针刺治疗女性肥胖伴发更年期综合征的临床研究

目的 探讨针刺治疗肥胖伴发更年期综合征的作用机制。方法 将30例女性肥胖伴发更年期综合征患者依据“辨证施治”基本原理，采用耳体针结合施治，观察针灸治疗前后症状、体征、肥胖指标、Kupperman指数、植物神经平衡指数(Y值)、雌二醇(E2)、促黄体生成素(LH)、促卵泡成熟激素(FSH)、促性腺激素释放激素(GnRH)、瘦素(LP)、胰岛素(INS)、一氧化氮(NO)、一氧化氮合酶(NOS)和胰岛素敏感性指数(IAI)水平的变化。结果 肥胖伴发更年期综合征患者肥胖指标、Kupperman指数、Y值、LH、FSH、GnRH、LP、INS水平畀常升高，而E2、NO、NOS和IAI水平畀常低下。针灸治疗取得良好减肥疗效同时，患者Kupperman指数、Y值、LH、FSH、GnRH、LP、INS的水平均显著下降(P<0．05或尸<0．01)，而B、NO、NOS和IAI水平均显著回升(P<0．01)。结论 针灸疗法对肥胖伴发更年期综合征患者Kupperman指数、Y值、E2、LH、FSH、GnRH、NO、NOS、LP、INS、IAI水平具有良性调整作用，针灸改善下丘脑一垂体一性腺轴，植物神经和血管舒缩紊乱的机能以及纠正瘦素抵抗(LR)和胰岛素抵抗(IR)可能是重要的作用机制。

Clinical Study on Female Obesity Complicated with Climacteric Syndrome Treated by Acupuncture

OBJECTIVE: To explore the mechanism of acupuncture in treating obesity complicated with climacteric syndrome (OCCS). METHODS: Thirty female OCCS patients were treated by acupuncture, combination of body and auricular acupuncture, according to the treating principle based on syndrome differentiation. The changes in symptoms, signs, obesity index, Kupperman index, vegetative nerve system equilibrium index (Y value), levels of estradiol (E2), luteinizing hormone (LH), follicle stimulating hormone (FSH), gonadotropin releasing hormone (GnRH), leptin (LP), insulin (INS), nitric oxide (NO), nitric oxide synthase (NOS) and insulin activation index (IAI) in patients were observed. RESULTS: The obesity index, Kupperman index, Y value, and levels of LH, FSH, GnRH, LP, and INS increased, while levels of E2, NO, NOS and IAI decreased in OCCS patients. After acupuncture treatment, in the same time of obtaining promising effect in reducing weight, reversing effect was shown in all the above-mentioned parameters (P < 0.05 or P < 0.01) . CONCLUSION: Acupuncture has favorable regulatory effect on Kupperman index, Y value, E2, LH, FSH, GnRH, NO, NOS, LP, INS and IAI in OCCS patients, its effect in improving the hypothalamic-pituitary-gonad axis, vegetative nerve function and vasomotor dysfunction, and adjusting the resistance to leptin and insulin may be the important mechanisms.