Study On Mechanism Of Abdominal Tuina Therapy For Simple Obesity Clinical And Fat Metabolism

With the deepening of the understanding of the pathogenesis of simple obesity(OB),the role of Tuina in promoting glucose and lipid metabolism has become the core of simple obesity research.PI3 K has become a hot target in recent years because of its ability to regulate glucose and lipid metabolism.PI3 K activation can not only promote the reduction of liver glycogen synthesis in vivo,but also improve the body's lipid metabolism with PPAR ?.This study was funded by the National Natural Science Foundation of China(No.86174092),and based on a large number of clinical practice and meta-analysis,relying on the abdominal Tuina method,we selected three methods: abdominal Tuina,abdominal Tuina and abdominal Tuina.This method has the effect of "dredging meridians,invigorating spleen and resolving turbidity".(1)Through clinical research and observation,we confirmed the clinical efficacy and advantages of abdominal Tuina therapy,and provided a treatment plan for the standardized treatment of simple obesity patients.(2)The mechanism of Tuina improving glucose and lipid metabolism in simple obesity rats was preliminarily revealed.1.Clinical Study Objective:In order to further study the efficacy and safety of Tuina in the treatment of simple obesity,we observed the influence of abdominal Tuina on the body weight,BMI,waist circumference,waist hip ratio,blood glucose,blood lipid,clinical symptoms and quality of life of patients with simple obesity,and preliminarily analyzed its efficacy and safety.Method:Clinical observation of abdominal Tuina in the treatment of simple obesityPatients were recruited from the Massage department of Affiliated Hospital of Changchun University of traditional Chinese medicine and massage clinic of Changchun Hospital of traditional Chinese Medicine from January 2019 to December 2020.The treatment group was treated with abdominal Tuina,while the control group was treated with diet control and exercise therapy.(1)Main outcome measures: body weight,BMI,waist circumference,waist hip ratio,TC,TG;(2)Secondary outcome measures: HDL-C,LDL-C,fasting blood glucose.Result:A total of 90 cases were included,including 4 cases falling off and 8 cases quitting.The total number of cases involved in the whole study was 78.The baseline data of gender,age,BMI and WHR of the both groups were consistent(P > 0.05),which was comparable.(1)The main evaluation indexes:(1)Weight: the weight of both groups decreased the treatment,and the body weight of the treatment group decreased conspicuously(P < 0.01),the weight of the control group decreased significantly(P < 0.05),the weight of the treatment group decreased more significantly(P < 0.05).(2)BMI: the BMI of the treatment group decreased conspicuously(P < 0.01),and that of the control group decreased dramatically(P < 0.05),compared with the BMI before and after treatment.The BMI change of the treatment group was more remarkable,compared with the body weight of the both groups after treatment(P < 0.05).(3)Waist circumference: the weight of the both groups decreased,and the waist circumference of the treatment group and the control group decreased markedly(P < 0.01),compared with the waist circumference before and after treatment.The waist circumference of the treatment group changed more significantly(P < 0.05),compared with the weight of the both groups after treatment.(4)Hip circumference: compared with hip circumference before and after treatment,the weight of the both groups decreased,and the hip circumference of the treatment group and the control group decresed significantly(P < 0.05).Compared with the hip circmferencet of the both groups after treatment,the hip circumference of the treatment group changed more significantly(P < 0.05).(5)TC,TG: TG of both groups before and after treatment,TG of both groups before and after treatment were substantially reduced(P < 0.01),TG of each group after treatment was significantly different(P<0.01).The TC of the both groups before and after treatment decreased significantly(P<0.01),and the difference was prominent(P<0.01).(2)Secondary evaluation index:(1)HDL-C,LDL-C: the HDL-C of the both groups before and after treatment was markedly decreased(P<0.01),and the HDL-C of each group after treatment was signficantly different(P<0.05).The LDL-C of the both groups before and after treatment decreased significantly(P<0.01),and the difference was significant(P<0.05).(2)Fasting blood glucose: compared with the fasting blood glucose before and after treatment,HFD+TN changed dramatically(P<0.01),and that of HFD changed obviously(P<0.05).There was significant difference between the both groups before and after treatment(P<0.01).(3)The patients had no adverse reactions in the course of 4 weeks of treatment.Conclusion:On the basis of routine exercise and diet control therapy,combined with abdominal Tuina therapy,can further improve the weight,waist circumference,hip circumference and other levels of simple obesity patients,through clinical observation.In the aspect of blood lipid,there was a downward trend in the blood lipid indexes of the both groups,and there were significant changes,which preliminarily showed that abdominal Tuina could promote the TG metabolism ability of the body.The changes of fasting blood glucose in the both groups before and after treatment suggest that abdominal Tuina has a good hypoglycemic effect on simple obesity,which can prevent simple obesity from further developing into insulin resistance or obesity type both diabetes and other metabolic diseases.2.Experimental StudyObjective:In order to further explore the mechanism of abdominal massage on the liver and white fat of obese rats,from the point of view of PI3K/Akt,the classic signal pathway of glucose and lipid metabolism,to the change of PPAR? protein expression in the liver and white fat as a starting point,it is assumed that massage therapy is used to treat simple obesity by acting on the white fat tissue of the body.Enhance the expression of PPAR?protein and gene in white adipose tissue,and then promote or inhibit the expression of obesity-related proteins and genes.Through the expression of these related genes,to further explore the mechanism of abdominal massage in the treatment of simple obesity on fat metabolism in the body.Method:(1)After a week of adaptive feeding,14 healthy male SD rats were selected to continue to be fed with normal diet,and the other rats were fed with high-fat diet for 4weeks to establish the model.The HFD was selected as the first 2/3 of the body weight and10% of the body weight was higher than the NFD.21 rats were randomly divided into model group(HFD),treatment group(HFD + TN)and drug group(HFD + ORL).Rats fed with common food were divided into normal group(NFD)and normal treatment group(NFD + TN).After successful modeling and intervention,fasting blood glucose(FBG)and oral glucose tolerance(OGTT)of rats were measured by tail blood sampling.The rats were sacrificed after abdominal aorta blood sampling after 4 weeks of intervention.Liver,epididymal fat and perirenal adipose tissue were preserved,and the tissues were fixed or frozen after weighing.The levels of TG,TC in serum were detected.The liver tissues of rats were made into sections for HE staining.(2)Mechanism of abdominal Tuina on simple obesity induced by high fat in male SD rats Part of frozen liver tissue and epididymal adipose tissue were taken and lysate was added After the protein concentration was determined,the expressions of PI3 K,Akt,p Akt and PPAR ? in liver tissue and adipose tissue were detected by Western blot.The mRNA of PPAR ?,PPAR ?,GLUT4 in liver tissue and PPAR ?,PPAR ?,UCP-1,PGC-1 ?,2.Experimental Study SREBP-1c,scd-1,Fas in adipose tissue were detected by RT-PCR.Result:(1)Tuina can ameliorate the accumulation of lipid in liver tissue,significantly reform the accumulation of white fat,reduce the levels of blood glucose and blood lipid in obese rats,and improve the disorder of glucose and lipid metabolism in obese rats.(2)Tuina can promote the expression of PPAR ? and GLUT4 in liver tissue and increase glucose consumption through PI3 K / Akt / PPAR ? signaling pathway.Increase the expression of PPAR ? in adipose tissue,promote the differentiation of adipocytes,the expression of UCP-1 and PGC-1 ?,promote the transformation of white fat.Inhibition of SREBP-1c,Fas and scd-1 gene expression in adipose tissue,inhibition of Fat signaling pathway,reduce lipid synthesis in vivo.Conclusion:The experimental results in this chapter showed that the content of PPAR? gene in rats with simple obesity induced by high fat diet was changed,which may affect the expression of UCP-1,PGC-1?,SREBP-1c and other genes in the body.After abdominal massage treatment,the activity of PPAR ? was stimulated by massage.The overexpression of PPAR? promoted the gene expression of PGC-1? and UCP-1,and inhibited the gene expression of SREBP-1c,Fas and SCD-1.Meanwhile,the wet weight of white fat showed that,after massage treatment,the expression of PPAR? was significantly higher than that of the control group.Wet weight of white fat in HFD+TN group was lower than that in HFD group.It can be speculated that massage can promote the transformation of white fat to a certain extent,but also inhibit the synthesis of lipids in the body,improve the state of obesity in rats.It is suggested that abdominal massage can promote the color and fat metabolism of simple obesity.