Objective: To explore the therapeutic effect and safety of acupoint thread embedding therapy in treatment of simple obesity of stomach heat and damp obstruction.
Methods: A total of 144 patients with simple obesity of stomach heat and damp obstruction were randomized into an acupoint thread embedding group (72 cases, 3 cases dropped off and 1 case removed) and a sham-embedding group (72 cases, 6 cases dropped off and 3 cases removed). On the base of the lifestyle adjustment, the acupoint thread embedding therapy with PGLA thread was applied to Tianshu (ST 25), Zhongwan (CV 12), Ganshu (BL 18), Shuidao (ST 28), etc. in the acupoint thread embedding group, while in the sham-embedding group, the acupoint selection and operation were all same as the acupoint thread embedding group, but without PGLA thread embedded. In either group, the treatment was given once every 2 weeks, consecutively for 12 weeks and the follow-up was conducted for 3 months after treatment. Separately, before and after treatment as well as in follow-up, the obesity indices (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR] and fat percentage [F%]) were observed in the two groups. Before and after treatment, the indices of blood glucose and insulin (fasting blood glucose [FBG], fasting insulin [FINS] and insulin resistance index [HOMA-IR]), adipocyte factor indices (adiponectin, leptin [LP] and serine protease inhibitor [Vaspin]) and inflammatory factor indices (tumor nercosis factor [TNF-α], interleukin-1β [IL-1β] and interleukin-6 [IL-6]) were observed separately in the two groups. The therapeutic effect and safety were compared between the two groups.
Results: After treatment and in follow-up, except WC and WHR in the sham-embedding group, BMI, WC, WHR and F% were all reduced as compared with those before treatment in the two groups (P<0.01, P<0.05), and the values in the acupoint thread embedding group were lower than the sham-embedding group (P<0.01). After treatment, except FBG, LP and Vaspin in the sham-embedding group, FBG, FINS, HOMA-IR, LP and Vaspin were all reduced as compared with those before treatment in the two groups (P<0.01, P<0.05), and adiponectin was increased as compared with that before treatment (P<0.01, P<0.05); the improvements in the acupoint thread embedding group were more significant than the sham-embedding group (P<0.01). After treatment, the levels of serum TNF-α, IL-1β and IL-6 in the acupoint thread embedding group were reduced as compared with the values before treatment and those in the sham-embedding group separately (P<0.01). The total effective rate was 89.7% (61/68) in the acupoint thread embedding group, higher than 19.0% (12/63) in the sham-embedding group (P<0.01). There was no severe adverse reaction reported in the two groups.
Conclusion: Acupoint thread embedding therapy with PGLA thread can alleviate obesity, regulate glucose metabolism and adipocyte factors activity, improve insulin resistance and inhibit the expression of pro-inflammatory factors in the patients with simple obesity with stomach heat and damp obstruction, and this therapy presents a satisfactory safety in treatment.
目的：观察穴位埋线治疗胃热湿阻型单纯性肥胖的疗效与安全性。方法：将144例胃热湿阻型单纯性肥胖患者随机分为穴位埋线组（72例，脱落3例，剔除1例）和假埋线组（72例，脱落6例，剔除3例）。两组在生活方式干预的前提下，穴位埋线组于天枢、中脘、肝俞、水道等穴采用PGLA线进行埋线；假埋线组，取穴及操作同穴位埋线组，但不埋入线体。两组均2周1次，连续治疗12周，并于治疗后3个月随访。治疗前后和随访时，观察两组患者肥胖程度指标[体质量指数（BMI）、腰围（WC）、腰臀比（WHR）和脂肪百分率(F%)]；治疗前后，观察两组患者血糖和胰岛素指标[空腹血糖（FBG）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA-IR）]、脂肪细胞因子指标[脂联素、瘦素（LP）、丝氨酸蛋白酶抑制剂（Vaspin）]、炎性因子指标[肿瘤坏死因子α(TNF-α)、白细胞介素1β（IL-1β）和白细胞介素6（IL-6）]，并比较两组疗效及安全性。结果：治疗后和随访时，除假埋线组WC、WHR外，两组BMI、WC、WHR和F%均较治疗前降低（P<0.01，P<0.05），且穴位埋线组均低于假埋线组（P<0.01）。治疗后，除假埋线组FBG、LP和Vaspin外，两组FBG、FINS、HOMA-IR、LP和Vaspin均较治疗前降低（P<0.01，P<0.05），脂联素较治疗前升高（P<0.01，P<0.05），且穴位埋线组以上指标均优于假埋线组（P<0.01）。治疗后，穴位埋线组血清TNF-α、IL-1β、IL-6水平较治疗前及假埋线组降低（P<0.01）。穴位埋线组总有效率为89.7%（61/68），高于假埋线组的19.0%（12/63，P<0.01）。两组均无严重不良反应发生。结论：PGLA线穴位埋线治疗胃热湿阻型单纯性肥胖可减轻患者肥胖程度，调节糖代谢和脂肪细胞因子，改善胰岛素抵抗，抑制促炎性因子表达，具有较好的安全性。.
Keywords: acupoint thread embedding; adipocyte factors; inflammatory factor; insulin resistance; simple obesity.