针刺对单纯性肥胖症患者TNF-α和Resistin水平的影响

目的:明确针刺治疗单纯性肥胖的机理,为治疗的客观化提供依据。方法:取足阳明胃经穴位梁丘、丰隆、天枢施泻法,足太阴脾经穴位箕门、腹结、大横、阴陵泉、血海施以补法,同时配以任脉穴位下脘、中脘平补平泻,治疗单纯性肥胖患者,并与正常人进行对照研究。观察单纯性肥胖患者治疗前后的体重指数(BMI)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、抗肿瘤坏死因子(TNF-α)、抵抗素(Resistin)、空腹血糖(FBG)的变化。结果:单纯性肥胖患者不同程度地存在胰岛素抵抗,其TNF-α、Resistin血浆浓度较正常对照组明显升高,且与胰岛素抵抗指数存在一定的相关性;经过针刺治疗,患者的胰岛素抵抗状况得以改善,TNF-α、Resistin浓度明显降低。结论:针对单纯性肥胖脾虚、胃热、痰结病机选穴的针刺治疗通过降低可溶性TNF-α、Resistin浓度,影响糖与脂的代谢,改善患者的胰岛素抵抗状态,起到治疗单纯性肥胖的作用。

Effect of Acupuncture on Serum TNF-α and Resistin in Simple Obesity Patients

Objective: To investigate the underlying mechanism of acupuncture in the treatment of simple obesity patients.Methods: A total of 40 simple obesity outpatients (acupuncture group) and 40 normal subjects(control group) were observed in this study.For obesity patients,Liangqiu(ST 34),Fenglong(ST 40),Tianshu(ST 25),Jimen(SP 11),etc.were selected according to spleen deficiency,stomach heat and phlegm accumulation syndromes,and punctured once daily in the first week and once every other day afterwards,one month altogether.Before and after treatment,the patients' and normal subjects' height and body weight were detected for calculating body mass index(BMI);and fasting venous blood samples were collected for assaying tumour necrosis factor-alpha(TNF-α),resistin,fasting glucose(FBG),and fasting insulin(FINS) levels in simple obesity subjects.In addition,homeostasis model assessment(HOMA) was used to compute insulin resistance(IR) index.Results: Compared with control group,BMI,serum FINS,FBG,TNFα and resistin contents,and HOMA-IR values of acupuncture group were significantly higher(P<0.05,0.01).Comparison between pre-and post-treatment showed that after acupuncture treatment,serum BMI,FINS,resistin and TNF-α contents and HOMA-IR decreased considerably(P<0.05,0.01),denoting that acupuncture could effectively lower obesity induced abnormal increase of the aforementioned indexes.There was a positive correlation between the difference of HOMA-IR and that of BMI,FINS,TNF-α and resistin between pre-and post-treatment.Conclusion: Acupuncture can improve metabolism of sugar and lipid,relieve insulin resistance through lowering concentrations of blood TNF-α and resistin levels and is thus an effective remedy for simple obesity.