| Objective:To evaluate the efficacy and safety of "Regulating Qi to Discharge Turbid and Dredging the Yangming" acupuncture in the treatment of overweight/obesity,and to search for differential proteins,differential metabolites,enrichment functions and pathways after weight loss by acupuncture,for further exploration of high evidence-based value.Methods:According to BMI and waist circumference as diagnostic criteria,strictly according to inclusion criteria and exclusion criteria screening,finally included 35 overweight/obese patients.Acupoints were selected with the acupuncture method of"Regulating Qi to Discharge Turbid and Dredging the Yangming ",and acupuncture treatment was performed 3 times a week,a total of 36 times for 12 weeks.The collection of anthropometric indicators was completed in the baseline period,after 12 treatments,24 treatments and 36 treatments,and the weight loss effect of acupuncture was statistically analyzed,and compared with the target value to evaluate the weight loss effect.Biochemical indicators related to cardiovascular and cerebrovascular disease risk and the Dutch Eating Behavior Questionnaire were completed at baseline and after 36 treatments.Blood samples were collected before and after treatment to analyze the differences in proteomics and metabolomics and explore the enrichment functions and pathways after acupuncture treatment.Results:A total of 35 patients were included in this study,and the before-after study suggested that acupuncture had a weight reduction effect(P<0.05).Main efficacy indicators:The percentage of weight change was-1.63±3.51%.Comparing the percentage of weight change with the target value(-5%),the percentage of weight change was lower,with a statistical difference(P<0.05).The total response rate was 20.00%,and there was no significant difference in response rate between males and females(P<0.05).Secondary efficacy indicators:After acupuncture,BMI,WC,and HC decreased significantly compared to before(P<0.05).The decrease in BMI was-0.59 ±1.14 kg/m2,the decrease in WC was-2.80±5.14 cm,and the change in HC was-3.80±4.22 cm.There was no significant change in WHR compared to before(P>0.05).After acupuncture,total cholesterol,triglyceride and low-density lipoprotein decreased,meanwhile,high-density lipoprotein increased.Triglyceride was the only one which decreased with statistical significance(P<0.05).Postprandial blood glucose,glycated hemoglobin,fasting insulin,and HOMA-IR all decreased,with no statistically significant difference(P>0.05).After acupuncture,the eating behavior of overweight/obese patients changed,the scores of emotionality eating and external factors eating decreased significantly(P<0.05),while the scores of restricted eating increased,with no statistically significant difference(P>0.05).Proteomics:63 differentially expressed proteins were found,including 7 up-regulated proteins and 56 down-regulated proteins.GO enrichment analysis suggested that protein functions were more enriched in biological processes(immune aspects and metabolic activities)and cell components.KEGG enrichment analysis found that tight junction signal pathways had the highest significant enrichment degree.Metabolomics:225 differential metabolites were identified,of which 144 were downregulated and 81 were upregulated.KEGG enrichment analysis found that metabolic pathways of valine,leucine and isoleucine biosunthesis,phenylalanine metabolism,pentose and glucuronate interconversions,caffeine metabolism and ascorbate and alfarate metabolism were more important.Conclusion:Acupuncture therapy with the principle of "Regulating Qi to Discharge Turbid and Dredging the Yangming"has a certain therapeutic effect on overweight/obese patients in reducing weight,improving comorbidities,and adjusting eating behavior.Through omics mechanisms,it has been found that acupuncture treatment for overweight/obesity involves multiple pathways such as immunity,metabolic activity,gut and blood-brain barrier,amino acid metabolism,and purine metabolism.The mechanism of acupuncture weight loss is the simultaneous action of multiple pathways. |
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