| Obesity refers to the overweight disease caused by overaccumulation of fat when absorption of energy is more than its consumption. Those occurred not after confirmed endocrinopathy is named as simply obesity, which occurs in the frequency of more than 95% in all obese case. So we commonly refer to it when obesity is interfered with. In our country the increase of the disease incidence is making great anxiety, and it is estimate that there are approximately 70 million obese case now. The critical harm from Obesity to the health is to contribute to such chronic diseases as diabetes, coronary heart disease, and high blood pressure. Among numerous approaches to obesity, acupuncture, with many advantages except from individual treatment, definite and stable effect, fine future effect, no side effect, economical and convenient, still can treat and improve obese syndrome, and bring social and economical benefit. Acupuncture for obesity is one of the hot topics in acupuncture study area. But it is still short of study in the area about therapeutic principle for specific syndrome differentiation and meridian function, and this has made clinical practice mostly relies on ancient and individual experience instead of evidence-based medicine. This study is aim at investigating the interferential function of stomach and spleen meridian to phlegm dampness constitution in obese case, clarifying the regulation of approaches to obesity with acupuncture, and exploring how to improve its effect ulteriorly.First: review of paper1: The viewpoint about the cause and pathogenesis of obesityin modern-day TCMTo summarize and induce three critical viewpoints in modern-day TCM about the cause and pathogenesis of obesity according to varies of assay: the first one is from the angle of visceral, encompassing malfunction of spleen and stomach, failure of the liver to dredge and regulate, and disbalance of kidney-yin and kidney-yang and so on; the second one is from the angle of qi and blood, encompassing sufficiency of qi and deficiency of blood, stagnation of defensive qi flow, and deficiency of genuine qi of three jiao; the third one is from the angle of meridians and collaterals, encompassing failure of belt vessel to control others, stagnation of phlegm in stomach meridian. 2 Acupuncture for simple obesityTo concluded that how to guide the practice, select the acupoints, decide the course and effect of treatment for obesity with acupuncture from the angle of viscera, qi and blood, meridians and collaterals.3: Research progress of the mechanism of acupuncture therapy for simple obesity.To summarize the Research progress of the mechanism of acupuncture therapy for simple obesity from the view of modern medicine, and to depict how to reduce fat from such three critical point as restraining the appetite, increasing the energy mataboly, correcting the turbulence of mass metaboly referenced by numerous of articles both native and abroad. Second: evidence for making the point1: The viewpoint of the relationship between obesity and phlegm dampness in ancient assay.The review of ancient assay indicates that obesity is caused by phlegm- dampness.2: The viewpoint and study of phlegm dampness in modern-day Chinese medicine.To summarize the study method and varies of conclusion of phlegm dampness in modern-day Chinese medicine, and to suggest the essence of phlegm dampness from the microcosmic angle of modern medicine.3: The relationship between obesity, symptom of it and phlegm dampness constitution.To index out the harm of obesity and phlegm dampness constitution, to suggest the compatibility between the obesity symptom and the development, prognosis of phlegm dampness constitution, and to clarify the meaning of the study about phlegm dampness constitution in obesity. 4: The probable difference of the effect in obesity between the stomach and spleen meridian.To suggest that the stomach and spleen meridian each has its strong point on the effect in obesity with different syndrome differentiation and constitution clinically and theoretically, thus to suggest the stomach and spleen meridian improve the phlegm dampness constitution in these case differently. Third: clinical studyObjective: To investigate the interferential function of acupuncture of obese case with phlegm dampness constitution in stomach and spleen meridians, and to clarify the regulation of approach to obesity with acupuncture.Methods: 67 simple-obesity cases with phlegm dampness constitution has been selected according to the symptom, syndrome and the metric integral with phlegm dampness constitution.20 cases were randomly assigned to stomach meridian treatment group while 21 cases to spleen meridian treatment group and 26 cases to stomach-spleen meridian treatment group . To assess the respective impact of three groups on dealing with obesity and improving phlegm dampness constitution according to the assigning of the change of weight, body mass index (BMI), waistline, waist to hip ratio, hemorheology, lipids, insulin release and three kinds of free radicals before and after the treatment Then compare the effect of two groups, and assess ulteriorly the effect of the two meridians in improving the phlegm- dampness constitution. Results:Results:1. Total effects: the total effective rate of the stomach meridian group is 65%; the one of the spleen meridian group is 71%; the sum of effective rate of the stomach-spleen meridian group is 88%. Comparing the effective rate betweenthe stomach meridian group and the stomach-spleen meridian group, there is a significant difference (P<0.05). So it does as the comparison between the spleen meridian and the stomach-spleen meridian group. While, no remarkable difference is found between the stomach meridian and the spleen meridian.2. Obesity index: the weight, mass body index(MBI), the waistline, the waist to hip ratio all decrease after treatment when compared with the one of before, moreover, there is a significant difference (P<0.01). The 4 index of the stomach group was all lower by sign of the set the range than the spleen- stomach group through set (P<0.01), the spleen group is, except the waistline, the waist to hip ratio through the set, other index decrease much lower than the range of the spleen- stomach group (weight :P<0.05, MBI: P<0.05) .Stomachmeridiangroup and the spleen meridian group relatively makes no difference through two curative effect.3. Lipid: total Cholesterol (TC), triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C), these three indexes all drop after treatment, meanwhile, increase in ApoA is found, all of these shows notable difference. All 2 index in the stomach meridian group refinement remarkably (P<0.01). Comparison between groups shows that the range of improvement in the stomach meridian group of TC, TG, LDL-C, ApoA, all lower than those of the spleen meridian group and those of stomach-spleen group. All other index comparison shows no remarkable group difference between spleen meridian group and the stomach-spleen meridian group except for the LDL-C index, which is P<0.05.4. Insulin release test: the serum insulin level of each group: The stomach meridian groups, the spleen meridian group, the stomach-spleen meridian group, all show a decrease at 3 time point, which are 0 min, 60 min, 120 min, after treatment. A significant difference (P<0.01) proves that anti-insulin reaction had been tremendously improved. Groups comparisons show as follow: on the stomach meridian group, the decrease range of serum insulin, is much lower than the one of the stomach-spleen meridian group, at 0 min, 60 min, 120 min (P<0.01). Moreover, it is also remarkably lower than the one of spleen meridian group, at the point of 60min, 120min, supporting by (P<0..05), (P<0.01). No significant variance is shown when comparing the spleen group and the stomach-spleen group.5. Hemorheology: These entire indexes, low notch of totalblood viscosity, high notch of total blood viscosity, K value of the sedimentation equation, hemagglutimation index, suggest a decrease trend, while erythrocyte deformation index grows after the treatment; support a remarkable differenceand a better improvement after treatment: Low notch of totalblood viscosity (P<0.05), high notch of total blood viscosity comparison shows (P<0.05), K value of the sedimentation equation is (P<0.05), hemagglutimation index is (P<0.01). The index of the stomach or the spleen group did not show a significant difference. On the other hand, the set of the index below did significantly lower than the ones of the stomach-spleen group. High notch of total blood viscosity comparison shows (P<0.05), K value of the sedimentationequation is (P<0.01), hemagglutimation index is (P<0.05), erythrocyte deformation index shows (P<0.05). While, the improved range of these two groups does not vary much.6. The Three free radicals: The three sets SODs and GSHs are compared before and after the treatment (P<0.01), the MDA falls dramatically (P<0.01). These suggest the metabolism of free radical get the improvement. The improvement range of the stomach meridian group is obviously lower than the one of the spleen meridian group. On the other hand, the MDA, GSH index improved of the spleen group is much lower compared with the stomach group, (P<0.05), while the MDA, GSH is much higher (P<0.05). The sets of the stomach or the spleen group did not show a significant difference.Conclusion:1. Acupuncture to obese case with phlegm dampness constitution in stomach and spleen meridians, for once matched the cause and pathogenesis of obesity according to a certain of assay, it can not only gain effort, but also, can on a certain degree, regulate cases like lipid metabolism, anti-insulin, malfunction of blood circulation, free radical metabolism.2. It is obvious that the spleen meridian has a privilege on the effect to obese case with phlegm dampness than the stomach meridian. For," deficiency of spleen" is of more importance and of bases on obese with phlegm dampness than "stomach heat" .3. Combination of the spleen and stomach meridian during treatment had shown a significant priority in therapy. As the two main causes and pathogenesis of obesity with phlegm dampness, the deficiency of spleen and the excess of stomach.
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