目的:观察穴位埋线对湿热困脾证2型糖尿病合并肥胖患者血清Apelin及胰高血糖素样肽-1(GLP-1)的影响.方法:将66例患者按随机数表法随机分为对照组和观察组,每组33例.对照组予艾塞那肽联合二甲双胍治疗,观察组在药物治疗基础上加用穴位埋线.治疗12周后观察两组患者体质量指数(BMI)、腰围、体脂率等肥胖相关指标,空腹血糖、餐后2 h血糖、糖化血红蛋白等糖代谢指标,总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)等脂代谢指标,以及血清Apelin和GLP-1水平的变化.结果:治疗后,两组BMI、腰围及体脂率均降低(均P<0.05),观察组BMI、腰围及体脂率均低于对照组(均P<0.05);两组空腹血糖、餐后2 h血糖及糖化血红蛋白水平均降低(均P<0.05),观察组空腹血糖、餐后2 h血糖及糖化血红蛋白水平均明显低于对照组(均P<0.05);对照组TC水平降低(P0.05),观察组TC、TG及LDL-C水平均明显降低(均P<0.05),且均低于对照组(均P<0.05);观察组血清Apelin水平降低(P<0.05),血清GLP-1水平升高(P<0.05),与对照组差异均有统计学意义(均P<0.05).结论:在常规用药基础上加用穴位埋线治疗湿热困脾证2型糖尿病合并肥胖患者可明显改善肥胖指标及糖脂代谢,这可能与其调节血清Apelin和GLP-1水平有关.“,”Objective: To observe the effects of acupoint thread-embedding therapy on serum apelin and glucagon-like peptide-1 (GLP-1) in type 2 diabetes mellitus patients with obesity due to dampness-heat encumbering spleen.Methods: Sixty-six patients were randomly divided into a control group and an observation group according to the random number table method, with 33 cases in each group. Patients in the control group were treated with exenatide and metformin, while patients in the observation group were treated with additional acupoint thread-embedding. After 12-week treatment, the obesity-related indicators, including body mass index (BMI), waist circumference and body fat rate, the glycometabolism indicators, including fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin, and the lipid metabolism indicators, including total cholesterol (TC), triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C), as well as serum apelin and GLP-1 levels were observed in patients of the two groups. Results: After treatment, the BMI, waist circumference and body fat rate of patients in the two groups were all reduced (all P<0.05), and were lower in the observation group than in the control group (all P<0.05); the fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin levels of patients in both groups were all decreased (all P<0.05), and were significantly lower in the observation group than in the control group (all P<0.05); the TC level was decreased (P0.05); the TC, TG and LDL-C levels were all significantly reduced in the observation group (all P<0.05), lower than those in the control group (all P<0.05); the serum apelin level was decreased (P<0.05) and the serum GLP-1 level was increased (P<0.05) in the observation group, statistically different from those in the control group (both P<0.05). Conclusion: Combined with the conventional medication, acupoint thread-embedding therapy can significantly improve the obesity-related indicators, glycometabolism and lipid metabolism in type 2 diabetes mellitus patients with obesity due to dampness-heat encumbering spleen. This may be achieved by regulating the serum apelin and GLP-1 levels.