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    Screening of acupuncture treatment for simple obesity

    2021-06-05 08:08:34YunYingQiaoXinYu
    Clinical Research Communications 2021年2期

    Yun-Ying Qiao, Xin Yu

    Screening of acupuncture treatment for simple obesity

    Yun-Ying Qiao1*, Xin Yu1

    1The Third Clinical college of Shanxi University of traditional Chinese Medicine, Taiyuan City, Shanxi, China.

    Observe the advantages and characteristics of Acupuncture therapy and Point Thread Embedding therapy in the treatment of simple obesity and to select the superior treatment schemes.on the basis of syndrome differentiation, acupuncture and Point Thread Embedding therapy were adopted respectively for 3 courses of treatment. Observe the changes of body weight and abdomen/waist/hip circumference in different stages of treatment and evaluate the curative effect.Both acupuncture and Point Thread Embedding could lessen the weight and the abdomen/waist/hip circumference of simple obesity. Acupuncture and Point Thread Embedding can not only reduce body weight, but also improve clinical symptoms of simple obesity. The effect rate of clinical symptoms is better than that of weight(< 0.05); The efficiency of Point Thread Embedding group is better than that of Acupuncture group(< 0.05).There was no significant weight loss from the second course of treatment especially in acupuncture group(> 0.05).Acupuncture and Point Thread Embedding in the treatment of simple obesity focus more on the adjustment of body shape and constitution of obese patients; Compare with acupuncture treatment, point thread embedding group had a slower onset time and a longer duration of curative effect while acupuncture group had a faster onset time but a shorter duration. When the body weight is reduced to 5kg, the plateau stage occurs. Point Thread Embedding therapy is easier to be popularized and applied in clinic Because of its convenient and stable therapeutic effect.

    Simple obesity, Point Thread Embedding, Acupuncture therapy, Superior scheme screening

    Background

    Simple obesity refers a kind of disease caused by the intake of calories in the body more than consumption, resulting in excessive accumulation of fat in the body, leading to abnormal weight [1]. Obesity is not only easy to produce complications, but also can lead the mortality increase. It has gradually become a serious world health problem [2]. As a non-drug therapy, acupuncture and moxibustion therapy has more advantages in the treatment of simple obesity because of its positive efficacy and small side effects.

    In this paper, we compared the acupuncture therapy and Point Thread-Embedding therapy and observed the effect of different treatment on simple obesity, so as to provide basis for the selection of superior therapy.

    Information and methods

    Clinical data

    60 patients with simple obesity were enrolled in our hospital from October 2017 to October 2018. They were randomly divided into two groups. There were 12 male and 18 female patients in point thread embedding group and 11 male and 19 female patients in acupuncture group. There was no significant difference between the two groups in general conditions.

    Inclusion criteria: ① Simple obesity was diagnosed according to the standard of Reference [3] and was classified according to syndrome differentiation of Traditional Medicine Research [1]. ② between 24?55 ages.③ the patient did not take any therapy before the treatment.④ Be aware of the study and sign a consent form.

    Exclusion criteria: ① patients who are under 18 or over 65 years old, Pregnant or lactating women, People who are allergic to this drug. ② Secondary obesity follows thalamic pituitary inflammation, tumor, trauma, insulin tumor and so on. ③ obesity accompanied by cardiovascular disease, cerebrovascular disease, infectious disease, diabetes, Gout, liver, kidney and hematopoiesis diseases and other serious primary diseases and mental disorders. ④ patients who use other therapy to lose weight. ⑤ Poor compliance, fail to follow the prescribed treatment or halfway out.

    Methods

    General acupuncture group. Main points: Select the points Zhongwan (CV12), Tianshu (ST25), Quchi (LI11), Yinlingquan (SP9), Fenglong (ST40), Taichong (LR3). Refer to the acupuncture and moxibustion textbook for the 13th Five-Year Plan.

    Match points: According to the “criteria for diagnosis and curative effect evaluation of simple obesity disease [1]”, the classification was added and subtracted. if spleen deficient can add Sanyinjiao (SP6) and Taibai (SP3), and use LI11 and Neiting (ST44) if stomach hot and wet. Liver depression and qi stagnation can add Ganshu (LR3) and Taichong (BL18). Spleen and kidney Yang deficiency plus Pishu (BL20), Shenshu (BL23), Qihai (CV6). add Zhigou (TE6) and Fujie (SP14) if the patient has symptoms of constipation, use Baihui (GV20) and Yintang (GV29) for Insomnia and depression, use Daheng (SP15) and Shuidao (ST28) if abdominal obesity is obvious, use Daimai (GB26) for fat around the waist. The filiform needle was applied to the manipulation of reinforcing and reducing according to the syndrome. The needle can retain for 30 minutes on the body, acupuncture once every other day,15 times one course of treatment, for 3 courses of treatment.

    Point thread embedding group. Points were selected as the acupuncture group. marked the points and sterilized it. Take the size of 0?0 protein line by forceps and place it into the tip of the disposable embedding needle and embed the protein line to the subcutaneous tissue or muscle layer of the points. Then cover with a Band-Aid on the points. 1 time/15 days, 2 times/course, for 3 courses of treatment.

    Both groups do not use any therapy during the menstrual period. There was no intentional change of diet, exercise habits and other ways to participate in the treatment.

    Curative effect evaluation

    The efficacy was evaluated according to the criteria of literature [1]. After the treatment, the clinical efficacy was evaluated according to the improvement of the patients' clinical symptoms. Invalid:There was no obvious improvement in clinical symptoms after treatment; Effective: The clinical symptoms were significantly alleviated;positive effect: Most of the clinical symptoms disappeared or basically disappeared.

    Clinical efficacy was evaluated according to the improvement of patients' body mass index (BMI). Invalid:After treatment, the BMI decreased < 2; Effective: The reduction in BMI ranged from 2 to 4; Positive effect: BMI decreased by ≥ 4.

    Observation indicators

    Before and after treatment, body weight, BMI, waist circumference, abdominal circumference, hip circumference, etc.

    Detection method

    According to literature [4], measurements were made by a fixed person before treatment and after treatment at different stages. The body weight, waist circumference, hip circumference and abdominal circumference were measured on an empty stomach in the morning.

    Statistical analysis

    Treatment Results

    Comparison of baseline data between the two groups (Table 1).

    The results showed that: Both the ordinary acupuncture group and the Point Thread Embedding group could reduce the weight and circumference of the patients with simple obesity, especially with the improvement of waist circumference is more obvious. With the prolongation of treatment time, the effect becomes more obvious. There was no significant difference between the acupuncture group from the third treatment course and the second treatment course. (Table 2)

    Table 1 Comparison of baseline data between the two groups (N = 30)

    NOTE. (> 0.05) There was no significant difference between the two groups, which was statistically significant.

    Table 2 Changes of body weight, waist circumference, abdominal circumference, hip circumference and other indexes in different treatment stages

    NOTE.?means< 0.05, compared with the previous treatment, the difference was significant and statistically significant.

    The rank sum test shows that the efficiency of ordinary acupuncture group was 83.33% while point thread embedding group was 93.33%; The marked effective rate of ordinary acupuncture group was 36.67% while point thread embedding group was 60.0% after three courses of treatment. The therapeutic effect of point thread embedding group was better, and the difference was statistically significant (< 0.05). (Table 3)

    The rank sum test shows that the efficiency of ordinary acupuncture group was 70.0% while point thread embedding group was 86.67%. The marked effective rate of ordinary acupuncture group was 33.33% while point thread embedding group was 40.0% after three courses of treatment. The therapeutic effect of point thread embedding group was better, and the difference was statistically significant (< 0.05). (Table 4)

    From the comparison of different effective rates between the two groups, the efficiency of weight improvement in the ordinary acupuncture group was 70%, while the efficiency of symptom improvement was 83.33%. The efficiency of weight improvement in point thread embedding group was 86.67%, while the efficiency of symptom improvement was 93.33%. The efficiency of simple obesity symptoms by acupuncture and point thread embedding was better than the efficiency of weight improvement (< 0.05), and the difference was statistically significant. (Table 5)

    In the ordinary acupuncture group, 9 patients fell off midway, while all patients in the point thread embedding group were treated with the treatment, and the compliance of the Point Thread Embedding group was better.

    Table 3 The improvement of clinical symptoms in each group after treatment

    NOTE.?means< 0.05, compared with the control group, the difference was significant and statistically significant.

    Table 4 Body mass index improved after treatment in both groups

    NOTE.?means< 0.05, compared with the control group, the difference was significant and statistically significant.

    Table 5 Comparison of different efficiency rates

    NOTE.▲means< 0.05,compared with the control group, the difference was significant and statistically significant.

    Discussion

    Discussion of treatment plan

    Point thread embedding has the advantages of economy, simplicity and no side effects in the treatment of simple obesity. In the observation of simple obesity, no other diet or exercise methods were involved in this program compared with other similar studies[5]. Therefore, its efficacy can be evaluated more objectively. In terms of the selection of the control group, compared with similar studies [6?7], this study takes acupuncture therapy as the control group, the aim is to select the superior plan among numerous green therapies and provide a better plan for the clinical treatment of simple obesity through acupuncture and moxibustion.

    Treatment effect and evaluation

    Neither of the two treatment schemes in this study was adopted in combination with diet or exercise, and the study results showed that the treatment effect could be achieved only by acupuncture or point thread embedding. The results showed that both the acupuncture and the point thread embedding could not only lessen the weight of the patients with simple obesity, but also play an adjustment role in the circumference, especially in waist circumference. After treatment, some patients’ weight did not produce obvious change, but three circumferences have changed. The results showed that acupuncture and point thread embedding therapy paid more attention to the shape of simple obesity. In terms of effective rate and apparent efficiency, the body weight and clinical symptoms of point embedding group were better than those of acupuncture group. From different evaluation effects, the effective rate of clinical symptoms in acupuncture group and point thread embedding group were better than that of BMI. Therefore, it is more objective to evaluate the efficacy of simple obesity in combination with the improvement of clinical symptoms and measurements than simply based on weight reduction. At the same time, it means that acupuncture and moxibustion therapy in the treatment of simple obesity is more important than the overall adjustment of body shape and constitution.

    Comparison of the onset time and effect of different treatment schemes

    In terms of the influence of the two different treatment schemes on body weight, the body weight of patients in the acupuncture group decreased significantly at the beginning of the first treatment course and reached the peak at the second treatment course. Body weight and waist circumference in embedding group decreased significantly from the second course of treatment to the third course of treatment. The results showed that the acupuncture group had a faster onset time in the treatment of simple obesity, but the maintenance of the effect was shorter. In the treatment of simple obesity, the effect of point thread embedding group was relatively mild, and the efficacy was maintained for a relatively long time. From the weight loss results, the two group’s body weight stopped dropping when it dropped to about 5kg and remained stable. It suggests that we should pay attention to the appearance of plateauing period and management measures in the process of weight loss no matter what kind of weight loss methods. Subsequent studies are expected to look at the length of the plateau by extending the duration of treatment.

    Analysis of the influence of patient compliance on treatment effect

    The results of case collection and treatment showed that although 9 patients in the ordinary acupuncture group fell off midway and all the patients in the point thread embedding group ended treatment, the number of cases included in the results analysis between the two groups was 30, and there was no significant difference in age and gender, so the comparison between the two groups was comparable.

    Selection of schemes

    Because the Period of treatment on simple obesity is long, and acupuncture treatment often requires once a day or every other day, and the time of needle retention is at least half an hour each time, many patients can not cooperate well in today's accelerated pace of modern life. For acupoint embedding method, the thread buried in the body can be absorbed by protein catabolism. As a kind of durable, soft and nonspecific stimulation, the thread can’t be absorbed until 15 to 20 days later.it played a “deep acupuncture and long staying” for patients with simple obesity. The frequency of the 15-20 days meets the requirement of patients because it saves time greatly. In terms of compliance, patients in point thread embedding group had better compliance; From the perspective of clinical efficiency, the point thread embedding group is superior to the acupuncture group in terms of both weight improvement and clinical symptoms improvement. And the efficacy is more lasting. Therefore, it is worthy of clinical promotion and application.

    1. Wei BH, Jia BP. Criteria for diagnosis and curative effect evaluation of simple obesity.. 1998;18(5):317?319.

    2. Fu ZZ. Advances in the diagnosis and treatment of obesity.2003;9(35):9.

    3. The Department of Disease Control.. Beijing: People's Medical Publishing House;2006:4?41.

    4. Xiao Y, Shen J, Xu GG. Clinical observation on the treatment of obesity type 2 diabetes mellitus with comprehensive weight reduction program in internal medicine.2015;37(8):1096?1099.

    5. Hao LZ, Meng H, Sun J, Li P. Retrospective evaluation of 398 cases of obese and non-obese patients treated with point catgut embedding.2015;30(10):3501?3504.

    6. Dong ZN, Yin LL. Observe on the effect of point catgut embedding on patients with obesity and insulin resistance.2018;39(16):2535?2537.

    7. Nie H, Jiao Y. Observation on the curative effect of point embankment in the treatment of spleen deficiency dampness-block type obesity combined with menopausal syndrome.2018;41(3):27?29.

    10.12032/TMRCR20210515006

    Yun-Ying Qiao. Shanxi Acupuncture and Moxibustion Hospital. No.2, Beiyuan Street, Pingyang Road, Xiaodian District, Taiyuan, Shanxi Province, China. Email: 834767379@qq.com

    The project was supported by the Scientific Research Project of Shanxi Administration of Traditional Chinese Medicine(NO.2016ZYYC07)

    BMI, body mass index.

    :The authors declare that they have no conflict of interest.

    : Qiao YY, Yu X. Screening of acupuncture treatment for simple obesity.. 2021;4(2):6.

    : Ying Chen.

    : 25 November 2020,

    20 April 2021,

    :15 May 2021

    ? 2021 By Authors. Published by TMR Publishing Group Limited. This is an open access article under the CC-BY license (http://creativecommons.org/licenses/BY/4.0/)

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