【作者】 Dr.Abir Mamdouh Aly Elnaggar；

【导师】 王玲玲；

【作者基本信息】 南京中医药大学 ， 针灸推拿学， 2012， 博士

【摘要】 肥胖是由于患者体内生化因素引起的一系列进食调控和能量代谢紊乱的疾病,即摄入大于消耗,能量失衡,体内脂肪积聚过多而造成体重超常的一种内分泌代谢性疾病。传统中医学认为脾主运化,即脾主运化水谷精微和水液,通过对食物的消化和吸收,转输其精微物质散于全身,生成精、气、血、津液,以充养人体,从而进行正常生理活动。脾胃功能失常,气血阴阳失衡,痰湿集聚,导致肥胖。所以肥胖患者其基本病机是脾失健运,痰湿积聚。关于对肥胖患者的减肥方式目前有很多,比如食欲抑制剂、代谢兴奋剂或吸收拮抗剂等。近年来针灸治疗肥胖病已取得了显著的疗效,且无毒副作用,因而深受青睐。本文运用针刺治疗单纯性肥胖病,与单纯饮食疗法对照,以观察针刺治疗肥胖的疗效。方法：80例患者分成两组：第一组为针刺组：40位患者全部运用针刺疗法；第二组为单纯饮食疗法组：40例患者仅通过饮食治疗。患者辨证为脾胃湿热,针刺治疗每周3次,选穴以腹部和下肢穴位为主并施以电针。选择电针波形疏密波2／100Hz,电流强度以病人耐受为度,留针时间30分钟。在第一次治疗时测病者体重,腰围及体重指数,之后每2周再重新检测,全部疗程为一个半月(6周)。同时患者需在治疗初和治疗结束时检测血压和血脂(胆固醇与甘油三酯)；停止治疗6个月之后再随访,对其中15位患者(协议同意)观察体重、体重指数、腰围等指标,同时进行实验室检查如甘油三酯、胆固醇和血压。结果：治疗6周后对针刺组与饮食组的相关数据如体重、腰围及体重指数进行统计分析。结果表明：针刺组优于饮食组并有明显统计学意义(P<O.001)；在停止治疗6个月随访中发现,针刺组15位患者中的12位,其体重指数及腰围与治疗前相比有明显统计学意义(P<O.001),其中甘油三酯、胆固醇显示已达正常。结论治疗结果表明,针灸治疗单纯性肥胖病具有很好的疗效。与单纯饮食治疗相比,患者体重指数、体重和腰围均有明显改善。因而针灸治疗单纯性肥胖病其效果优于饮食疗法,同时甘油三酯、胆固醇和血压在临床观察中也恢复到良好水平。更多还原

【Abstract】 Purpose:obesity is a misbalance nutritional disease caused by special biochemistry factors which leads to serious disorders of energy. Calorie absorbed in the body is much more than it is consumed then stored in the body as fat. As a result, obesity appears. Traditional Chinese medicine (TCM) believes that the function of the spleen which governs transportation and transformation means that the spleen can digest food, absorb nutrients and water then transport them to qi, blood and body fluids. The spleen holds qi under the interaction of exogenous pathogenic factors and endogenous pathogenic factors. The imbalance of qi, blood and yin and yang results in the stasis of phlegm and dampness. This all appears as obesity. The basic pathogenesis is the disorders of the stomach and spleen leading to disturbance of the body fluid and stagnation of phlegm. There are several ways to lose weight such as appetite inhibitors, metabolic stimulants or absorption blockers. In recent years, the use of traditional Chinese medicine for treatment of obesity has achieved significant results with non-toxic side effects. This study aims to use Chinese acupuncture to treat obesity and show it is more effective than diet only.Methods:80patients were divided into2groups where the first group which consists of40patients was treated by acupuncture and the2nd group (40patients) was treated by diet only. The patients suffered from deficiency of spleen-stomach and dampness. The treatment was3times a week and few points of the abdomen were selected for electro-acupuncture. Two couples of wires with corresponding points were connected respectively. The frequency at100Hz and frequency of condensation-rarefaction wave group was2to5/50to100Hz by cycling. The needles are kept in the body for30minutes. Weight, waist circumferences and body mass index is measured in the first session then every2weeks until the treatment time is finished which are one month and a half. Blood pressure and blood tests are taken for level of triglycerides and cholesterol at the beginning and the end of the treatment time. Follow up was undertaken after6months for15patients who agreed. The weight, BMI, waist circumference was measured and lab test for triglyceride, cholesterol and blood pressure was taken. The same follow up was done for the same patients after10days then15days.Results: After two courses of treatment, which included the group treated with acupuncture and group treated with diet only, body weight, BMI and body circumference were analyzed statistically. The results showed that there is a significant difference of the means of the2groups which show after6weeks with regard to the BMI and waist only at5%significance level and the3variables at10%significance level. The results for the follow ups showed that12patients out of the15showed a significant change in the body weight, BMI, waist circumference (P<0.001). Triglyceride and cholesterol level in the blood returned to normal.Conclusion:The results show that treatment with acupuncture showed good clinical efficacy, improved indicators of body weight and body circumference compared to treatment with diet only. The significant affect of acupuncture only treatment appeared as late as6weeks. As a result, the efficacy of acupuncture only treatment was superior to that of diet only treatment. It can affect levels of triglyceride, cholesterol in the blood and blood pressure returning it to normal.更多还原