Objective: To assess the efficacy of the combined treatment with electroacupuncture (EA) and intradermal needling on simple obesity and explore its underlying effect mechanism.
Methods: A total number of 116 patients with simple obesity were randomized into an observation group (58 cases, 3 cases dropped off and 2 cases removed) and a control group (58 cases, 4 cases dropped off and 1 cases removed). Patients in the control group received EA at Zhongwan (CV 12), Quchi (LI 11), Zusanli (ST 36), Pishu (BL 20), Weishu (BL 21), etc., for 30 min each time. On the base of the intervention as the control group, the patients in the observation group received the intradermal needling at Tianshu (ST 25), Daheng (SP 15), Zusanli (ST 36), Shangjuxu (ST 37), Quchi (LI 11), Pishu (BL 20) and Weishu (BL 21). In each group, the intervention was given once every two days, 3 times a week, consecutively for 3 months. Before and after treatment, the obesity indexes (body mass [BW], body mass index [BMI], body fat percentage [F%], adiposity [A] and waist circumference [WC]), the serum intestinal lymphatic function-related factors (vascular endothelial growth factor C [VEGF-C], delta-like ligand 4 [DLL4], adrenomedullin [ADM]), blood lipid (total cholesterol [TC], triglyceride [TG] and low density lipoprotein-cholesterol [LDL-C]), and fasting plasma glucose (FPG), fasting insulin (FINS) and insulin resistance index (HOMA-IR) were observed in the patients of both groups; and the efficacy was assessed.
Results: The effective rate was 88.7% (47/53) in the observation group, higher than 71.7% (38/53) in the control group (P<0.05). After treatment, except FPG in the control group, BW, BMI, F%, A, WC, and the concentrations of serum VEGF-C, DLL4 and ADM, as well as TC, TG, LDL-C, FBG, FINS and HOMA-IR were all reduced compared with those before treatment in both groups (P<0.05). The reduction ranges of BW, BMI, F%, A, WC, and the concentrations of serum VEGF-C, DLL4 and ADM, and TC, LDL-C, FINS and HOMA-IR in the observation group were all larger than those in the control group (P<0.05).
Conclusion: Electroacupuncture combined with intradermal needling can reduce body weight and lipid, and improve insulin resistance in treatment of simple obesity, which is achieved probably through inhibiting lymphangiogenesis and promoting lymphatic endothelial permeability.
目的：观察电针联合揿针治疗单纯性肥胖病的临床疗效，探讨其可能的作用机制。方法：将116例单纯性肥胖病患者随机分为观察组（58例，脱落3例，剔除2例）和对照组（58例，脱落4例，剔除1例）。对照组予电针治疗，穴取中脘、曲池、足三里、脾俞、胃俞等，每次30 min；在对照组治疗基础上，观察组予揿针治疗，穴取天枢、大横、足三里、上巨虚、曲池、脾俞、胃俞。均隔日1次，每周3次，连续治疗3个月。观察两组患者治疗前后肥胖指标[体质量（BW）、体质量指数（BMI）、体脂百分率（F%）、肥胖度（A）及腰围（WC）]、血清肠淋巴管功能相关因子[血管内皮生长因子C（VEGF-C）、delta样配体4（DLL4）、肾上腺髓质素（ADM）]水平、血脂[总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白-胆固醇（LDL-C）]、空腹血糖（FPG）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA-IR），并评定临床疗效。结果：除对照组FPG外，两组患者治疗后BW、BMI、F%、A、WC，血清VEGF-C、DLL4、ADM水平及TC、TG、LDL-C、FPG、FINS、HOMA-IR均较治疗前降低（P<0.05），且观察组BW、BMI、F%、A、WC，血清VEGF-C、DLL4、ADM水平及TC、LDL-C、FINS、HOMA-IR降低幅度大于对照组（P<0.05）。观察组有效率为88.7%（47/53），优于对照组的71.7%（38/53，P<0.05）。结论：电针联合揿针治疗单纯性肥胖病可以减重减脂、改善胰岛素抵抗，可能通过抑制淋巴管新生、改善淋巴管内皮通透性实现。.
Keywords: blood lipid; electroacupuncture; insulin resistance; intradermal needling; serum intestinal lymphatic function-related factors; simple obesity.