CAJ | 학술논문

目的:探讨针刺是否具有抑制脂毒性的作用,及其可能机制.方法:临床针刺治疗34例单纯性肥胖病患者3个疗程,治疗前后测量体重指数(BMI)、脂肪百分率(F%),酶联免疫法测定血清胰岛素、脂联素,生化比色法测定血脂、血糖,高效液相色谱法测定主要的八种游离脂肪酸,并与20例正常人对照.结果: 临床总有效率88.2%,针刺可提高患者降低的胰岛素敏感指数(IAI,t=-5.103,P=0.000).针刺后F%的降低与不饱和脂肪酸升高的相关性具有显著性意义(r=0.402,P=0.019),与不饱和脂肪酸与饱和脂肪酸的比值的升高的相关性亦具有显著性意义(r=0.348,P=0.044).高密度脂蛋白升高与二十碳五烯酸的升高的相关性具有显著性意义(r=0.352,P=0.041),BMI的降低与高密度脂蛋白的升高的相关具有显著性意义(r=0.357,P＝0.038).针刺后脂联素水平显著升高(与治疗前相比P=0.000),FFAs降低与脂联素升高的相关性具有显著性意义(r=-0.349,P=0.043).结论:针刺可以降低肥胖患者的游离脂肪酸水平,提高其胰岛素敏感性,从而表现出抑制脂毒性的效应.针刺抑制脂毒性的作用与提高脂联素水平有一定的关系.
목적:탐토침자시부구유억제지독성적작용,급기가능궤제.방법:림상침자치료34례단순성비반병환자3개료정,치료전후측량체중지수(BMI)、지방백분솔(F%),매련면역법측정혈청이도소、지련소,생화비색법측정혈지、혈당,고효액상색보법측정주요적팔충유리지방산,병여20례정상인대조.결과: 림상총유효솔88.2%,침자가제고환자강저적이도소민감지수(IAI,t=-5.103,P=0.000).침자후F%적강저여불포화지방산승고적상관성구유현저성의의(r=0.402,P=0.019),여불포화지방산여포화지방산적비치적승고적상관성역구유현저성의의(r=0.348,P=0.044).고밀도지단백승고여이십탄오희산적승고적상관성구유현저성의의(r=0.352,P=0.041),BMI적강저여고밀도지단백적승고적상관구유현저성의의(r=0.357,P＝0.038).침자후지련소수평현저승고(여치료전상비P=0.000),FFAs강저여지련소승고적상관성구유현저성의의(r=-0.349,P=0.043).결론:침자가이강저비반환자적유리지방산수평,제고기이도소민감성,종이표현출억제지독성적효응.침자억제지독성적작용여제고지련소수평유일정적관계.
Objective:To investigate if acupuncture has an inhibitory effect on fatty toxicity and its possible mechanism. Methods: Thirty-four patients with simple obesity were clinically treated with acupuncture for 3 courses. Before and after treatment, body mass index(BMI) and fat percentage(F%) were determined, and serum insulin and adiponectin were measured by enzyme linked immunoassay, blood lipid and sugar by biochemical colorimetry and eight kinds of free fatty acids(FFAs) by high performance liquid chromatography. Twenty normal persons were selected as a control. Results:The total efficacy rate was 88.2%. Acupuncture could increase the decreased insulin sensitivity index(ISI) in the patients(t=-5.103, P=0.000). The correlation of a decrease in F% with an increase in unsaturated fatty acid after acupuncture was of significance(r=0.402, P=0.019) and its correlation with an increase in the ratio between unsaturated fatty acid and saturated fatty acid was also of significance(r=0.348, P=0.044). The correlation between increases in high density lipoprotein and in eicosapentaenoic acid was of significance(r=0.352, P＝0.041). The correlation between a decrease in BMI and an increase in high density lipoprotein was of significance(r=0.357, P=0.038). Adiponectin level significantly rose after acupuncture (compared with pre-treatment, P=0.000). The correlation between a decrease in FFAs and an increase in adiponectin was of significance(r=-0.349, P=0.043). Conclusion: Acupuncture can lower the levels of free fatty acids in the patients and increase their sensitivity to insulin to inhibit the fatty toxicity. The inhibitory effect of acupuncture on fatty toxicity is somewhat related to a rise in adiponectin level.