摘要
目的:观基于“微生物-肠-脑轴”理论的三部穴位干预法治疗内脏型肥胖伴高脂血症的疗效。方法:选择2021年12月—2023年1月于本院内脏型肥胖伴高脂血症患者126例,采用随机数字表法分为埋线组、埋线头穴组以及联用组各42例。在常规治疗的基础上,埋线组对脐周八穴进行埋线治疗;埋线头穴组在埋线组基础上针刺头穴(选择正中线和额旁1、2与3线);联用组在埋线头穴组基础上采用穴位敷贴。分析治疗前后的体质量指数(BMI)、腰围(WC)、腰臀比(WHR)、腹部脂肪厚度与内脏脂肪指数(VAI),再检测粪便肠道菌群丰度以及血脂相关指标。结果:一般体脂参数方面,联用组在BMI、WHR低于其余两组,差异具有统计学意义(P<0.05),而在WC仅低于埋线组,差异具有统计学意义(P<0.05),与埋线头穴组比较差异无统计学意义(P>0.05);在腹部脂肪厚度、VAI比较,联用组在两项指标均低于其余两组,差异具有统计学意义(P<0.05);肠道菌群丰度,联用组在拟杆菌门、变形菌纲、产碱杆菌科与巨球型菌属均高于其余两组,差异具有统计学意义(P<0.05),在厚壁菌门低于埋线组、丁酸弧菌属高于埋线组,而与埋线头穴组比较差异无统计学意义(P>0.05)。而梭菌纲和伯克菌目3组间比较差异无统计学意义(P>0.05)。血脂相关水平,联用组在TC、血清内脂素低于其余两组,差异具有统计学意义(P<0.05),ADP高于其余两组,差异具有统计学意义(P<0.05),而TG指标3组间比较差异无统计学意义(P>0.05)。相关性分析显示,BMI指数与TC、血清内脂素呈正相关,差异具有统计学意义(P<0.05),与ADP、拟杆菌门、变形菌纲、产碱杆菌科和巨球型菌属呈现负相关,差异具有统计学意义(P<0.05)。结论:三部穴位干预法干预内脏型肥胖,可以降低体质量、腹围,减少内脏脂肪厚度,降低血脂水平,改善相关生化指标和肠道菌群丰度,疗效显著。
Objective:To observe the therapeutic effect of three-portion acupoints intervention in treating visceral obesity with hyperlipidemia based on‘microbia-gut-brain axis’theory.Methods:126 patients with visceral obesity and hyperlipidemia were randomly divided into the catgut embedding group,the catgut embedding scalp acupoints group and the combination group,with 42 cases in each group.On the basis of routine treatment,the catgut embedding group performed catgut embedding treatment on the eight points around the navel;the catgut embedding scalp acupoints group was intervened by needling midline and frontalis 1,2,and 3 lines;the combination group used acupoint application on the basis of catgut embedding scalp acupoints intervention.Body mass index(BMI),waist circumference(WC),waist–hip ratio(WHR),abdominal fat thickness,visceral adiposity index(VAI)were analyzed before and after the treatment,and then fecal gut microbiota abundance and blood lipid related indicators were detected in the three groups.Results:In terms of general body fat parameters,the BMI and WHR were lower in the combination group compared to those in the other two groups(P<0.05);WC was lower in the combination group only than that in the catgut embedding group(P<0.05),and there was no statistical difference in WC between the combination group and the catgut embedding scalp acupoints group(P>0.05).In terms of abdominal fat thickness and VAI,they were lower in the combination group than those in the other two groups(P<0.05).In terms of the abundance of gut microbiota,Bacteroidota,Proteobacteria,Alcaligenes and Megasphaera were higher in the combination group than those in the other two groups(P<0.05);Bacillota was lower and Butyrivibrio was higher than that in the catgut embedding group respectively,in which there were no statistical differences between the combination group and the catgut embedding group(P>0.05).There were no statistical differences in Clostridia and Burkholderia among the three groups(P>0.05).In terms of blood lipid related levels,TC and serum visfatin were lower(P<0.05),and ADP was higher in the combination group than those in the other two groups(P<0.05);but there were no statistical differences in TG among the three groups(P>0.05).Correlation analysis showed that BMI index was positively correlated with TC and serum visfatin(P<0.05),and negatively correlated with ADP,Bacteroidota,Proteobacteria,Alcaligenes and Megasphaera(P<0.05).Conclusion:The intervention of three-portion acupoints on visceral obesity can reduce body weight,abdominal circumference,visceral fat thickness,blood lipid level,and improve related biochemical indicators and gut microbiota abundance with its significant effect.
作者
王茜
曾阳
WANG Qian;ZENG Yang(The First People's Hospital of Zigong,Zigong 643000,China)
出处
《针灸临床杂志》
2023年第12期20-26,共7页
Journal of Clinical Acupuncture and Moxibustion
基金
自贡市2021年第一批市级科技计划重点项目,编号:2021YLSF03。
