疏肝健脾法针灸治疗脾虚型肥胖的临床研究
|
摘要
肥胖是指因机体热量的摄入大于消耗,过剩的热量以脂肪的形式储存体内,脂肪积聚过多而使体重过度增加的营养失衡性疾病。
中医认为,单纯性肥胖是在内(先天禀赋不足、七情内伤)外(饮食不节、喜逸恶劳)因素作用下,机体脏腑功能失调,导致痰湿盛于体内所致。其中,胃强脾弱,津液代谢失常,痰湿停留于肌肤腠理或五脏六腑是基本病机。《素问.奇病论》指出:“夫五味入口,藏于胃,脾为之行其精气。”《素问.至真要大论》:“诸湿肿满,皆属于脾”说明肥胖的发病,脾是基础。因此,加强脾胃的功能,使脾得健运,水湿痰饮得以运化转输代谢,成为肥胖的治疗中极为重要的环节。
从现代医学角度来讲,中医的脾虚,在人体即发生了物质代谢的障碍,涉及到唾液的分泌、小肠的吸收、胰液的分泌、胆汁的分泌等等诸多环节,表现在唾液的分泌方面,即会出现唾液淀粉酶活性低下。许多研究表明,唾液淀粉酶活性比值已成为诊断脾虚证的重要客观指标,本研究将其与脾虚症状积分量表相结合,比较全面地反映了脾虚型肥胖的实质。
本研究在查阅相关文献研究及大量临床病历的总结基础上,对60例脾虚型肥胖患者随机分为疏肝健脾组和单纯健脾化湿组,进行针灸治疗,两组患者的年龄、性别、病程、肥胖度均无明显差异(p＞0.05),具有可比性。主穴:中脘、天枢、水道、大横、支沟、丰隆、阴陵泉、足三里、三阴交、血海、期门、日月、太冲、肝俞;配穴:胃肠腑热加上巨虚、合谷、内庭;真元不足加肾俞、关元。两组均随证配穴,每天一次,每次留针30分钟,15次为1疗程,观察2个疗程。
临床观察结果如下:
1.两组均取得了一定疗效,治疗组总有效率93.33%,对照组总有效率86.67%,差异显著(p＜0.05)。
2.肥胖衡量指标方面,组间比较,两组治疗后体重、BMI比较差异显著(p＜0.05)。
3.两组在治疗后的唾液淀粉酶活性均有明显升高(p＜0.01),且组间比较差异显著(p＜0.05)。说明疏肝健脾法能够明显改善唾液腺酶分泌。
4.两组在治疗前后的脾虚积分均有明显下降(p＜0.01),且组间比较差异显著(p＜0.05)。说明健脾疏肝法改善脾虚型肥胖症状作用显著。
结论:疏肝健脾法针灸治疗通过疏肝理气,调整全身气机,调节脾胃功能,使胃纳脾运有续,气血生化有源,祛痰化浊以达到治疗目的,对脾虚所表现出的消化功能、能量代谢紊乱,具有良好的调节作用。
Obesity is an disbalance nutrition disease caused by special biochemistry factors, which lead to a series of disorders of energy. Calory absorbed in body is much more than that of consumed,then stored in body fat,and the final result is obesity. It is characterized with digestive system dysfunction related to assimilation,incretion,immunity,dysfunction of parasympathetic system in splenic deficiency syndrome.
TCM believes that the function of the spleen to govern transportation and transformation means that the spleen can digest food,absorb nutrients of food and water,and then transport them to qi, blood and body fluid. It holds that,under the interaction of exogenous pathogenic factors and endogenous pathogenic factors,the inbalance of qi,blood,yin and yang come forth rsulting in the stasis of phlegm,rheum,water and dampness,and then simple obesity happens. The basic pathogenesis is the disorders of stomach and spleen leading to disturbance of body fluid and the stagnancy of the production of phlegm and rheum due to the accumulation of body fluid. It is said in HuangdiNeiJing that dampness,edema and swelling result from the spleen.
Deficiency of spleen in TCM is similar to the obstruction of substance metabolization involving saliva secretion,small intestine absorption,pancreas excretion and bile exudation,The study combined clinical symptom characteristic in urination with integral list reflects the essential of deficiency of spleen comparatively all -sided.
Methods:60 cases were randomly divided into the observation goup treated by navel moxibustion with acupuncture,and the control group treated by simple acupuncture.there were no obvious difference in sex,course of disease and obesity degree between the two groups. The same points were used. They mainly were: zhongwan, tianshu, shuidao, daheng, zhigou,fenglong,yinlingquan,zusanli,sanyinjiao,xuehai,qimen,riyue,taichong,ganshu.And we added some other points when needed. The period of treatment is one moth. It was observed after two periods.
Results:
1. The waistline minishing effective rate were 93.33% in the observation group,and 86.67% in the control group,with significant difference(p<0.05).
2.After the period ,both of the two groups have made positive prescription on the weigh,waistline , BMI and the thickness of fattiness in abdomen.
3. clinical symptom characteristic in urination has been heightened after treatment showing notable difference between the two groups(p<0.05).It means that navel moxibution could improve absorbency of small intestine.
4.The splenic deficiency integral both dropped after treatment. And the index in the observation group has a remarkable differenxe(p<0.05)cluing on a good function for obesity of splenic deficiency syndrome.
Conclusion: naval moxibustion could regulate the splenic degiciency syndromes commendably. In the view of TCM,it could regulate meridians,strengthen spleen and kidney,develop healthy qi and dispel pathogenic factors in order to lose weighe by the herbals'action,the points and the especial point,navel.
中医认为,单纯性肥胖是在内(先天禀赋不足、七情内伤)外(饮食不节、喜逸恶劳)因素作用下,机体脏腑功能失调,导致痰湿盛于体内所致。其中,胃强脾弱,津液代谢失常,痰湿停留于肌肤腠理或五脏六腑是基本病机。《素问.奇病论》指出:“夫五味入口,藏于胃,脾为之行其精气。”《素问.至真要大论》:“诸湿肿满,皆属于脾”说明肥胖的发病,脾是基础。因此,加强脾胃的功能,使脾得健运,水湿痰饮得以运化转输代谢,成为肥胖的治疗中极为重要的环节。
从现代医学角度来讲,中医的脾虚,在人体即发生了物质代谢的障碍,涉及到唾液的分泌、小肠的吸收、胰液的分泌、胆汁的分泌等等诸多环节,表现在唾液的分泌方面,即会出现唾液淀粉酶活性低下。许多研究表明,唾液淀粉酶活性比值已成为诊断脾虚证的重要客观指标,本研究将其与脾虚症状积分量表相结合,比较全面地反映了脾虚型肥胖的实质。
本研究在查阅相关文献研究及大量临床病历的总结基础上,对60例脾虚型肥胖患者随机分为疏肝健脾组和单纯健脾化湿组,进行针灸治疗,两组患者的年龄、性别、病程、肥胖度均无明显差异(p＞0.05),具有可比性。主穴:中脘、天枢、水道、大横、支沟、丰隆、阴陵泉、足三里、三阴交、血海、期门、日月、太冲、肝俞;配穴:胃肠腑热加上巨虚、合谷、内庭;真元不足加肾俞、关元。两组均随证配穴,每天一次,每次留针30分钟,15次为1疗程,观察2个疗程。
临床观察结果如下:
1.两组均取得了一定疗效,治疗组总有效率93.33%,对照组总有效率86.67%,差异显著(p＜0.05)。
2.肥胖衡量指标方面,组间比较,两组治疗后体重、BMI比较差异显著(p＜0.05)。
3.两组在治疗后的唾液淀粉酶活性均有明显升高(p＜0.01),且组间比较差异显著(p＜0.05)。说明疏肝健脾法能够明显改善唾液腺酶分泌。
4.两组在治疗前后的脾虚积分均有明显下降(p＜0.01),且组间比较差异显著(p＜0.05)。说明健脾疏肝法改善脾虚型肥胖症状作用显著。
结论:疏肝健脾法针灸治疗通过疏肝理气,调整全身气机,调节脾胃功能,使胃纳脾运有续,气血生化有源,祛痰化浊以达到治疗目的,对脾虚所表现出的消化功能、能量代谢紊乱,具有良好的调节作用。
Obesity is an disbalance nutrition disease caused by special biochemistry factors, which lead to a series of disorders of energy. Calory absorbed in body is much more than that of consumed,then stored in body fat,and the final result is obesity. It is characterized with digestive system dysfunction related to assimilation,incretion,immunity,dysfunction of parasympathetic system in splenic deficiency syndrome.
TCM believes that the function of the spleen to govern transportation and transformation means that the spleen can digest food,absorb nutrients of food and water,and then transport them to qi, blood and body fluid. It holds that,under the interaction of exogenous pathogenic factors and endogenous pathogenic factors,the inbalance of qi,blood,yin and yang come forth rsulting in the stasis of phlegm,rheum,water and dampness,and then simple obesity happens. The basic pathogenesis is the disorders of stomach and spleen leading to disturbance of body fluid and the stagnancy of the production of phlegm and rheum due to the accumulation of body fluid. It is said in HuangdiNeiJing that dampness,edema and swelling result from the spleen.
Deficiency of spleen in TCM is similar to the obstruction of substance metabolization involving saliva secretion,small intestine absorption,pancreas excretion and bile exudation,The study combined clinical symptom characteristic in urination with integral list reflects the essential of deficiency of spleen comparatively all -sided.
Methods:60 cases were randomly divided into the observation goup treated by navel moxibustion with acupuncture,and the control group treated by simple acupuncture.there were no obvious difference in sex,course of disease and obesity degree between the two groups. The same points were used. They mainly were: zhongwan, tianshu, shuidao, daheng, zhigou,fenglong,yinlingquan,zusanli,sanyinjiao,xuehai,qimen,riyue,taichong,ganshu.And we added some other points when needed. The period of treatment is one moth. It was observed after two periods.
Results:
1. The waistline minishing effective rate were 93.33% in the observation group,and 86.67% in the control group,with significant difference(p<0.05).
2.After the period ,both of the two groups have made positive prescription on the weigh,waistline , BMI and the thickness of fattiness in abdomen.
3. clinical symptom characteristic in urination has been heightened after treatment showing notable difference between the two groups(p<0.05).It means that navel moxibution could improve absorbency of small intestine.
4.The splenic deficiency integral both dropped after treatment. And the index in the observation group has a remarkable differenxe(p<0.05)cluing on a good function for obesity of splenic deficiency syndrome.
Conclusion: naval moxibustion could regulate the splenic degiciency syndromes commendably. In the view of TCM,it could regulate meridians,strengthen spleen and kidney,develop healthy qi and dispel pathogenic factors in order to lose weighe by the herbals'action,the points and the especial point,navel.
引文
1.王启才.实用针灸临床辨证论治精要.北京:中医古籍出版社,2003,第一版:275.
2.同上。
3.于鸿等;肥胖的研究现状及国内外展[J].中国卫生工程学,2000;9(3):126-128.
4.StunkardAJ,SorensenTI,H-anis C,et al.An adoptions tudy of human obesity,N Engl J Med,1986;314:193-8.
5.孙志娟,黄之瑜.肥胖的研究进展[J].生理科学通报,2001.32(1):39-44.
6.梅长林,李兆申等编著.内科学教程[M].第一版.北京:人民卫生出版社,2003,1246-1247.
7.Zhang Y,Proenca R,Mafei M,et al.Positional cloning of the mouse obesity gene and its human homologue[J].Nature,1994,372:425-431.
8.同上
9.贾伟平,项坤三,陆俊茜等.局部体脂与内分泌脂肪调节激素对瘦素水平的影响.中华内分泌代谢杂志[J].2000,16(2):70-73.
10.Kalra SP,Dube.MG,Pu S,et al.Interacting appetite-regulating pathways in the hypothalamic regulation of body weight[J].Endocr Rev,1999,20(ⅰ):68-10.
11.王海霞.下丘脑食欲调节网络与肥胖[J].国外医学儿科学分册,2001,28(3):158-160.
12.戴经铨.肥胖与减肥药研究的新动向[J].国外医药一合成药.生化药.制剂分册 2002.23(3):142-146.
13.李风英.膳食因素在防治肥胖中的作用[J].中华预防医学杂志.2001,35(2):143.
14.Trembley A,LavelleeN,Almeras N,et al.Nitrional determinants of the inerease in energy intake associated with a high gat diet[J].Am J Ciin Nutr.1991,53:1134-1137.
15.那莎.肥胖病病因病机的研究进展[J].河北中医药学报.2003,18(4):42-45.
16.罗冬林,肖春梅,闰立新等.单纯性肥胖者有效减肥的饮食和运动方案[J].中国临床康复,2003,7(18):2630-2631.
17.Jia WP,XiangKS,chen L,et al.Epidemiological study on obesity and its comorbidities in urban Chinese older than 20 years of age in Shanghai,China.Obesity reviews[J].2002,3(3):157-165.
18.张秀珍.关注肥胖症.生物学教学,2003;28(6):53.
19.赵银龙编著.实用减肥疗法[M].第一版.北京:中国医药科技出版社,1992,28-32.
20.李嘉.肥胖病针刺辨证要点[J].江苏中医,1998,19(2):34-36.
21.刘志诚,孙凤氓,胡葵.针灸为主治疗单纯性肥胖患者的临床研究[J].上海针灸杂志,1997,16(1):6-8.
22.李嘉,刘志诚.针刺治疗单纯性肥胖病40例疗效观察[J].中国针灸,1998,18(9):539-540.
23.蔡敬宙.针刺治疗单纯性肥胖症50例疗效观察[J].中国临床康复,2002,6(7):1037.
24.沈沽,侯庆.针刺华佗夹脊治疗单纯性肥胖疗效观察[J].上海针灸杂志,2000,(1):29.
25.高军,战菊.针刺“老十针”治疗单纯性肥胖50例[J].吉林中医药,2002,22(8):51.
26.陈俊鸿,郭佳士.针灸治疗单纯性肥胖症30例[J].中国针灸,1984(4):24.
27.魏群利,刘志诚.耳针、体针、耳体结合治疗单纯性肥胖病临床疗效比较[J].南京中医药大学学报(自然科学版),2002,18(1):45-47.
28.赵锦梅等.耳穴帖压减肥102例疗效观察[J].现代中西医结合杂志,2004,13(23):3110-3111.
29.王国明,李丽霞,宋永强等.穴位埋线治疗单纯性肥胖症60例疗效观察[J].中国针灸,2001,21(7):395-396.
30.许姿妙.穴位埋线治疗肥胖症100例临床观察[J].中国针灸,2002,22(2):95.
31.李雪莹,葛宝和.穴位埋线疗法治疗肥胖症的临床研究[J].中国中医药科技,2006,13(2):70-72.
32.孙力.针灸治疗单纯性肥胖20例小结[J].甘肃中医,2004,17(12):35-36.
33.针刺配合耳穴帖压治疗单纯性肥胖症52例[J].中国民间疗法,2002,10(8):15.
34.杨金山.温针药灸与电针治疗单纯性肥胖的临床研究[J].中国针灸,2002,22(4):237-239.
35.王荥蕾,王东.针刺配合推拿治疗单纯性肥胖症150例经验总结[J].中医药学报,2003,31(1):31.
36.刘运珠.针刺为主治疗单纯性肥胖症疗效观察[J].中国针灸,2002,22(2):93.
37.娄玉方,张雅珍,谭馥梅.针刺在减肥中作用的临床研究[J].上海针灸杂志,2001,20(2):12.
38.Dung HC;Role of the Vagus Nerre in Weight Reduction Through Auricular Acupunctttre.Am.J.Acup,1986;14(3):249.
39.刘志诚,孙凤氓,苏静等;针刺对肥胖大鼠下丘脑腹内侧核作用的研究[J].中医杂志,2000;41(1);25-26.
40.马骋,刘志诚;电针对刺激家兔下丘脑外侧区引起胃机能亢进的调节作用[J].针刺治疗,1994;19(2):42-45.
41.赵玫,刘志诚,苏静;针刺减肥中枢作用的时效关系[J].南京中医药大学学报,1999;15(2):97-98.
42.徐兴军,邵淑丽,立旭艳;ICR小鼠肥胖过程中的基础代谢率的变化[J].高师理科 学刊,2004;24(4);41
43.何样梁,傅祖伯;瘦素抵抗的研究进展[J].国外医学.内分泌分册,2001;28(10);46.
44.顾卫琼,陈名道,唐金凤等;中国人血清瘦素水平与肥胖度的关系[J].中华内分泌代谢杂志,1999;15(1):15-18.
45.威贵明,朱智明;胰岛素抵抗和瘦素与高血压[J].海军总医院学报;2000;13(2):
87.李俊,许燕峰,冉燕雪等;胰岛素抵抗与单纯性肥胖[J].实用儿科杂志,1995;10(6):1144.
46.徐康,张蔚琴,冯晨曦等;肥胖症与慢性病的关系[J].中国校医,1997;11(2):81.
47.王琦,叶加农;肥胖人痰湿体脂的血液流变学及甲皱微循环研究[J.]中国中医基础医学杂志,1995;(1):52-54.
48.孙凤氓,刘志诚,王芹争等;针灸减肥及其对水盐代谢的影响[J].针刺研究,1996;21(2):19-23.
49.刘志诚,孙凤氓,孙志等;针刺对肥胖大鼠瘦素和胰岛素含量的影响[J].现代中西医结合杂志,2003;12(5):460-462.
50.刘志诚,孙凤氓,胡葵等;针灸减肥的临床观察及其降脂质的研究[J].中国康复,5(3):110-114.
51.刘志诚,孙凤氓,赵东红等;针刺对单纯性肥胖瘦素和胰岛素抵抗的影响研究[J].中国药学刊,2003;21(1):40-41.
52.广州中医学院脾胃研究组.脾虚患者唾液淀粉酶活性初步观察.中华医学杂志,198;60(5):290.
53.广州中医学院脾胃研究组.脾虚患者唾液淀粉酶活性再观察.广州中医学院25周年校庆论文选编。1981.35.
54.沈自尹.中国虚证辨证参考标准.中西医结合杂志,1986:6(10):598.
55.陈志雄.上消化道出血“火热”病机之临床研究.广州中医学院学报,1990:7(1):8.
56.郭绞.心脾肺气虚证的唾液淀粉酶测定[J],广州中医学院学报,1990;7(2):87.
57.余幼鸣.多指标同步观察肾脏疾病之脾虚证的研究。广州中医学院研究生毕业论文(90级).
58.李顺民.重症肌无力脾虚唾液淀粉酶活性及D-木糖醇排泄率分析.广州中医学院学报,1991;8(4):270.
59.邱向红.脾虚证计量诊断的探讨.广州中医学院学报,1990;7(1):24.
60.孙弼纲,刘健,鄢顺琴等.脾虚证分度定量诊断研究.中国中西医结合杂志,1994;14(3):135.
61.申屠瑾;800例单纯性肥胖患者与中医分型的关系[J].中国医药学报,1990;5(6):22-23.
62.明.俞牟.续医说.北京:北京中医研究院图书馆藏.手抄本.1522.
63.清.何梦瑶.医编.上海:上海科学技术出版社.1982;115.
64.中医研究院.岳美中论医集.北京:人民卫生出版社.1978;56.
65.明.赵养葵.医贯.卷二.清文运堂刻本:44.
66.杨林.论肝郁与抑郁症.陕西中医.2000;21(6):260-261.
67.邹襄谷,陈文发.中药对慢性胃病脾虚兼肝郁证的胃点影响.福建中医学院学报;1995,5(3):22-25.
68.张超,汤晓云月巴胖病中医病因探讨[J].云南中医杂志,1989,(5):46.
69.左媛媛,杨云;从肝失疏泄论糖尿病的发生[J].云南中医学院学报,2003:26(1):22-23.
70.周中华,马建东,郎艳;糖尿病教育对2型糖尿病患者情绪障碍及糖代谢的影响[J].中国行为医学科学杂志,2003;12(1),34-35.
71.郑筱萸.中药新药临床研究知道原则(试行版).北京:中国医药科技出版社,2002:361-363.
72.广州中医学院脾胃研究组.脾虚患者唾液淀粉酶活性初步研究.中华医学杂志1980,60(5):290.
73.李春节,成小松,李春艳等.针刺丰隆穴对正常和高脂血症大鼠血脂的调节作用[J].中国临床康复,2005,9(27):86-87.
74.徐斌,刘志诚,张中成.针刺治疗肥胖临床方案制定的基本思路和方法[J].中国针灸,2004,24(2):129-133.
2.同上。
3.于鸿等;肥胖的研究现状及国内外展[J].中国卫生工程学,2000;9(3):126-128.
4.StunkardAJ,SorensenTI,H-anis C,et al.An adoptions tudy of human obesity,N Engl J Med,1986;314:193-8.
5.孙志娟,黄之瑜.肥胖的研究进展[J].生理科学通报,2001.32(1):39-44.
6.梅长林,李兆申等编著.内科学教程[M].第一版.北京:人民卫生出版社,2003,1246-1247.
7.Zhang Y,Proenca R,Mafei M,et al.Positional cloning of the mouse obesity gene and its human homologue[J].Nature,1994,372:425-431.
8.同上
9.贾伟平,项坤三,陆俊茜等.局部体脂与内分泌脂肪调节激素对瘦素水平的影响.中华内分泌代谢杂志[J].2000,16(2):70-73.
10.Kalra SP,Dube.MG,Pu S,et al.Interacting appetite-regulating pathways in the hypothalamic regulation of body weight[J].Endocr Rev,1999,20(ⅰ):68-10.
11.王海霞.下丘脑食欲调节网络与肥胖[J].国外医学儿科学分册,2001,28(3):158-160.
12.戴经铨.肥胖与减肥药研究的新动向[J].国外医药一合成药.生化药.制剂分册 2002.23(3):142-146.
13.李风英.膳食因素在防治肥胖中的作用[J].中华预防医学杂志.2001,35(2):143.
14.Trembley A,LavelleeN,Almeras N,et al.Nitrional determinants of the inerease in energy intake associated with a high gat diet[J].Am J Ciin Nutr.1991,53:1134-1137.
15.那莎.肥胖病病因病机的研究进展[J].河北中医药学报.2003,18(4):42-45.
16.罗冬林,肖春梅,闰立新等.单纯性肥胖者有效减肥的饮食和运动方案[J].中国临床康复,2003,7(18):2630-2631.
17.Jia WP,XiangKS,chen L,et al.Epidemiological study on obesity and its comorbidities in urban Chinese older than 20 years of age in Shanghai,China.Obesity reviews[J].2002,3(3):157-165.
18.张秀珍.关注肥胖症.生物学教学,2003;28(6):53.
19.赵银龙编著.实用减肥疗法[M].第一版.北京:中国医药科技出版社,1992,28-32.
20.李嘉.肥胖病针刺辨证要点[J].江苏中医,1998,19(2):34-36.
21.刘志诚,孙凤氓,胡葵.针灸为主治疗单纯性肥胖患者的临床研究[J].上海针灸杂志,1997,16(1):6-8.
22.李嘉,刘志诚.针刺治疗单纯性肥胖病40例疗效观察[J].中国针灸,1998,18(9):539-540.
23.蔡敬宙.针刺治疗单纯性肥胖症50例疗效观察[J].中国临床康复,2002,6(7):1037.
24.沈沽,侯庆.针刺华佗夹脊治疗单纯性肥胖疗效观察[J].上海针灸杂志,2000,(1):29.
25.高军,战菊.针刺“老十针”治疗单纯性肥胖50例[J].吉林中医药,2002,22(8):51.
26.陈俊鸿,郭佳士.针灸治疗单纯性肥胖症30例[J].中国针灸,1984(4):24.
27.魏群利,刘志诚.耳针、体针、耳体结合治疗单纯性肥胖病临床疗效比较[J].南京中医药大学学报(自然科学版),2002,18(1):45-47.
28.赵锦梅等.耳穴帖压减肥102例疗效观察[J].现代中西医结合杂志,2004,13(23):3110-3111.
29.王国明,李丽霞,宋永强等.穴位埋线治疗单纯性肥胖症60例疗效观察[J].中国针灸,2001,21(7):395-396.
30.许姿妙.穴位埋线治疗肥胖症100例临床观察[J].中国针灸,2002,22(2):95.
31.李雪莹,葛宝和.穴位埋线疗法治疗肥胖症的临床研究[J].中国中医药科技,2006,13(2):70-72.
32.孙力.针灸治疗单纯性肥胖20例小结[J].甘肃中医,2004,17(12):35-36.
33.针刺配合耳穴帖压治疗单纯性肥胖症52例[J].中国民间疗法,2002,10(8):15.
34.杨金山.温针药灸与电针治疗单纯性肥胖的临床研究[J].中国针灸,2002,22(4):237-239.
35.王荥蕾,王东.针刺配合推拿治疗单纯性肥胖症150例经验总结[J].中医药学报,2003,31(1):31.
36.刘运珠.针刺为主治疗单纯性肥胖症疗效观察[J].中国针灸,2002,22(2):93.
37.娄玉方,张雅珍,谭馥梅.针刺在减肥中作用的临床研究[J].上海针灸杂志,2001,20(2):12.
38.Dung HC;Role of the Vagus Nerre in Weight Reduction Through Auricular Acupunctttre.Am.J.Acup,1986;14(3):249.
39.刘志诚,孙凤氓,苏静等;针刺对肥胖大鼠下丘脑腹内侧核作用的研究[J].中医杂志,2000;41(1);25-26.
40.马骋,刘志诚;电针对刺激家兔下丘脑外侧区引起胃机能亢进的调节作用[J].针刺治疗,1994;19(2):42-45.
41.赵玫,刘志诚,苏静;针刺减肥中枢作用的时效关系[J].南京中医药大学学报,1999;15(2):97-98.
42.徐兴军,邵淑丽,立旭艳;ICR小鼠肥胖过程中的基础代谢率的变化[J].高师理科 学刊,2004;24(4);41
43.何样梁,傅祖伯;瘦素抵抗的研究进展[J].国外医学.内分泌分册,2001;28(10);46.
44.顾卫琼,陈名道,唐金凤等;中国人血清瘦素水平与肥胖度的关系[J].中华内分泌代谢杂志,1999;15(1):15-18.
45.威贵明,朱智明;胰岛素抵抗和瘦素与高血压[J].海军总医院学报;2000;13(2):
87.李俊,许燕峰,冉燕雪等;胰岛素抵抗与单纯性肥胖[J].实用儿科杂志,1995;10(6):1144.
46.徐康,张蔚琴,冯晨曦等;肥胖症与慢性病的关系[J].中国校医,1997;11(2):81.
47.王琦,叶加农;肥胖人痰湿体脂的血液流变学及甲皱微循环研究[J.]中国中医基础医学杂志,1995;(1):52-54.
48.孙凤氓,刘志诚,王芹争等;针灸减肥及其对水盐代谢的影响[J].针刺研究,1996;21(2):19-23.
49.刘志诚,孙凤氓,孙志等;针刺对肥胖大鼠瘦素和胰岛素含量的影响[J].现代中西医结合杂志,2003;12(5):460-462.
50.刘志诚,孙凤氓,胡葵等;针灸减肥的临床观察及其降脂质的研究[J].中国康复,5(3):110-114.
51.刘志诚,孙凤氓,赵东红等;针刺对单纯性肥胖瘦素和胰岛素抵抗的影响研究[J].中国药学刊,2003;21(1):40-41.
52.广州中医学院脾胃研究组.脾虚患者唾液淀粉酶活性初步观察.中华医学杂志,198;60(5):290.
53.广州中医学院脾胃研究组.脾虚患者唾液淀粉酶活性再观察.广州中医学院25周年校庆论文选编。1981.35.
54.沈自尹.中国虚证辨证参考标准.中西医结合杂志,1986:6(10):598.
55.陈志雄.上消化道出血“火热”病机之临床研究.广州中医学院学报,1990:7(1):8.
56.郭绞.心脾肺气虚证的唾液淀粉酶测定[J],广州中医学院学报,1990;7(2):87.
57.余幼鸣.多指标同步观察肾脏疾病之脾虚证的研究。广州中医学院研究生毕业论文(90级).
58.李顺民.重症肌无力脾虚唾液淀粉酶活性及D-木糖醇排泄率分析.广州中医学院学报,1991;8(4):270.
59.邱向红.脾虚证计量诊断的探讨.广州中医学院学报,1990;7(1):24.
60.孙弼纲,刘健,鄢顺琴等.脾虚证分度定量诊断研究.中国中西医结合杂志,1994;14(3):135.
61.申屠瑾;800例单纯性肥胖患者与中医分型的关系[J].中国医药学报,1990;5(6):22-23.
62.明.俞牟.续医说.北京:北京中医研究院图书馆藏.手抄本.1522.
63.清.何梦瑶.医编.上海:上海科学技术出版社.1982;115.
64.中医研究院.岳美中论医集.北京:人民卫生出版社.1978;56.
65.明.赵养葵.医贯.卷二.清文运堂刻本:44.
66.杨林.论肝郁与抑郁症.陕西中医.2000;21(6):260-261.
67.邹襄谷,陈文发.中药对慢性胃病脾虚兼肝郁证的胃点影响.福建中医学院学报;1995,5(3):22-25.
68.张超,汤晓云月巴胖病中医病因探讨[J].云南中医杂志,1989,(5):46.
69.左媛媛,杨云;从肝失疏泄论糖尿病的发生[J].云南中医学院学报,2003:26(1):22-23.
70.周中华,马建东,郎艳;糖尿病教育对2型糖尿病患者情绪障碍及糖代谢的影响[J].中国行为医学科学杂志,2003;12(1),34-35.
71.郑筱萸.中药新药临床研究知道原则(试行版).北京:中国医药科技出版社,2002:361-363.
72.广州中医学院脾胃研究组.脾虚患者唾液淀粉酶活性初步研究.中华医学杂志1980,60(5):290.
73.李春节,成小松,李春艳等.针刺丰隆穴对正常和高脂血症大鼠血脂的调节作用[J].中国临床康复,2005,9(27):86-87.
74.徐斌,刘志诚,张中成.针刺治疗肥胖临床方案制定的基本思路和方法[J].中国针灸,2004,24(2):129-133.