| ObjectiveTo investigate the efficacy difference of catgut embedding in different levels under the guidance of B-ultrasound on female abdominal obesity and defecation function,so as to provide a safer and more effective clinical treatment plan.Method105 cases of female subjects with abdominal obesity due to stomach heat dampness were randomized into a deep embedding group(35 cases,with 2 cases falling off),a shallow embedding group(35 cases,with 4 cases falling off)and a false embedding group(35 cases,with 7 cases falling off).The abdominal acupoints including Zhongwan,Guanmen,Tianshu,Daimai,Guanyuan,Shuidao and the limbs points including Quchi and Fenglong were selected as catgut embedding locations for the 3 groups.Under the guidance of B-ultrasound,the thread was embedded in the fat layer+muscle layer in the deep embedding group;the thread was embedded in the fat layer in the shallow embedding group;the needle insertion depth in the false embedding group was only in the fat layer,and then the needle was withdrawn without wire embedding.The thread was buried once every two weeks and 4 times in total.Baseline indexes were compared with those after 8 week's treatment among the three groups,including TCM syndrome integral,abdominal obesity indexes(weight,BMI,body fat rate,waist circumference,hip circumference,waist hip ratio,abdominal subcutaneous fat thickness;triglycerides,serum total cholesterol,low density lipoprotein cholesterol,high density lipoprotein cholesterol)and defecation function indexes(weekly spontaneous defecation frequency,Bristol fecal traits score).After 8 week's treatment,the effectiveness rate,the correlation between waist circumference and abdominal subcutaneous fat thickness and the appetite inhibition duration due to catgut embedding were evaluated.At 4 week's follow-up after treatment,indexes such as weight,BMI,body fat rate,waist circumference,hip circumference,waist hip ratio,weekly spontaneous defecation frequency and Bristol fecal traits score were recorded and compared with baseline.Plus,the safety and compliance of catgut embedding therapy was also evaluated.Result1.Comparison of TCM symptom scores in each group:Compared with baseline,the scores of deep and shallow catgut embedding group both decreased after treatment(P<0.05),while there was no significant difference for the false embedding group(P>0.05).Comparison between groups:after treatment,the TCM symptom scores of deep thread embedding group were lower than that of shallow embedding thread group(P<0.05),and scores of shallow embedding thread group was lower than that of false embedding thread group(P<0.05).2.Comparison of the effective rate:The effective rate of deep catgut embedding group(87.9%)was higher than that of shallow catgut embedding group(48.4%)(P<0.05),and the effective rate of shallow catgut embedding group was higher than that of false catgut embedding group(10.7%)(P<0.05).3.Comparison of weight,BMI,body fat rate,waist circumference,hip circumference and waist hip ratio:Compared with baseline,those indexes after 8 weeks of treatment both dropped for the deep and shallow catgut embedding groups(P<0.05).Those indexes at the follow-up period dropped for the deep catgut embedding group(P<0.05),and remained no significant difference for the shallow catgut embedding group(P>0.05).While for the false catgut embedding group,those indexes were not significantly different both after 8 weeks of treatment and at the follow-up period(P>0.05).Comparison among 3 groups after 8 weeks of treatment and at the follow-up period is that the indexes of the deep thread embedding group were smaller than that of the shallow embedding thread group(P<0.05),and the shallow thread embedding group was smaller than that of the false embedding thread group(P<0.05).4.Comparison of the abdominal subcutaneous fat thickness at Zhongwan,Guanyuan,Tianshu and Daimai acupoints:Compared with baseline,the abdominal subcutaneous fat thickness dropped in both deep and shallow catgut embedding group after 8 weeks of treatment(P<0.05),while there was no significant difference in false catgut embedding group at all four points(P>0.05).After 8 weeks of treatment,the subcutaneous fat thickness of Zhongwan,Guanyuan,Tianshu and Dai Mai in the deep thread embedding group was lower than that in the shallow embedding thread group(P<0.05),and that in the shallow embedding thread group was lower than that in the false embedding thread group(P<0.05).There was a linear correlation and regression relationship between the abdominal subcutaneous fat thickness and waist circumference(P<0.01).5.Comparison of triglyceride,serum total cholesterol,low-density lipoprotein cholesterol and high-density lipoprotein cholesterol:Compared with baseline,triglyceride,serum total cholesterol and low-density lipoprotein cholesterol in deep and shallow catgut embedding group decreased after 8 weeks of treatment(P<0.05),while the high-density lipoprotein cholesterol increased(P<0.05);there was no significant difference in all 4 indexes in false catgut embedding group(P>0.05).Compared among groups,after 8 weeks of treatment,triglyceride,serum total cholesterol and low-density lipoprotein cholesterol in the deep thread embedding group were lower than that in the shallow embedding thread group(P<0.05),and that in the shallow embedding thread group were lower than that in the false embedding thread group(P<0.05).After 8 weeks of treatment,high-density lipoprotein cholesterol in the deep thread embedding group was higher than that in the shallow embedding thread group(P<0.05),and that in the shallow embedding thread group was higher than that in the false embedding thread group(P<0.05).6.Comparison of weekly spontaneous defecation frequency and Bristol fecal traits score:Compared with baseline,the defecation function indexes of both deep and shallow catgut embedding group were increased after 8 weeks of treatment(P<0.05).During the follow-up period,the defecation function indexes of the deep thread embedding group were increased compared with those before treatment(P<0.05),and the shallow thread embedding group had no significant difference(P>0.05).There was no significant difference in defecation function index in the false thread embedding group at all periods(P>0.05).Compared among groups,the defecation function indexes of deep catgut embedding group were greater than that of shallow catgut embedding group(P<0.05),and indexes of shallow catgut embedding group were greater than that of sham catgut embedding group(P<0.05).7.Comparison of appetite inhibition duration:There was no significant difference in the duration of appetite inhibition at different time points among the three groups(P>0.05).Compared among groups,the duration of appetite inhibition in the deep thread embedding group were longer than that in the shallow embedding thread group(P<0.05),and the duration of appetite inhibition in the shallow thread embedding group were greater than that in the false thread embedding group(P<0.05).8.Comparison of acceptability and compliance:There was no significant difference in the acceptability of thread embedding among the three groups(P>0.05),The compliance of deep thread embedding group was higher than that of shallow embedding line group and false embedding line group(P>0.05).There were no adverse events such as infection,induration and thread exposure in the three groups.Conclusion1.Under the guidance of B-ultrasound,deep acupoint catgut embedding has better curative effect on female abdominal obesity caused by stomach heat dampness,which effectively reduces patients' TCM symptom scores,weight,BMI,body fat rate,waist circumference,hip circumference,waist hip ratio and the abdominal subcutaneous fat thickness.2.The blood fat level of patients can be improved by deep acupoint catgut embedding under the guidance of B-ultrasound.3.The defecation function can be improved by deep acupoint catgut embedding under the guidance of B-ultrasound.can be improved by deep acupoint catgut embedding under the guidance of B-ultrasound.4.The safety and patient's compliance can be improved by deep acupoint catgut embedding under the guidance of B-ultrasound. |
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