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目的基于HPA轴中枢调控探讨灸法干预胰岛素抵抗的作用。方法将114例胰岛素抵抗患者随机分为治疗组A(37例)、治疗组B(38例)与对照组(39例),治疗组A、治疗组B分别采用俞募配穴的艾灸疗法、背俞穴的艾灸疗法,对照组采用西药治疗。分别在治疗前、后检测空腹血糖、胰岛素,甘油三酯、高密度脂蛋白胆固醇、胰岛素抵抗指数、腰围、促肾上腺皮质激素释放激素、促肾上腺皮质激素、皮质醇,评估汉密尔顿抑郁评定量表、汉密尔顿焦虑评定量表。结果与结论治疗组A疗效明显优于治疗组B、对照组(P<0.05)。三组的血糖、甘油三酯、高密度胆固醇脂蛋白较治疗前有明显改善(P<0.05),治疗组A与治疗组B的胰岛素、胰岛素抵抗指数、空腹促肾上腺皮质激素释放激素、促肾上腺皮质激素、皮质醇,汉密尔顿抑郁评定量表评分、汉密尔顿焦虑评定量表评分较治疗前明显改善(P<0.05),优于对照组(P<0.05)。治疗组A的腰围较治疗前明显改善(P<0.05),优于治疗组B、对照组(P<0.05)。俞募配穴灸法干预胰岛素抵抗作用明显,疗效与口服西药相似,HPA轴对灸法干预胰岛素抵抗具有中枢调控作用。HPA轴-应激-胰岛素抵抗三者之间存在相关,临床应重视从心理及中枢调控方面治疗胰岛素抵抗。
Objective To explore the effect of moxibustion on insulin resistance based on HPA axis center regulation. Methods A total of 114 patients with insulin resistance were randomly divided into treatment group A (37 cases), treatment group B (38 cases) and control group (39 cases). Treatment group A and treatment group B were treated with Shufu acupoint moxibustion , Back shu points of moxibustion therapy, the control group treated with Western medicine. Fasting blood glucose, insulin, triglyceride, high density lipoprotein cholesterol, insulin resistance index, waist circumference, corticotrophin releasing hormone, adrenocorticotropic hormone, cortisol were measured before and after treatment. The Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale. Results and Conclusion The efficacy of treatment group A was significantly better than that of treatment group B and control group (P <0.05). The blood sugar, triglyceride and high-density cholesterol lipoprotein in the three groups were significantly improved (P <0.05), and the insulin, insulin resistance index, fasting corticotropin releasing hormone, adrenal gland The scores of cortisol, cortisol, Hamilton Depression Rating Scale and Hamilton Anxiety Scale were significantly improved (P <0.05) compared with those before treatment (P <0.05). The waist circumference of treatment group A was significantly improved (P <0.05), better than that of treatment group B and control group (P <0.05). Shu-acupoints acupuncture moxibustion intervention obvious effect of insulin resistance, efficacy and western medicine similar to the HPA axis moxibustion intervention insulin resistance has a central regulatory role. HPA axis - stress - insulin resistance exists between the three, clinical attention should be paid from the psychological and central control of insulin resistance.