【作者】 賴郁凱；

【导师】 许能贵；

【作者基本信息】 广州中医药大学 ， 针灸推拿学， 2012， 博士

【摘要】 目的：本课题旨在观察子午流注法治疗脾虚湿盛型单纯性肥胖症的临床疗效,为进一步推广提供临床依据。方法：研究对象为在台湾赖郁凯中医诊所治疗的符合病例筛选标准的60例脾虚湿盛型单纯性肥胖症患者。按照进入实验的编号随机分为子午流注法治疗组(简称治疗组)与对照组,治疗组按照子午流注时辰原则,脾虚湿盛型单纯性肥胖症患者在巳时(北京时间9点-11点)选取脾经五输穴,即隐白、大都、太白、商丘、阴陵泉穴位进行针刺；对照组则不在巳时进行针刺(除了巳时的任何时间),针刺穴位仍然为脾经五输穴。两组患者在一周治疗5次,四周为一疗程,连续治疗两个疗程。每个疗程后选用体重指数(BMI)、体重指数BMI评价疗效、腰臀比(WHR)、脾虚湿盛型中医症候评分、血高密度脂蛋白胆固醇(HDL-C)、血低密度脂蛋白胆固醇(LDL-C)血总胆固醇(TC)及血甘油三酯(TG)等指标进行评价。将数据记录输入SPSS18.0进行统计分析,结果：两组入选的病例在年龄均数及分布情况、体重指数、肥胖程度、腰臀比、中医症候评分、血脂四项等方面都没有显著性差异(P>0.05),具有可比性。1.治疗组在利用子午流注治疗4周后,BMI显著下降(P<0.05),8周后下降更明显(P<0.01),对照组治疗4周后,BMI与治疗前比较下降不明显(P>0.05),但是8周后,有显著下降(P<0.05)。组间比较显示：4周后,两组无明显区别(P>0.05),8周后,治疗组在降低BMI方面优于对照组(P<0.05)。2.利用子午流注治疗4周后,治疗组与对照组的WHR都没有显著性变化(p>0.05),在8周后,WHR有明显改善(P<0.05)。说明WHR的改变需要更长时间的巩固。两组组间比较提示：4周后,两组对于改善WHR没有明显差异(P>0.05),但是8周后,治疗组优于对照组(P<0.05)。3.利用子午流注治疗4周后,治疗组与对照组的中医证候疗效评分都有显著性降低(P<0.05),说明对于脾虚湿盛的症状有所改善,并且在8周后,改善更明显(P<0.01)。两组组间比较提示：4周后,两组对于改善脾虚湿盛的症状没有明显差异(P>0.05),但是8周后,治疗组优于对照组(P<0.05)。4.利用子午流注治疗4周后,治疗组与对照组的血高密度脂蛋白胆固醇(HDL-C)、血低密度脂蛋白胆固醇(LDL-C)及血总胆固醇(TC)都没有显著性变化,在8周后,血甘油三酯(TG)有明显降低。两组组间比较提示：4周后,两组对于血脂四项没有明显差异,但是8周后,针对TG治疗组优于对照组。结论：利用子午流注法治疗脾虚湿盛型单纯性肥胖症能显著降低BMI及WHR,改善脾虚湿盛的症状情况及改善TG情况,并且如果按照子午流注时辰原则施以针刺,则疗效更显著。更多还原

【Abstract】 Objective:This research attempts to study the clinical curative effect of Midnight-moon and Ebb-flow Doctrine in the treatment of Simple Obesity of the type of Damp Abundance due to Splenic Asthenia and provide clinical proof for its further promotion.Methods:Select60patients who meet the case selection criteria of Simple Obesity in the type of Damp Abundance due to Splenic Asthenia from Dr. Lai Yukai’s TCM Clinic in Taiwan as research objects. Randomly classify the objects into the Midnight-moon and Ebb-flow Doctrine Group (Treatment Group) and the Control Group according to the serial number of joining the research. Based on the Hour Principle of Midnight-moon and Ebb-flow Doctrine, patients of Simple Obesity in the type of Damp Abundance due to Splenic Asthenia in the Treatment Group were given acupuncture treatment on the five Shu-acupoints on the spleen meridian, i.e. Yinbai, Dadu, Taibai, Shangqiu, Yinlingquan at the hour of the sixth of the twelve Earthly Branches (9to11a.m. of Beijing Time). Acupuncture is given to patients in the Control Group on the same five Shu-acupoints on the spleen meridian at other time except9to11a.m. of Beijing Time. Patients in the two groups are treated5times a week for two consecutive treatment courses with4weeks as one treatment course. After each course, evaluate such indexes as TCM Syndrome Scoring for Damp Abundance due to Splenic Asthenia, BMI, BMI-related Curative Effect Evaluation, HDL-C, LDL-C, TC, TG, etc. Input and analyze these data by SPSS18.0Software.Results:No significant difference is found among the cases of the two groups in aspects of age average and its distribution, BMI, obesity degree, TCM Syndrome Scoring and blood lipid (HDL-C, LDL-C, TC, TG) which demonstrates comparability (P>0.05)1. Patients’BMI in the Treatment Group decreases significantly after4weeks of treatment with Midnight-moon and Ebb-flow Doctrine (P<0.05), and it decreases more obviously after8weeks (P<0.01). Patients’BMI in the Control Group doesn’t decrease obviously after4weeks of treatment with Midnight-moon and Ebb-flow Doctrine (P>0.05) compared with that before treatment, but it decreases significantly after8weeks (P<0.05). The intergroup comparison demonstrates that no obvious difference is found between the two groups after4weeks (P>0.05), while after8weeks, the Treatment Group is superior to the Control Group in lowering BMI (P<0.05)2. No significant change is found in WHR of two groups after4weeks’ treatment with Midnight-moon and Ebb-flow Doctrine (P>0.05), while obvious improvement is observed after8weeks (P<0.05). The intergroup comparison indicates that after4weeks, there’s no obvious difference between two groups in improving the WHR, but after8weeks, the Treatment Group is superior to the Control Group (P<0.05)3. The TCM Syndrome Scores are significantly lowered in the Treatment Group and the Control Group after4weeks’treatment with Midnight-moon and Ebb-flow Doctrine(P<0.05) which explains that symptoms of Damp Abundance due to Splenic Asthenia are improved at certain degree. The improvements are more obvious after8weeks (P<0.01). The intergroup comparison demonstrates that no obvious difference is found between the two groups after4weeks in improving symptoms of Damp Abundance due to Splenic Asthenia (P>0.05), while after8weeks, the Treatment Group is superior to the Control Group (P<0.05)4. No significant change is found in blood lipid HDL-C, LDL-C, TC and TG of two groups after4weeks’treatment with Midnight-moon and Ebb-flow Doctrine (P>0.05), while obvious improvement of TG is observed after8weeks (P<0.05). The intergroup comparison indicates that after4weeks, there’s no obvious difference between two groups in improving the blood lipid HDL-C, LDL-C, TC and TG (P>0.05), but after8weeks, the Treatment Group of TG is superior to the Control Group (P<0.05)Conclusion:Applying Midnight-moon and Ebb-flow Doctrine in the treatment of Simple Obesity in the type of Damp Abundance due to Splenic Asthenia can significantly lower BMI, improve the symptoms of damp abundance and splenic asthenia and lower high blood lipid. Combining with the acupuncture treatment according to the Midnight-moon and Ebb-flow Hour Principle, the curative effect will be more obvious.更多还原