The Observation Of The Clinical Efficacy Treating Simple Obesity By Combining Acupuncture With Scraping

BackgroundThe concept of obesity has evolved over a 200-year history.Pathological obesity is due to body composition,excessive fat accumulation,and anomalous fat distribution that cause weight gain equaling or greater than 20%of the standard weight.Obesity results in excess energy being stored in the form of fat in the body.This accumulation of excess fat presents a risk to an individual' s health and is characterized by weight gain,fatigue,and lassitude.In recent years,studies have shown that some forms of obesity are also caused by specific biochemical factors.How these factors influence food regulation and energy metabolism,chronic metabolic disease,and endocrine disease is very complicated and remains an open question.The association of obesity with cerebrovascular and cardiovascular diseases as well as diabetes mellitus is a major public health concern.In Chinese Medicine,Body Fat is considered to be the accumulation of phlegm turbidity.Phlegm is generated by the condensation of liquid and humor in the body.Three organs,the Lung,Spleen and Kidney,are said to be responsible for the regulation of liquid and humors in the body;however,the Spleen is the main organ responsible for the development of obesity.The Spleen controls the transformation of liquid into damp and phlegm.Damaged Spleen function can result in a failed transformation function,leading to the accumulation of damp pathogens.In the long-term,the damp pathogen condenses into phlegm(fat)and causes obesity.Acupuncture has been found to be effective in weight control since the 1980s.An increasing body of evidence demonstrates that acupuncture produces good effects for weight loss without causing adverse reactions.Acupuncture therapy for obesity is increasingly accepted by more and more people around the world.In addition,acupuncture can help with the treatment of obesity-related diseases.Extensive research on acupuncture weight loss has been conducted in both basic and clinical areas in recent years.Gua sha is a healing technique of traditional East Asian medicine.Sometimes called 'coining,spooning or scraping',Gua sha is defined as instrument-assisted unidirectional press-stroking of a lubricated area of the body surface to intentionally create transitory therapeutic petechiae called 'sha' representing extravasation of blood in the subcutis.Raising sha removes blood stagnation considered pathogenic in traditional East Asian medicine.Modern research shows the transitory therapeutic petechiae produce an anti inflammatory and immune protective effect that persists for days following a single Gua sha treatment accounting for the immediate relief that patients feel from pain,stiffness,fever,chill,cough,wheeze,nausea and vomiting,lose weight,etc.ObjectiveThis study aims to evaluate the efficacy and safety of Acupuncture and Acupuncture plus Guasha for the treatment of patients with simple obesity.This study also will identify which acupuncture points are most effective to treat patients with obesity(Mu points or Shu points).To observe the clinical efficacy for treating simple obesity by combining Scraping therapy embedding Mu points with acupuncture and Shu points on common used points for simple obesity,and to prove a very effective therapeutic method.The study is a randomized controlled trial that consists of a treatment of three groups(Acupuncture and Guasha therapy)and control(Acupuncture)groups.Method90 patients divided into 2 treatment groups and control group,control group include only acupuncture treatment.Treatment group include acupuncture treatment while Guasha scraping therapy twice a week.The points of prescription contains Zhongwan(CV 12),Tianshu(ST 25),Daheng(SP 15),Quchi(LI 11),Yinlingquan(SP 9),Fenglong(ST 40)and Shangjuxu(ST 37),Daimai(GB 26).Treatment time is 30min.Guasha Therapy include every session gets red spots on the skin less than 5 min.2 times a week and 16 sessions in total.Treatment can do when skin recover from last session.Treatment Group session include the points of prescription contains Zhongwan(CV 12),Tianshu(ST 25),Daheng(SP 15),Quchi(LI 11),Yinlingquan(SP 9),Fenglong(ST 40)and Shangjuxu(ST 37),Daimai(GB 26).Supplementary points Add Hegu(LI 4),and Neiting(ST 44)to the pattern of stomach and intestinal heat;add Pishu(BL 20)and Zusanli(ST 36)to the pattern of deficiency of the spleen and stomach;and add Shenshu(BL 23)and Guanyuan(CV 4)to the pattern of kidney qi deficiency.Every session lasted 30 mins.2 times a week and 16 sessions in total.Based on the acupuncture treatment,treatment group involved the scrapping therapy as well.The scrapping locations is Mu or Shu points.Every session lasted until skin gets red spots on the skin 2 times a week and 16 sessions in total.Apply gently and slowly scraping on deficiency type patient who having period,weak constitution,or liver and kidney deficiency syndrome,strong manipulation is not suitable for those patient,because strong stimulation is for reduce excess.Thus,strong and quick scraping is for excessive patients who having blood stagnation in the meridians.If the red spot on the skin by last treatment session stay until next treatment,each treatment scrapping on different area on different Mu or Shu points ??:Front Mu Points:Tianshu(ST 25),Zhongwan(RN 12),Zhangmen(LR 13),Guanyuan(RN 4),Jingmen(GB 25),Shimen(RN 5),Riyue(GB 24)Qimen(LR 14).???:Back shu points:Dachangshu(BL 25),Weishu(BL 21),Pishu(BL 20),Xinshu(BL 15),Sanjiaoshu(BL 22),Danshu(BL 19),Ganshu(BL 18).The results will be evaluated before and after the treatment,body mass index(BMI),body weight and waist and legs circumference will be measure,changes of body mass index(BMI),body weight,waist and legs circumference and symptoms and signs will be observed before and after treatment 4 weeks after treatment,8 weeks after treatment.ResultsThe Study recruited a total of 90 participants.The participant gender representation within the study is female(90%;n=80).The subjects aged from 18 to 65 years.The current research using acupuncture and acupuncture plus Guasha in mu and shu points shows effectiveness to treat simple obesity.When used acupuncture and acupuncture plus Guasha was effective treatment for reducing BW and BMI at the end of treatment period.All of the groups reduce weight and BMI however there is a significant difference between groups.According to the analysis of variance:single factor analysis of variance ANOVA the treatment group acupuncture plus guasha mu points got total weight reduction is 0.069191841,second one is acupuncture plus guasha shu points 0.068214696 and then the control group acupuncture 0.054948355 which means the group acupuncture plus guasha mu points have a bigger reduction of weight.The difference between groups is 6.03180176-10.003522274.For the analysis of BMI the results show that the treatment group acupuncture plus guasha mu points have a significant reduction 0.069096545,followed by acupuncture group plus guasha shu points 0.06712287 and in the last control group acupuncture treatment 0.055607577,the difference between groups is 3.911378503-0.023626007.ConclusionSimple obesity is a common problem in any ages.Guasha is one of many effective treatments in traditional Chinese medicine.This study observed the clinical efficacy for treating Simple obesity by combining Scraping therapy embedding Mu and Shu points with acupuncture on common used points for Simple obesity and Combination of acupuncture and Guasha therapy proved a safe and very effective therapeutic method for the Simple obesity.Acupuncture may be a safe and effective form of obesity treatment in combination with diet,exercise and cognitive therapy.Acupuncture can be more beneficial if it is individualized according to CM syndrome differentiation.When combined with other treatment(i.e.Psychotherapy,diet therapy,exercise,etc.),acupuncture showed more benefits for BW,BMI.Changes in dietary and physical activity patterns are often the result of environmental and societal changes associated with development and lack of supportive policies in sectors such as health,agriculture,transport,urban planning,environment,food processing,distribution,marketing,and education.Overweight and obesity,as well as their related non communicable diseases,are largely preventable.Overweight and obesity be reduced,supportive environments and communities are fundamental in shaping people' s choices,by making the choice of healthier foods and regular physical activity the easiest choice(the choice that is the most accessible,available and affordable),and therefore preventing overweight and obesity.At the individual level,people can:· limit energy intake from total fats and sugars;· increase consumption of fruit and vegetables,as well as legumes,whole grains and nuts;and· engage in regular physical activity(at least 60 minutes a day for children and 150 minutes spread through the week for adults).Individual responsibility can only have its full effect where people have access to a healthy lifestyle.