| [Background] Simple obesity was a chronic metabolic disease with excessive fat accumulation and (or) abnormal distribution caused by many factors in human body, which was reflected by weight gain and excessive fat accumulation at some parts. Occurrence of the disease was a result of combined action between gene and environmental factor. The former contained genetic abnormality, reduction in the number of brown adipose tissue, while the latter included excessive ingestion, reduction in amount of exercise, unscientific feeding behavior as well as mental and character disorder. This disease belonged to the scope of obesity of traditional Chinese medicine. Its pathogenesis usually involved asthenic disease of Qi, blood, Yin and Yang, imbalance of Zang-Fu function and interference of pathogenic factors. Imbalance of spleen and renal function was its pathological basis, and deficiency of vital energy, phlegm, dampness and stasis were basic pathogenesis.Currently, there were many therapeutic schedules of simple obesity, whose main purpose lay in:(1) reducing redundant fat in human body,(2) slimming and shaping, and (3) alleviating or curing diseases resulted from obesity. Modern medicine mainly focused on drug therapy. In addition, there were liposuction and behavior therapy etc. However, their curative effect was not ideal. Instead, they generate many side reactions. Chinese traditional treatment mainly contained treatment by Chinese herbs, traditional Chinese dietary therapy, acupuncture and massage, auricular-point treatment and acupoint acupoint catgut-embedding. All of them had precise curative effect.Weigh loss by acupoint catgut-embedding, which had emerged in recent years, was an efficient, time-saving and economic new way to lose weight, which had few toxic and side effect. Compared with acupuncture treatment of simple obesity, interval time of acupoint catgut-embedding therapy was long, effect was steady and lasting, which adapted to fast pace of life in modern times. With respect to charge for treatment, total charge for course of treatment was less than that of acupuncture although expense of acupoint catgut-embedding therapy each time was higher than that of acupuncture. Acupoint catgut-embedding therapy was a method that embedded catgut into acupoint and used continuous simulation of catgut on acupoints to treat diseases. In the therapeutic process, it could not only help patients with complications like hyperlipidemia, coronary disease, high blood pressure and diabetes mellitus lose weight and become slim but also prevent and cure such complications.Catgut-embedding weight loss method had been widely applied to clinical treatment and popular with patients. However, it still had many nonstandard operations. Firstly, length of its course of treatment was not uniform. As we all know, length of course of treatment directly related to curative effect. In addition, specific course of treatment could prevent shortages of therapeutic dose, which not only helped with treatment of diseases but also prevented medical resources from being wasted and made patients know their therapeutic goals clearly. Secondly, interval time of catgut embedding. Because of differences in thread-embedding materials, personal habitus and the time when acupoint absorbed materials, type and specifications of materials should be standardized in order to determine interval of treatment. On the premise that curative effect was ensured, thread-embedding interval time should be extended as much as possible. Thirdly, selection of acupoints was not consistent. In future, we should pay attention to selection of optimal acupoints for different patterns of syndrome to improve clinical effect.In accordance with clinical treatment of a number of diseases, summary of experience and reference of literatures, we focused on tonifying spleen and reinforcing stomach and proposed ’eight weight-loss acupoints’:Zhongwan, Xiawan, Tianshu, Daheng, Qihai, weight-loss acupoint, Zusanli and Fenglong. Physiologically, the spleen managed muscle. Pathologically, pathomechanism of simple obesity was deficiency of vital energy, phlegm, dampness and stasis. The spleen and stomach provided the material basis of the acquired constitution and were sources of Qi and blood biochemistry. In addition, the spleen acts as the source of phlegm. The main cause for simple obesity was that transportation and transformation of both spleen and stomach were abnormal and phlegm and dampness accumulated. Combination of the eight acupoints could smooth functions of the whole body, regulate spleen and stomach, strengthen middle-jiao, distribute body fluid, tonify deficiency, remove phlegm and dampness and dredge stasis. By this task, it was hoped that clinical effect of the method that used’eight weight-loss acupoints’ acupoint catgut-embedding to treat simple obesity and insufficiency of the spleen with overabundance of dampness.[Objective]To treat simple obesity and insufficiency of the spleen with overabundance of dampness by using two therapeutic methods, i.e.,’eight weight-loss acupoints’ acupoint catgut-embedding and conventional electric acupuncture. According to comparison about situations before the acupoint catgut-embedding treatment and the electric acupuncture treatment, differences in curative effect of the foregoing two therapeutic methods were compared, curative effect of ’eight weight-loss acupoints’ acupoint catgut-embedding treatment and changes in various indexes were observed, which not only provided effective therapeutic schedules for clinical treatment of simple obesity by the acupoint catgut-embedding method but also optimized medical resources.[Methods] Time and place:this experiment was finished at Departments of Acupuncture and Moxibustion, Affiliated Southern Hospital of Southern Medical University and Hospital of Traditional Chinese and Western Medicine from December2012to December2013.Subjects came from:cases collected by Southern Medical University, its Affiliated Southern Hospital and Hospital of Traditional Chinese and Western Medicine. By mastering inclusion and exclusion criteria strictly,65cases were collected according to requirements. Such cases were divided into acupoint catgut-embedding group (treatment group) and electric acupuncture group (control group) randomly. The treatment group was composed of33cases, and the control group included32cases.Subjects’ materials:in all,65patients took part in this experiment, i.e.,33cases were included in the treatment group and32cases were involved in the control group. Two patients of the control group quitted midway, so the two cases did not accept statistical analysis. At last,63complete cases were collected, i.e.,33cases in the treatment group and30cases in the control group, including19men and44women. Among such patients, the youngest one was15years old and the oldest one was62years old; the shortest course of disease was2years and the longest course of disease was32years. Specifically, the treatment group included11men and22 women, with an average age of33.39±11.17and10.18±3.34years’ average course of disease. The control group consisted of8men and22women, with an average age of31.43±7.64and9.90±5.07years’ average course of disease. Via the differences found by corresponding statistical test, they had comparability.Process of the experiment:patients’ height, weight, waistline and hipline were measured before and after each course of treatment, respectively. Weight:(1) adult’s standard body weight (kg)=[height (cm)-100]×0.9.2-4hours after the meal, weight was measured after defecating and urinating regularly. It was required that patients should wear the simplest upper clothes and trousers.(2) Waistline:patients wore unlined clothes, put down their hands and separated their feet by25-30cm to make their weight distribute two legs evenly. The measuring person sat on one side of a patient, placed a tape measure on midpoint level between anterior superior spine and the lowest edge line of the12th rib closely (the tape measure must not oppress soft tissue) and recorded length at the end of the patient’s natural breath (precise value was0.1cm).(3) Hipline:requirements for measurement were the same as the ones for waistline. In detail, surrounding cross-section diameter of the hip with the most prominent point of pelvis was measured (precise value was0.1cm).(4) Body mass index (BMI):weight (kg)/[height (m)]2.(5) Waist hip ration (WHR):waist (cm)/hip (cm). The therapeutic process was shown as follows.1. Acupoint catgut-embedding treatment:patients were in a supine position, partial skin of acupoint was disinfected conventionally, and disposable catgut-embedding auxiliary package was used for treatment (produced by Yangzhou Longhu Medical Apparatus Factory, YZB/SY0071-2011). About1cm disinfected catgut was taken and placed at the front end of needle tubing and then connected with core of the needle. Then, the index finger of the left hand was used to tighten or hold the skin where the needle was inserted, and the right hand held and inserted the needle to the needed depth. After acupuncture feeling had appeared, the core of the needle was pushed when the needle tubing was withdrawn. Meanwhile, the catgut was embedded in subcutaneous tissue or muscular layer of the acupoint, and the needle was withdrawn. The part with pinhole was disinfected again for treatment. At the same time, check whether there was thread residue and ensure there was no blooding. Catgut-embedding treatment was administered once two weeks, and four treatments were given in all (treatment was suspended during menstrual period). Acupoints used for patients’ treatment mainly included’eight weight-loss acupoints’:Zhongwan, Xiawan, Tianshu (both sides), Daheng both sides), weight-loss acupoint (both sides), Qihai, Zusanli (both sides) and Fenglong (both sides). Ashi acupuncture point increase or decrease for patients with partial obesity:Belt vessel was added for patients with waist obesity, Naohui was added for patients with upper arm obesity, and Biguan, Futu, Liangqiu, Chengjin and Chengshan were added for patients with lower limb obesity.2. Treatment by electric acupuncture:patients were in a supine position, partial skin of acupoint was disinfected conventionally,0.25*40mm Tianxie Brand stainless acupuncture needle was applied to acupoints at abdomen (Suzhou Tianxie Instruments for Acupuncture and Moxibustion Co., Ltd., GB2024-1994), and0.3*40mm needle was used at acupoints of arms and legs. Needles were inserted rapidly. After the desired sensation was obtained, needles were kept for320minutes. Changcheng Brand electric acupuncture apparatus was used (Wujin Changcheng Medical Apparatus Co., Ltd., KWD-8081) to connect Tianshu on both sides and Weight-loss acupoint by continuous wave and2HZ frequency. The strength should follow maximum value that patient could bear, and the time lasted30minutes. The treatment was carried out once two days, i.e., three times a week, and lasted two months constantly. Acupoints for patients’ treatment were similar to that of the acupoint catgut-embedding treatment group. Date processing:statistics and analyses of all data were carried our on spss16.0. Data were expressed by mean±tandard deviation. For comparison about measuring materials, t test was used. Considering enumeration data, X2test was utilized. Data comparison of the same group of subjects before and after treatment adopted pairing t test, t test of two independent samples was used for comparison about different groups of subjects after treatment. X2test was utilized for comparison about efficiency of two groups’ treatment. In this way, differences in changes in the same group before and after the treatment and between different groups after the treatment were obtained.[Result](1) Comparison about all indexes of the catgut-embedding group before and after the treatment:changes in subjects’ weight, BMI, waistline, hipline and WHR before and after the treatment had statistical significance.(2) Comparison about all indexes of electric acupuncture group before and after the treatment:changes in subjects’ weight, BMI, waistline, hipline and WHR before and after the treatment had statistical significance.(3) Comparison about difference value of each index of the two groups after the treatment:By comparing the treatment group with the control group, changes in weight and weight index had statistical significance. The treatment group reduced faster, while changes in waistline, hipline and WHR had no statistical significance.(4) Comparison about efficiency of the two groups after the treatment:effective rate of the acupoint catgut-embedding group was90.91%and that of the electric acupuncture group was73.33%. Comparison about efficiency of the two groups had statistical significance, and curative effect of the acupoint catgut-embedding group was superior to that of the electric acupuncture group.[Conclusion] Both’Eight weight-loss acupoints’acupoint catgut-embedding method and electric acupuncture treatment had precise curative effect on simple obesity, and both of them could improve subjects’ figure. However, curative effect of the acupoint catgut-embedding group was better than that of the electric acupuncture group. |
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