| 郭亚楠,王恩杰,杨威,刘芳,卫海燕,陈永兴.针刺联合揿针对儿童单纯性肥胖胰岛素抵抗的影响[J].中国康复,2026,41(6):330-336 |
| 针刺联合揿针对儿童单纯性肥胖胰岛素抵抗的影响 |
| Clinical efficacy of acupuncture combined with press needling in the treatment of simple obesity in children (strong stomach and weak spleen pattern) and its influence on insulin resistance |
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| DOI：10.3870/zgkf.2026.06.002 |
| 中文关键词: 肥胖 儿童 针刺 揿针 |
| 英文关键词: obesity children acupuncture press acupuncture |
| 基金项目:河南省中医药专项课题项目(2024ZY3090)；郑州市医学科研项目（ZZYK2024096） |
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| 中文摘要: |
| 目的：评价普通针刺联合揿针疗法对儿童单纯性肥胖（胃强脾弱证）的临床疗效及其对胰岛素抵抗的影响，并结合生物信息学分析初步探讨其潜在机制。方法：将98例6～16岁单纯性肥胖儿童随机分为对照组（接受普通针刺治疗）与观察组（接受普通针刺联合揿针治疗），疗程共12周。比较2组治疗前后体质量、体重指数（BMI）、体脂率（BFP）、腰围以及空腹血糖（FPG）、空腹胰岛素（FINS）及胰岛素抵抗指数（HOMA-IR）的变化。结合GEO数据库(GSE9624, GSE100599)，探讨针刺对肥胖相关信号通路的潜在调控机制。结果：治疗12周脱落11例，最终观察组45例，对照组42例完成本研究，2组体质量、BMI、BFP及腰围均显著下降（均P＜0.05），且观察组各指标改善程度均优于对照组（均P＜0.05）。在糖代谢方面，观察组FINS及HOMA-IR的下降幅度显著大于对照组（P＜0.01）。生物信息学分析提示，肥胖抑制PI3K-Akt与胰岛素信号通路，激活FoxO与内分泌抵抗通路；电针干预调节糖脂代谢相关通路，调节内分泌系统及神经回路改善肥胖。结论：普通针刺联合揿针能更有效改善儿童单纯性肥胖（胃强脾弱证）的体成分和胰岛素抵抗，其优势源于揿针的长效刺激与高依从性。该疗法可能通过调节中枢和外周胰岛素信号通路发挥作用，为儿童肥胖管理提供了安全有效的方案。 |
| 英文摘要: |
| Objective: To evaluate the clinical efficacy of conventional acupuncture combined with press needle therapy in children with simple obesity (strong stomach and weak spleen pattern) and its impact on insulin resistance, and to preliminarily explore the potential mechanisms using bioinformatics analysis. Methods: A total of 98 children aged 6-16 years with simple obesity (strong stomach and weak spleen pattern) were randomly divided into a control group (receiving conventional acupuncture) and an observation group (receiving conventional acupuncture combined with press needle therapy). The treatment lasted for 12 weeks. Changes in body weight, body mass index (BMI), body fat percentage (BFP), waist circumference, fasting plasma glucose (FPG), fasting insulin (FINS), and homeostasis model assessment-insulin resistance (HOMA-IR) were compared before and after treatment between the two groups. Additionally, transcriptomic data from the GEO database (GSE9624, GSE100599) were analyzed to investigate obesity-related abnormal signaling pathways and the potential regulatory mechanisms of acupuncture. Results: A total of 11 cases dropped out. Ultimately, 45 cases in the observation group and 42 cases in the control group completed this trial. Both groups showed significant reductions in body weight, BMI, BFP, and waist circumference (all P<0.05), with the observation group demonstrating greater improvements in all indicators than the control group (all P<0.05). In terms of glucose metabolism, the decreases in FINS and HOMA-IR were significantly greater in the observation group than in the control group (P<0.01). Bioinformatics analysis revealed that the PI3K-Akt and insulin signaling pathways were inhibited, while the Fo-xO and endocrine resistance pathways were activated in the obese state. Electroacupuncture intervention enriched pathways related to glucose and lipid metabolism and regulated hypothalamic central signaling.Conclusion: Conventional acupuncture combined with press needle therapy can safely and effectively improve body composition and insulin resistance in children with simple obesity (strong stomach and weak spleen pattern), with superior efficacy compared to conventional acupuncture alone. The mechanism of this combined therapy may involve modulation of the central nervous system and reversal of insulin signaling pathway abnormalities in peripheral adipose tissue. |
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