针刺治疗单纯性肥胖73例临床观察

单纯性肥胖是人体内热量的摄入大于消耗和利用，造成脂肪在体内积聚，导致体重超常的病症。随着我国经济的发展，人民生活习惯的改变及饮食结构的变化，肥胖人口数蛰也呈急剧上升趋势。肥胖不仅影响人们外观形体的审美，更严重的是它危害人体的健康，是脂质代谢紊乱、冠心病、2型糖尿病、心脑血管病的危险因素。目前肥胖已成为严重威胁人类身心健康的全球性疾病，减肥已成为热门课题．减肥方法较多。针灸作为一种非药物疗法且效果显著．在临床已得到广泛运用。笔者收集了112例肥胖病人．其中73例用针刺治疗．取得较好的效果。     

肥胖外科治疗研究进展

肥胖已于1997年被世界卫生组织列为全球性流行病,不管是从生理上还是从心理上,它都容易引发一系列疾病,给肥胖患者带来莫大的压力与痛苦。一些简单保守的减肥方法已无法达到预期效果,减肥手术已然成为了治疗肥胖病的有效方法。从传统的吸收不良型手术到胃内水球术、腹腔镜可调节胃束带手术,肥胖外科的发展日新月异,广大肥胖患者将会有更加健康的明天。     

GLP-1受体激动剂应用于肥胖治疗的研究进展

胰高血糖素样肽-1受体激动剂(GLP-1受体激动剂, GLP-1RA)最早用于治疗2型糖尿病,后来在应用过程中发现了其减轻体重的附加作用,其治疗肥胖的作用开始被逐渐认识和开发。GLP-1RA减轻体重的机制包括通过神经系统减少食物摄入以及对脂肪细胞的调控, GLP-1RA在临床试验中已被证明是安全有效的,其中利拉鲁肽和司美格鲁肽已通过临床试验并获美国食品药品监督管理局(FDA)批准作为治疗肥胖的药物上市,目前, GLP-1RA作为有前途的抗肥胖药物获得广泛关注且拥有开阔的发展前景。     

胃内水球术减肥治疗一例

目前肥胖症已成为全球流行病，肥胖会引发许多疾病，导致不良后果。如何控制肥胖及其相关并发症已引起广泛重视。胃内水球（BioEnterics Intragastric Balloon，BIB）是一种非手术非药物的减肥方法。目前。该方法在国外许多国家已被广泛应用．其有效性和安全性得到充分的认可。我院于2005年9月30日成功地为一位肥胖患者行胃内水球治疗，现报告如下。     

盐酸西布曲明治疗单纯性肥胖的临床观察

盐酸西布曲明 (Ｓｉｂｕｔｒａｍｉｎｅ)为 5 -羟色胺和去甲肾上腺素再摄取抑制剂 ,通过降低食欲、减少进食、增加产热 ,从而降低体重 ,在国外已用于单纯性肥胖患者的治疗[1] 。我院于 1 999年 1 1月至 2 0 0 0年7月对国产的盐酸西布曲明进行Ⅱ期临床研究 ,旨在评价其对单纯性肥胖患者的减肥疗效和安全性 ,现报告如下。对象与方法　体重指数 (ＢＭＩ)≥ 2 7、年龄 1 8～65岁、临床诊断的单纯性肥者 91例 ,采用双盲双模拟安慰剂随机对照试验 ,将纳入病例应用计算机ＳＰＳＳ/ＰＣ软件随机分为Ａ、Ｂ、Ｃ　 3组 ,分别含 3 0例、3 0例与 3 1例。…     

盐酸西布曲明对营养性肥胖大鼠的减肥作用

目的 :研究盐酸西布曲明对营养性肥胖大鼠的减肥作用。方法 :给刚断乳的SD大鼠饲喂营养性饲料 ,7wk后养成营养性肥胖模型 ,分组给药 ,连续 6wk。结果 :盐酸西布曲明 9.0、3.0、1.0mg·kg-1灌胃给药 ,能明显降低肥胖大鼠体重、Lee's指数和脂肪重量 ,降低血清甘油三酯水平 ,抑制脂肪细胞增大 ,但对肥胖大鼠空肠绒毛的密度和肠绒毛直径无明显影响。结论 :盐酸西布曲明灌胃给药对营养性肥胖大鼠有显著的减肥降脂作用。     

京尼平苷对谷氨酸钠诱导性肥胖小鼠的减肥作用研究

目的:研究京尼平苷对L-谷氨酸钠(MSG)诱导性肥胖小鼠的减肥作用。方法:观察京尼平苷对MSG肥胖小鼠体重、Lee氏指数、血糖、血甘油三酯、血胆固醇、脂肪细胞大小的影响。结果:800mg·kg-1剂量下京尼平苷可明显抑制MSG肥胖小鼠的摄食量,减轻体重,降低血甘油三酯、血胆固醇含量,使白色脂肪细胞变小,但对血糖无影响。结论:京尼平苷对MSG肥胖小鼠具有减肥作用。     

单纯性肥胖的外科手术治疗

随着我国人民生活水平的不断提高,人们的营养物质摄入不断增加,肥胖症已在我国普遍存在,因肥胖而导致的如高血压、心脏病、脂肪肝、糖尿病、中风等疾病有明显地上升趋势。直接影响着人们的健康安全,怎样有效地扼制肥胖已成为医学界研究的重要课题。以往的方法,如药物减肥,虽然能达到一定的疗效、但不能持久,且易反弹,达不到永久治疗肥胖的目的。自1996年6月～2003年6月,我们通过外科手术的方式治疗单纯性肥胖的患者共12例,收到良好的临床效果。现总结报告如下：     

健康教育对肥胖患者进行干预的效果评价

目的评价健康教育对肥胖患者的干预效果。方法选取北京牛街社区肥胖患者40人,通过健康教育进行干预,1年后进行效果评价。结果健康教育后患者体重指数下降有显著性。结论通过健康教育对肥胖患者进行减肥干预是必要的。     

减肥药研发:窘境背后的希望

肥胖严重威胁着人们的健康,已经成为全球性的流行病。由于目前能有效治疗肥胖的手段有限,肥胖难以得到有效控制。由于药物的不良反应问题,已上市的减肥药大部分都被淘汰,肥胖正在面临无药可治的窘迫局面。人体中有许多靶点能够起到调节能量代谢,控制体重的作用。作用于这些靶点的减肥药物正在研发中。本文综述了治疗肥胖相关的药物靶点和作用机制以及减肥药物的研发现状。     

Pharmacotherapy of obesity

Long-term success in obesity therapy is difficult to obtain, therefore drug therapy appears to be helpful. Until today, end-point studies for obesity drugs beyond the improvement of individual surrogate parameters are still missing. For all available drugs, medical treatment can be recommended only for a limited period of time due to the data of the studies and under consideration of side effects. Although a weight reduction leads to an improvement of cardiovascular risk factors and hence a reduction of cardiovascular morbidity and mortality should be expected, no study could prove it so far. Despite the positive influence on individual surrogate parameters, the use of the present available therapies appears underwhelming. In this overview the approved substances and perspectives of new therapeutic concepts are represented.     

Genetics of obesity

Obesity is a typical common multifactorial disease in which environmental and genetic factors interact. In rare cases of severe obesity with childhood onset, a single gene has a major effect in determining the occurrence of obesity, with the environment having only a permissive role in the severity of the phenotype. Exceptional mutations of the leptin gene and its receptor, pro-opiomelanocortine (POMC), prohormone convertase 1 (PC1) and more frequently, mutations in the melanocortin receptor 4 (1 to 4% of very obese cases) have been described. All these obesity genes encode proteins that are strongly connected as part of the same loop of the regulation of food intake. They all involve the leptin axis and one of its hypothalamic targets; the melanocortin pathway. Pathways of bodyweight regulation involved in monogenic forms of obesity might represent targets for future drug development. Successful leptin protein replacement in a leptin-deficient child has contributed to the validation of the usefulness of gene screening in humans. However, the individual variability in response to leptin treatment might be related to genetic variability. The efficiency of leptin itself or of small-molecule agonists of the leptin receptor should be studied in relation with genetic variations in the leptin gene promoter. The most common forms of obesity are polygenic. Two general approaches have been used to date in the search for genes underlying common polygenic obesity in humans. The first approach focuses on selected genes having some plausible role in obesity on the basis of their known or presumed biological role. This approach yielded putative susceptibility genes with only small or uncertain effects. The second approach attempts to map genes purely by position and requires no presumptions on the function of genes. Genome-wide scans identify chromosomal regions showing linkage with obesity in large collections of nuclear families. Genome-wide scans in different ethnic populations have localized major obesity loci on chromosomes 2, 5, 10, 11 and 20. Susceptibility gene(s) for obesity may be positionally cloned in the intervals of linkage. The candidate gene and positional cloning of major obesity-linked regions approaches are discussed in this paper.     

Pharmacological management of obesity

Obesity is a major chronic health problem in adults. It is a complex, multifactorial disorder characterised by excess accumulation of adipose tissue. It is associated with a number of complications including cardiovascular disease, hypertension, type 2 diabetes, dyslipidaemia and cancer. A weight loss in the order of 5-10% is associated with clinically meaningful reductions with respect to all comorbidities. Diet and exercise has been the cornerstone of weight management therapy, but this approach has limitations, especially for weight maintenance. Previous drugs used in obesity had serious side effects including valvular heart disease. However, recent drugs like orlistat and sibutramine have been rigorously tested and proven safe. Orlistat, a lipase inhibitor, inhibits absorption of dietary fat by approximately 30%. Taken with a hypocaloric diet, it produces and maintains clinically meaningful weight loss. Sibutramine is a centrally-acting agent which enhances satiety and thermogenesis by inhibiting serotonin and noradrenaline re-uptake. It is appropriate for patients who are unable to lose weight by lifestyle modification.