The Study Of Clinical Effect And Molecular Mechanism In Treating Simple Obesity With Catgut Implantation At Acupoint

Objectives:This thesis investigates the clinical effect and molecular mechanism in treatingsimple obesity and obesity complicated by psoriasis with catgut implantation atacupointMethods:1. Clinical research:(1)84patients with simple obesity were chosen, guided by thetheory of traditional Chinese Medicine, combined with clinical sydrome differentiation,selected acupoint dialectically, determined the treatment program, every2weeks,treated the patients clinically for3months, and observed the changes and correlations ofbody mass index, body fat percentage, body girth, skin-fold thickness, insulin sensitivity,leptin, insulin and blood lipid.(2) The author chose30patients with obesity complicatedby psoriasis, observed the effects on body mass index, waist hip ratio, body fatpercentage, blood lipid, blood sugar, leptin and insulin, and also observed the psoriasisarea and severity index (PASI) score and the change of traditional chinese medicine(TCM) syndrome integral before and after treatment.2. Experiments on animals: The author categorized rats fed by standard diet as thenormal group, and divided experimental obese rats (who were fed by high fat diet formore than12weeks and whose weights exceeded20%of those fed by standard diet)randomly into the model group and catgut implanting group. The author observed thethe amount of water consumed, food intake, feeding behavior, fat weights in differentparts (pericardium, perinephrium, epididymis), weights of liver and kidney weights andfat cell morphology, also observed fasting blood sugar, total cholesterol, triglyeerideand high density lipoprotein cholesterol after treatment in different groups, and obeserats’ blood fasting insulin and serum leptin. The author observed the effects of catgut implantation at acupoint on obese rats’ hypothalamic insulin, leptin content, leptinreceptor gene (OB-RbmRNA) expression, hypothalamic suppressor of cytokinesignaling (SOCS-3) expression, content of peripheral serum (SOCS-3) and peripheralskeletal muscle uncoupling protein(UCP)expression by means of ELISA and RT-PCR.Results:1. Clinical research: The total clinical effective rate of the treatment of catgutimplantation at acupoint for simple obesity is84.52%, with88.88%of male and83.33%of female, the effective rate of syndrome differentiation of patients with thestomach and intestine excess-heat type is91.48%. PASI of the treatment of obesitycomplicated with psoriasis and TCM syndrome score before and after the treatment havesignificant difference (P<0.05), there is a positive correlation between PASI and body massindex (P<0.01). Catgut implantation at acupoint can regulate each obesity-related index ofpatients with simple obesity, including body weight, body mass index, body fat percentage,body girth, skin-fold thickness, waist hip ratio, etc. Obesity indexes have significantdifference before and after the treatment (P<0.05); Blood lipid-related indicators (totalcholesterol, triglyeeride, fasting blood sugar, leptin, insulin) declined significantly aftertreatment, compared with those before the treatment, there was a very significant difference(P<0.01), high density lipoprotein cholesterol, insulin sensitivity index got improvedobviously after the treatment and there was a significant difference (P<0.05).2. Experiments on animals: After the treatment of catgut implantation at acupoint,the rats’ food intake and water intake, body weight and Lee’s index declined, there wasstatistically significant difference before and after the treatment (P<0.01); After thetreatment, the fat mass and the liver weight of the rats’ three parts (pericardium,perinephrium, epididymis) declined, compared with the rats in the model group, therewas significant difference (P<0.05); Compared with the rats in the model group, the fatcell diameter, area and volume of the rats in catgut implanting group were significantlydecreased (P<0.001); The rats’ content of fasting blood sugar, triglyeeride and totalcholesterol in catgut implanting group were significantly lower than those in the modelgroup (P<0.05); There was no significant difference between high density lipoproteincholesterol of the rats in catgut implanting group and those in the model group (P>0.05);The content of serum leptin, insulin of the rats in catgut implanting group decreasedsignificantly compared with those in model group(P<0.05), while the content ofhypothalamus leptin and insulin and the ratio increased significantly, compared withthose in the model group (P<0.05); The rats’ hypothalamus OB-RbmRNA expression level in the catgut implanting group increased significantly compared with those in themodel group rats (P<0.05), while the SOCS-3mRNA expression level and SOCS-3content in serum decreased significantly (P<0.05); The rats’ skeletal muscleUCP2mRNA, UCP3mRNA expression level in the catgut implanting group increasedsignificantly, compared with those in the model group (P<0.05).Conclusions:1、The total clinical effective rate of the treatment of catgut implantation atacupoint for simple obesity is84.52%, this treatment has better effects on male patientsthan on female patients and patients with stomach heat type have comparatively bettereffects. The treatment can reduce patients’ weight of obesity complicated by psoriasiseffectively, and at the same time, significantly improve the skin lesions of psoriasis.2、The treatment of catgut implantation at acupoint for simple obesity can reducepatients’ weight and at the same time, more importantly,it reduces the clinical andlaboratory indicators associated with obesity, such as, total cholesterol, triglyeeride,fasting blood sugar, etc, which suggests that the treatment can improve lipid metabolism,reshape figure and prevent and reduce complications of obesity.3、The study has shown that the weight loss mechanism of catgut implantation atacupoint has a correlation with the regulation of the central and peripheral leptin, insulin,OB-Rb, SOCS-3expression level. This treatment can improve insulin, leptin bloodbrain transport barrier and insulin, leptin receptor signal transduction disorder andcorrect insulin and leptin resistance, and improve the insulin and leptin biology effect.4、The treatment of catgut implantation at acupoint can up-regulate peripheralUCPmRNA gene expression, increase obese organism’s peripheral heat production andenergy metabolism, and increase fat burning and help achieve the purpose of weight loss.5、The treatment of catgut implantation at acupoint can shrink obese rats’ thediameter and volume of white fat cells, promote the conversion of white fat cells intobrown ones, and increase the heat production and metabolism of fat so as to lose weight.