| Objective:To research the interventional effect of strengthening spleen and clearing phlegm combined with catgut implantation for treatment of simple obesity of spleen deficiency type in adult womenMethods:The research was a randomized controlled trial with12weeks follow up. Participants diagnosed with simple obesity who fulfill the inclusion and exclusion criteria were recruited from January until December2013from "Lili" private clinic in Surabaya, Indonesia. This research used catgut-embedding therapy that was applied in certain acupoints.Simple obesity diagnostic standard is based on the Chinese and Western Integrative Medicine Diagnose and Criterion of Therapeutic Effect on Simple Obesity formulated at the Fifth Shanghai National Obesity Research Academic Conference in1997.Diagnosis standard for Simple Obesity with Spleen Deficiency and phlegm-wet stagnancy, main symptoms are:obesity, fatique, fatiqued and heavy body, little absorption and abdominal distension, loose stools and oliguresis, occasional mild edema of the lower limbs, pale tongue with tooth marks around the edges, greasy fur on tongue, soft pulseParameters that were used in this research are Body Mass Index (BMI) and waist circumference. BMI=body weight (kg)[body height (m)]2 Obesity in adult according to Asia Pasific criteria that released by World Health Organization (WHO):Waist circumferenceWaist circumference is a measure of the distance around the abdomen. Waist circumference is one of the most practical tools to assess abdominal fat for chronic disease risk and during weight loss treatment. As recommended by WHO due to recent research findings, those at increased risk for developing chronic disease include:Asian women with a waist circumference of more than31inches (78,74cm)-Asian men with a waist circumference of more than35inches (88,9cm)Sixty women with simple obesity (dampness stagnancy due to spleen deficiency type), with body mass index (BMI)>23kg/m2and waist circumference (WC)>78.74cm, were randomly divided into a treatment group (30cases) and a control group (30cases). The treatment group was treated with catgut implantation combined with electro-acupuncture at acupoint that can strengthen spleen and clear phlegm. The catgut implantation was given at Tianshu (ST25), Zhongwan (RN12), Futu (ST32), Daimai (GB26), Shuidao (ST28). and electroacupuncutre was applied at Zusanli (ST36), Pishu (BL20), Fenglong (ST40). The control group was treated with catgut implantation only.The treatment was given once a week for12weeks. The body weight, body mass index (BMI), waist circumference were evaluated before and after treatment. For assessment of therapeutic effects of simple obesity (treatment effect standard) in this research using the modified criteria stipulated at3rd national conference on obesity by integrated Chinese and western medicine in1991:Recent clinical cure:Body weight decreases to the standard level; BMI is near to23.0kg/m2or Waist Circumference is near to79cm-Effect:Body weight decreases^2.0kg, and BMI decreases≥2.0kg/m2, or waist circumference decreases≥2cm-Failure:Body weight decreases<2.0kg, and BMI decreases<2.0kg/m2or waist circumference decreases<2cmAll statistical analyses were performed using the software statistical package SPSS version12(SPSS, Chicago, IL, USA). A paired t-test was used to analyze the differences in mean values before and after treatment within each group (Treatment and Control Group). Independent samples t-test was used for comparison between groups. Also chi square (X2) was used to analyse the non-parametric data. Values are presented as means±SD.Results:From January2013until December2013, a total of65patients were recruited from "Lili" private clinic in Surabaya.Screening was done and among65people5had to be excluded because did not fulfill the criteria. Informed consent was obtainedAmong60participants who fulfill the criteria are all female, among which the youngest was19years, the oldest was58years (average:38years). Body mass index (BMI) range between23.10kg/m2to31.75kg/m2(average:25.91kg/m2). Waist circumference range between78.80cm to119cm (average:86.69cm).Result data were examined with independent sample t-test and there were no significantly different in the distribution of age (p=0.001), body masss index (BMI) before treatment (p=0.155) and waist circumference before treatment (p=0.916). There were also no statistically different with chi square (x2) test in marital status and occupation between the treatment group and control group (p<0.005).Body weight decreased significantly from64.35±6.81to57.76±7.37in Treatment Group and from62.36±6.85to57.72±7.32in Control Group, and the weight decreases in the treatment group significantly higher than in the Control Group(p<0.005).BMI decreased significantly from25.81±2.39to23.22±2.51in Treatment Group and from24.76±2.74to23.00±2.93in Control Group, and table11showed the BMI decreases in the Treatment Group significantly higher than in the Control Group (p<0.005).Waist circumference decreased significantly from86.44±10.22to82.21±10.94in Treatment Group and from86.67±11.67to84.27±12.09in Control Group, and the waist circumference decreases in the Treatment Group significantly higher than in the Control Group (p<0.005)The total effective rate of96.67%in the treatment group was significantly higher than that of83.33%in the control group (p<0.005).Conclusion:It is concluded that using catgut implantation at acupoints effectively reduces body weight and fat mass in simple obesity obesity woman with spleen deficiency and phlegm accumulation. The combination of catgut implantation at acupoints with electro-acupunture at modified acupoints that can strengthen spleen and clear phlegm have significantly more effective effect in treating women with simple obesity. The addition of acupuncture to this regimen add, according to our findings, a substantial advantage. |
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