不同波型电针治疗肥胖症伴内分泌代谢异常的疗效比较

目的：对比疏密波、连续波电针结合雷火灸治疗不同证型肥胖症伴血脂、血清瘦素异常患者的疗效，为选择不同电针波型治疗不同证型肥胖症提供临床依据。方法：60例血脂、血清瘦素异常的肥胖症患者按就诊先后顺序，采用随机数字表法分为疏密波组和连续波组，每组30例。按中医辨证分为胃肠实热型、脾胃虚弱型和脾肾阳虚型，分别给予电针天枢、大横、足三里、上巨虚、丰隆、阴陵泉、曲池、支沟、合谷，并给予雷火灸治疗。疏密波组电针频率为2Hz／100Hz，连续波组电针频率为2Hz，2组均每天治疗1次，每周6次，共治疗4周，然后随访3个月。比较两组治疗前后和随访时的体质量、体脂百分率；比较两组疗效，并对疏密波组不同证型患者的疗效进行统计。采用全自动生化分析仪检测两组治疗前后血脂水平，用流式细胞分析系统检测两组治疗前后血清瘦素含量。结果：治疗4周后两种电针波型均能有效降低患者的血脂、血清瘦素水平及体质量、体脂百分率；随访3个月，两组患者肥胖指标继续下降（P〈0．01，P〈0．05），且疏密波组的改善程度均优于连续波组（P〈0．05，P〈0．01）.疏密渡组疗效明显优于连续波组（P〈0．01）。疏密波组不同证型的疗效以脾胃虚弱型最佳。结论：疏密波电针结合雷火灸治疗血脂、血清瘦素异常的肥胖症，近期和远期效果均明显优于连续波电针，其中脾胃虚弱型的疗效优于脾肾阳虚型和胃肠实热型。

Comparison of efficacy of treating obese patients with endocrine-metabolic abnormity by electroacupuncture of different types of wave modes

Objective To compare the efficacy of treating obese patients with abnormity of lipids and serum leptin by dilatational wave or continuous wave of electroacupuncture combined with thunder-fire moxibustion in order to provide a clinical basis for selecting wave types of electroacupuncture for different patterns of obesity. Methods Sixty obese patients with abnormal lipids and serum leptin were randomly divided into a dilatational wave group and a continuous wave group via random number table, with 30 cases in each group. They were divided by TCM differentiation into three types： stomachintestine excessive heat, weakness of the spleen-stomach and spleen-kidney yang deficiency, treated by electroacupuncture on Tianshu （天枢 ST 25）, Daheng （大横 SP 15）, Zusanli （足三里ST 36）, Shangjuxu （上巨虚 ST 37）, Fanglong （丰隆 ST 40）, Yinlingquan （阴陵泉 SP 9）, Quchi （曲池 LI 11）, Zhigou （支沟 TE 6） and Hegu （合谷 LI 4） along with thunder-fire moxibustion. The frequency of electro-acupuncture in the dilatational wave group and the continuous wave group was 2 Hz/100 Hz and 2 Hz, respectively. Patients in the two groups were treated once a day, six times a week. The treatment lasted for 4 weeks with 3-month follow-up. Body mass and body fat percentage before and after the treatment, as well as during the follow-up, were compared. The effectiveness rates in the two groups were compared, and the efficacy statistics of patients with different TCM patterns in the dilatational wave group were also analyzed. Lipid levels of the patients in two groups before and after the treatment were measured with an automatic biochemical analyzer, and serum leptin levels were detected with flow cytometry system. Results After the treatment, the patients＇ blood lipids, serum leptin levels, body mass and body fat percentage were effectively reduced in the two groups; three months＇ follow-up witnessed continuous decline of obesity indicators （P〈0.01 or P〈0.05）, and patients in the di