脂联素在针刺抑制脂毒性中作用的临床观察

目的探讨针刺是否具有抑制脂毒性的作用，及其可能机制。方法临床针刺治疗34例单纯性肥胖病患者3个疗程，治疗前后测量体重指数（BMI）、脂肪百分率（F％），酶联免疫法测定血清胰岛素、脂联素，生化比色法测定血脂、血糖，高效液相色谱法测定主要的八种游离脂肪酸，并与20例正常人对照。结果临床总有效率88．23％，针刺可提高患者降低的胰岛素敏感指数（IAI，t=-5．103，P=0．000）。针刺后F％的降低与不饱和脂肪酸升高的相关性具有显著性意义（r=0．402，P=0．019），与不饱和脂肪酸与饱和脂肪酸的比值的升高的相关性亦具有显著性意义（r=0．348，P=0．044）。高密度脂蛋白升高与二十碳五烯酸的升高的相关性具有显著性意义（r=0．352，P=0．041），BMI的降低与高密度脂蛋白的升高的相关具有显著性意义（r=0．357，P=0．038）。针刺后脂联素水平显著升高（与治疗前相比P=0．000），FFAs降低与脂联素升高的相关性具有显著性意义（r=-0．349，P=0．043）。结论针刺可以降低肥胖患者的游离脂肪酸水平，提高其胰岛索敏感性，从而表现出抑制脂毒性的效应。针刺抑制脂毒性的作用与提高脂联素水平有一定的关系。

Clinical Observations on the Effect of Adiponectin in Acupuncture Inhibition of Fatty Toxicity

Objective To investigate if acupuncture has an inhibitory effect on fatty toxicity and its possible mechanism.Methods Thirty-four patients with simple obesity were clinically treated with acupuncture for 3 courses. Before and after treatment, body mass index(BMI) and fat percentage(F%) were determined, and serum insulin and adiponectin were measured by enzyme linked immunoassay, blood lipid and sugar by biochemical colorimetry and eight kinds of free fatty acids(FFAs) by high performance liquid chromatography. Twenty normal persons were selected as a control.Results The total efficacy rate was 88.23%. Acupuncture could increased the low insulin sensitivity index(ISI) in the patients(t= -5.103, P= 0.000). The correlation of a decrease in F% with an increase in unsaturated fatty acid after acupuncture was of significance(r= 0.402, P= 0.019) and its correlation with an increase in the ratio between unsaturated fatty acid and saturated fatty acid was also of significance(r= 0.348, P= 0.044). The correlation between increases in high density lipoprotein and in eicosapentaenoic acid was of significance(r= 0.352, P= 0.041). The correlation between a decrease in BMI and an increase in high density lipoprotein was of significance(r= 0.357, P= 0.038). Adiponectin level significantly rose after acupuncture (compared with pretreatment, P= 0.000). The correlation between a decrease in FFAs and an increase in adiponectin was of significance(r= -0.349, P= 0.043). Conclusion Acupuncture can lower the levels of free fatty acids in the patients and increase their sensitivity to insulin to inhibit the effect of fatty toxicity. The inhibitory effect of acupuncture on fatty toxicity is somewhat related to a rise in adiponectin level.