针灸治疗肥胖症并发原发性高血压的临床研究

背景:减肥是防止原发性高血压的重要措施,针灸具有无毒副作用的减肥降压效果。目的:探讨针灸治疗肥胖症并发原发性高血压的作用机制。设计:以诊断为依据的病例对照研究。地点、对象和方法:选择南京中医药大学专家门诊患者,将针灸治疗肥胖症并发原发性高血压和肥胖症无并发症的患者作为研究对象,与正常人相比较,观察针灸治疗前后症状、体征、肥胖指标、血压、植物神经平衡指数(Y值)、胰岛素、胰岛素敏感指数(insulinactivationindices,IAI)、瘦素、一氧化氮、一氧化氮合酶(nitricoxidesynthase,NOS)水平的变化。主要观察指标:痰湿壅盛、肝火亢盛、阴虚阳亢和阴阳两虚四型肥胖症并发原发性高血压患者、胃肠实热、肝郁气滞和脾虚湿阻三型肥胖症无并发症患者与正常健康人针灸前后肥胖指标、植物神经功能、血糖、胰岛素、瘦素、一氧化氮、NOS的比较。结果:针灸治疗肥胖症并发原发性高血压和肥胖症均可降低肥胖指标参数、瘦素和胰岛素水平(P<0.05和P<0.01);还可升高IAI、一氧化氮和NOS水平(P<0.01);前者Y值结果明显回降(P<0.05)而后者Y值显著回升(P<0.01)。针灸后植物神经功能犤针灸治疗后神经功能参数分别为(2.19±0.61),(0.98±0.48)犦,胰岛素犤69.88±91.12),(121.16±52.52)mU/L犦,瘦素犤(111.28±49.25),

Clinical research on the treatment of obesity complicated with primary hypertension with acupuncture

BACKGROUND: Losing weight is the essential measure on the prevention of primary hypertension. Acupuncture acts on weight losing and blood pressure reducing without toxic side effects.OBJECTIVE: To probe into the mechanism of acupuncture on the treatment of obesity complicated with hypertension.DESIGN: The control research was carried out on the cases based on the diagnosis.SETTING, PARTICIPANTS and INTERVENTION: The patients were selected from the expert clinic of Nanjing University of Traditional Chinese Medicine. The objects in the research were the patients with obesity complicated with primary hypertension and the patients with obesity without complication. All of the patients were treated with acupuncture and compared with the normal persons to observe the changes of the symptoms, physical signs, obese indices, blood pressure, vegetative indices(Y value), insulin,insulin activation indices(IAI), the levels of leptin, NO and nitricoxide synthase(NOS) before and after acupuncture treatments.MAIN OUTCOME MEASURES: To observe the changes of obese indices,vegetative function, blood sugar, insulin, leptin, NO, NOS in the patients with obesity complicated with primary hypertension in the types of excessive phlegm damp, hyperactivity of liver fire, yang hyperactivity due to yin deficiency and deficiency of both yin and yang, and in the patients with obesity without complications in the types of excess-beat of stomach and intestines,the stagnation of liver qi and the retention of damp due to spleen deficiency,comparing with the normal beulthy persons before and after acupuncture.RESULTS: By the treatment of acupuncture for the group of obesity complicated with primary hypertension and the group of obesity, the obese indices and the levels of leptin and insulin were reduced( P ＜ 0. 05 and P ＜0. 01 ), the levels of IAI, NO and NOS increased( P ＜ 0. 01 ), the results of Y value in the former group remarkably reduced ( P ＜ 0. 05) and in the latter group significantly increased( P ＜ 0.01 ). After acupuncture, there were improvements(P ＜ 0.05-0.01) compared with the conditions before acupuncture in the aspects of vegetative functionthe vegetative indices after acupuncture treatment were (2.19±0.61), (0.98±0.48)], insulin (169.88±91.12), (121.16±52.52) mU/L], leptin (111.28±49.25), (78.33 ± 22. 16) μg/L] and NO (55.38 ± 19.53), (89. 39 ±23.25) μ mol/L].CONCLUSION: Acupuncture acts on effective regulations on the levels of vegetative function, insulin, leptin and NO in the patients with obesity complicated with primary hypertension, which is probably the essential mechanism in achieving the effects on weight losing and blood pressure reducing.