| Objective:The purpose of this study is to observe the clinical efficacy of acupoint catgut embedding therapy and its effect on patients’appetite,serum leptin and GSH-Px levels,combined with the existing literature evidence,to explore the possible neural and molecular mechanism of acupoint catgut embedding therapy in the treatment of simple obesity,in order to provide some basis for clinical work and scientific research.Method:A total of 60 patients who were diagnosed as simple obesity in the outpatient clinic of the Department of Acupuncture and moxibustion of Wuhan first Hospital from 2018.12 to 2020.12 were randomly divided into two groups:acupoint catgut embedding group(ACE group)and manual acupuncture group(MA group).There were 30 cases in each group,and 56 cases completed the experiment,including 29 cases in ACE group,1 case in exclusion group and 27 cases in MA group.The other 2 cases were exfoliated and 1 case was removed.The ACE group was treated with catgut embedding at acupoints.After relaxing,patients were advised to lie prone on the treatment bed.0.2%iodine cotton balls were used to disinfect the catgut embedding points(back Shu selected bilateral Pishu and Weishu,spteen and kidney yang deficiency plus Shenshu).The needle core of disposable catgut embedding needle(Granz)was retreated 2cm,and a piece of absorbable catgut soaked in 75%alcohol was removed with sterile tweezers(Boda).4-0#)placed at the front of the catgut embedding needle,the left thumb and the second finger tighten the skin near the catgut embedding acupoint,after the right hand holds the needle into the acupoint at a certain depth,push the needle core white withdrawing the needle tube,place the absorbable suture body between the muscle layer and the fat layer,press the needle hole with a dry cotton ball untit there is no obvious blood oozing,apply it with medical application(Kefu),and then instruct the patient to take a supine position.Similarly,0.2%iodine cotton balls were used to disinfect the buried acupoints twice(main acupoints:Zhongwan,bilateral Tianshu,Qihai,Guanyuan,bilateral Zusanli,spleen deficiency plus moisture,bilateral Fenglong,spleen and stomach damp-heat plus bilateral Ququan and Sanyinjiao),the method of embedding absorbable sutures into acupoints is the same as above,the above operation is carried out once every 2 weeks,for one course of treatment,and 6 consecutive courses of treatment are observed.In the MA group,the acupoints were the same as those in the ACE group.The acupuncture points of Pishu,Weishu,Shenshu,Zhongwan,Shuishui,Tianshu,Qihai,Guanyuan,Zusanli,Fenglong,Sanyinjiao or downward obtlique needling 1-1.5inch,Ququan straight needling toward the popliteal fossa,retaining the needle for 30 minutes after acupuncture,once every other day,three times a week,every two weeks as a course of treatment.Six consecutive courses of treatment were given.The BMI index,waist circumference(WC),appetite visual analogue scale(VAS),general food craving questionnaire(G-FCQ-T),serum leptin and GSH-Px levels were observed in the two groups before and after treatment.During the whole process of treatment and within 1 month after treatment,follow-up was maintained to pay attention to whether the patients had any treatment-related adverse reactions.Statistical analysis using SPSS19.0,to select appropriate statistical methods to analyze the changes of the above observation indicators.Results:(1)Comparison of BMI index between the two groups before and after treatment:compared with before treatment,BMI decreased in both groups(P<0.05),and the difference was statistically significant(P<0.05).After treatment,the BMI index in ACE group was significantly lower than that in MA group,P<0.05,indicating that ACE group was better than MA group in weight loss.(2)Comparison of WC between the two groups before and after treatment:the WC value of the two groups decreased after treatment,P<0.05,the difference was statistically significant,the WC value of the ACE group decreased more significantly than that of the MA group,P<0.05,the difference was statistically significant,indicating that the ACE group was better than the MA group in reducing waist circumference.(3)Comparison of VAS score of appetite between the two groups before and after treatment:compared with that before treatment,the level of VAS in the two groups decreased after treatment(P<0.05),and the difference was statistically significant(P<0.05),indicating that the appetite of the two groups decreased after treatment,and there was significant difference between the two groups after treatment(P<0.05),but the difference of VAS between the two groups was P>0.05.(4)Comparison of G-FCQ-T scores between the two groups before and after treatment:after treatment,the G-FCQ-T scores of the two groups were lower than those before treatment(P<0.05),and the difference was statistically significant(P<0.05),but there was no significant difference in G-FCQ-T scores between the two groups after treatment(P>0.05).Comprehensive(3)(4)analysis showed that the appetite and feeding behavior of ACE group and MA group decreased after treatment,but the difference between them was not significant.(5)The level of serum leptin in both groups after treatment was significantly lower than that before treatment(P<0.05),and the change of serum leptin in ACE group was significantly higher than that in MA group(P<0.05).(6)The level of serum GSH-Px in both groups after treatment was significantly higher than that before treatment(P<0.05),and the change of serum GSH-Px in ACE group was significantly higher than that in MA group(P<0.05).(7)Adverse reactions:there were no obvious adverse reactions in ACE group and MA group during treatment and within 1 month after treatment.Conclusion:(1)Both acupoint catgut embedding and ordinary acupuncture can reduce the BMI index and waistline of patients with simple obesity,which proves that both acupoint catgut embedding and ordinary acupuncture are effective in the treatment of simple obesity,but the overall curative effect of acupoint catgut embedding is more dominant.(2)Both acupoint catgut embedding and ordinary acupuncture are effective in the improvement of appetite and feeding behavior,but there is no significant difference between them in terms of subjective appetite.(3)Both acupoint catgut embedding and ordinary acupuncture can down-regulate the levels of serum leptin and up-regulate GSH-Px in patients with simple obesity,indicating that acupoint catgut embedding and ordinary acupuncture may regulate the function of central nervous system by improving leptin resistance and lipid peroxidation,thus causing changes in patients’subjective appetite,and the effect of acupoint catgut embedding on serum leptin level is more obvious than that of ordinary acupuncture.Catgut embedding at acupoints is more effective in improving the levels of both,but whether the level of serum GSH-Px can represent the level of lipid peroxidation in hypothalamus remains to be discussed,because GSH-Px enzymes are mainly distributed in intracellular cytoplasm rather than extracellular serum components.Follow-up experiments will be conducted through animal experiments or human extracellular cell experiments to observe the intracellular GSH-Px level in obese individuals.(4)Both acupoint catgut embedding and ordinary acupuncture have no obvious adverse reactions in the treatment of simple obesity,and the overall effect of acupoint catgut embedding is more significant,indicating that catgut embedding at acupoint can be used as one of the means for the treatment of simple obesity. |
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