菌群,来探讨GAD这一疾病的病因病机和伏痰的现代生物学机制,寻找伏痰和GAD的相关性和共同特点。以期丰富治疗焦虑障碍类疾病的科学内涵,且找寻中医传统名方温胆汤治疗此类疾病遣方用药的理论基础,为今后GAD的防治提供理论基石。