Clinical Research Of Embedded Needle Acupuncture Therapy In Treating Female Menopausal Obesity And The Implications Of Reproductive Hormones In Blood Serum

Due to modern lifestyle changes and improvement in living standards, a large proportion of adults are overweight or obese, more often women than men. Obesity has become a global health problem for the 21st century, and specialized research of obesity has become a hot spot in the medical world. Clinically there are more and more patients requesting help losing weight. Menopausal obesity has become a common, frequently seen clinical disease. It is extremely worthwhile to research its pathogenesis and etiology to find an ideal method of treatment without adverse side effects.Embedded needle acupoint therapy was formed on the basis of retaining and burying acupuncture needles, and thus is classified as a long-term effective treatment. In recent years its use in treating both simple obesity and female menopause syndrome has shown good results, additionally the treatments are few, time-saving, economical, have lasting effect, and show a clear effectiveness. As the treatment does not cause much pain and patients are compliant, it is worthwhile to continue further research.Female menopause and ovarian function recession are related. After ovarian secretions of estrogen and progesterone are reduced, a change in the normal balance of the hypothalamus, pituitary, and ovarian axis takes place. The negative feedback controls weaken, resulting in hyperactivity of the hypothalamus and pituitary, manifesting in an overproduction of gonadotropin (FSH, LH), thus affecting the regulatory activity of the central nervous system. The purpose of this study is to treat female menopausal obesity using embedded needle acupoint therapy, and evaluate its efficacy; to see whether there is improvement in quality of life and adjustment in reproductive hormones after the menopausal women have lost weight.In recent years there have been many reports on the use of acupuncture in treating obesity and female menopause syndrome, because its applications are simple, effective, and with few side effects it has received widespread attention from the medical community. But research on the topic of female menopausal obesity, whether in the field of clinical efficacy or experimental research, is actually very rare, and leaves a lot of space for development of future research. Hopefully by addressing this issue, we can further investigate treatment of menopausal obesity by building on accumulated previous research and experience, to find a method of treatment that is safe, effective, and can be repeated.Part I: Literature ReviewObesity is one type of hormone imbalance condition. Menopausal women with receding ovarian function have rapidly declining secretion of estradiol (E₂), an increase in FSH and LH, an imbalance of the hypothalamus-pituitary-ovarian axis, affecting insulin, adrenal cortex hormones, growth hormones and causing other metabolic disorders, resulting in dysfunction of sugar and fat metabolism, and showing an important probable link between the incidence of menopause and obesity.The main forms of treatment for menopausal obesity are a controlled diet, exercise, and medication. Currently the main forms of medication are appetite suppressants, digestion inhibitors, and hormone replacement therapy. Of course this can achieve the goal of losing weight, but there are certain side effects. Acupuncture is simple, convenient and easily administered. As a form of TCM treatment, from ancient times, acupuncture has always been held with great respect. In recent years the use of acupuncture to treat obesity, metabolic disorders, diabetes, hyperlipidemia, menopause syndrome, and other diseases has shown great results. Existing animal experiments and clinical research has shown that in treating menopausal obesity, acupuncture can suppress appetite, regulate hormone imbalances, and improve endocrine and metabolic abnormalities. The link between female reproductive hormones and menopausal obesity is especially worthwhile to investigate, and is also beneficial in obtaining an overall grasp of menopausal obesity mechanisms.After a lot of literary research, we feel that treatment of obesity and menopause syndrome using acupuncture has a definite scientific foundation and a precise clinical healing effect. Conducting a thorough research investigation of the use of embedded needle acupoint therapy as long term treatment method can still be considered very worthwhile. As based on the above mentioned foundation, a study of the efficacy of embedded needle therapy in treating female menopausal obesity, and a further investigation into this treatment methods affect on and mechanism of adjusting female reproductive hormones (E₂, FSH, LH) can improve the theoretical basis and establish a foundation for clinical research of the treatment of female menopausal obesity using embedded needle acupuncture.Part II: Clinical ResearchPurpose: This study will use both diet control and embedded needle therapy to treat female menopausal obesity, and will use the diet control group (control group) to evaluate clinical efficacy.Method: 1. 36 patients in the diet control group. 2. 36 patients in the diet control + embedded needle group. 3. 10 priority patients afraid of needles or with needle sickness were placed in the diet control group. 4. 8 patients were placed in the diet control group and 21 in the diet control + embedded needle group as based on their wishes. 5. Of the remaining patients 18 were placed in the diet control group and 15 in the diet control + embedded needle group as based on a random drawing.1400 kcal was set as the reference standard for daily caloric intake of patients in the diet control group, the nutritional breakdown of food was: 15% protein, 20% fats, and 65% carbohydrates. This menu merely provides a reference for patients to consult for daily meals, but all patients were requested to avoid intake of high-calorie and fried foods as much as possible. All daily meals were self prepared by the patients and recorded in a table, which was returned to medical personnel every two weeks for examination. If any unusual or abnormal situation occurred, the patient was asked to provide a self-review. As long as there was no appearance of patients engorging food, most were able to accept and maintain a steady level.The diet control + embedded needle group relied on TCM fundamental theory and pattern classification in splitting up 5 groups for treatment; reassessment was performed every two weeks, and 3 months was considered one observational treatment period.1. Stomach and intestine repletion heat: treatment based on clearing and draining heat from the stomach and intestine bowels. Acupoints: NeiTing, ZuSanLi, ZhongWan, ShangJuXu, TianShu, SanYinJiao, etc.2. Liver depression with qi stagnation: treatment based on comforting the liver and rectifying the qi, quickening the blood and transforming stasis. Acupoints: TaiChong, TianShu, ZuSanLi, GanShu, QiMen, SanYinJiao, etc.3. Spleen vacuity with damp obstruction: treatment based on fortifying the spleen and expelling dampness. Acupoints: PiShu, ShangJuXu, TianShu, ZuSanLi, SanYinJiao, FengLong, etc.4. Kidney Yin vacuity: treatment based on nourishing the kidney and liver, fostering yin and submerging yang. Acupoints: GuanYuan, GanShu, ZuSanLi, ShenShu, SanYinJiao, TaiChong, etc.5. Kidney Yang vacuity: treatment based on warming the kidney and aiding the yang. Acupoints: GuanYuan, ZuSanLi, ShenShu, PiShu, QiHai, SanYinJiao, etc.Results: A group of 45-55 year old women were used as research subjects for the study of female menopausal obesity. Through literature survey, clinical research, and analysis of clinical efficacy of diet control and embedded needle treatment of menopausal obesity, the following preliminary conclusions were made;1. Clear efficacy of diet control and embedded needle treatment of obesity.2. Diet control was regarded as the obtained basic validation for effective treatment of obesity.3. Diet control had little effect on changing reproductive hormones (E2, LH, FSH) of obese women.4. There was a clear difference in the achieved effect of embedded needle acupuncture in changing reproductive hormones (E2, LH, FSH) of obese women.5. For menopause syndrome the Blatt-Kupperman Menopausal Index (MI), clear efficacy is seen of both diet control and embedded needle therapy, with no observed difference between the two groups. This result may be related to the mode of calculation, and thus a better measurement index must be considered.6. Only in the embedded needle acupuncture treatment of menopausal women did the MI efficacy achieve a notable difference (p<0.05).Diet control showed results in weight loss, but the overall efficacy rate declined, with no effect on reproductive hormones, and not much help in improving symptoms of menopause syndrome. Embedded needle acupuncture not only showed results in weight loss, but at the same time was able to adjust imbalances in reproductive hormones, and thus improve menopause syndrome.Conclusion: Embedded needle acupuncture, by means of influencing food absorption and increasing the body' s metabolic energy, can produce a slimming effect. Results of this study illustrate that treatment of female menopausal obesity using embedded needle acupuncture has good results in weight loss while also improving menopause syndrome. The active mechanism is possibly the adjusting effect of embedded needle acupuncture on the hypothalamus-pituitary-ovarian axis. By increasing levels of E₂ and decreasing FSH and LH levels, aging and loss of function of the hypothalamus-pituitary-ovarian axis system is delayed, improving disorders of the cardiovascular system, psychological and nervous system, and metabolic system triggered by imbalances in reproductive hormone levels.