中文摘要：

目的：观察温针联合耳针对脾虚湿阻型肥胖并发高脂血症患者的疗效,并探讨其作用机制。方法：将110例脾虚湿阻型肥胖并发高脂血症患者随机分成观察组和对照组,每组55例,并设立健康组52例进行对比。对照组穴取太白、冲阳、阴陵泉、足三里等,予温针疗法,隔日1次。观察组在对照组疗法基础上增加耳穴针刺,穴取脾、胃、肺、肾等,2～3日治疗1次。两组均治疗3个月后评定疗效。观察两组患者治疗前后的肥胖指标[体质量、肥胖度（A）、体质指数（BMI）、体脂百分率（F%）],血脂指标[血清总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白（LDL-C）、高密度脂蛋白（HDL-C）],脂肪-胰岛内分泌轴指标[空腹血糖（FPG）、空腹瘦素（FLP）、空腹胰岛素（FINS）、胰岛素敏感性指数（ISI）、胰岛素抵抗指数（Homa-IR）、胰岛β细胞功能指数（Homa-β）]及自主神经功能指数（Y）的变化,并评定两组疗效。结果：观察组总有效率为96.4%（53/55）,优于对照组的87.3%（48/55,P〈0.01）。在改善各项肥胖指标方面,两组比较差异无统计学意义（均P〉0.05）。两组患者治疗前TC、TG、LDL-C、FLP、FPG、FINS、Homa-IR均显著高于健康组（均P〈0.01）,而HDL、ISI、Homa-β、Y值显著低于健康组（均P〈0.01）。治疗后,除Homa-β外,两组各项指标均显著改善（均P〈0.01）,且观察组优于对照组（均P〈0.01）。结论：脾虚湿阻型肥胖并发高脂血症患者存在脂质代谢、＂脂肪-胰岛内分泌轴＂功能和自主神经功能的紊乱,温针联合耳针或单纯温针具有减肥和降脂的作用,且温针联合耳针法优于单纯温针法。疗效机制可能与良性调整血糖、脂质代谢、脂肪-胰岛内分泌轴、自主神经功能有关。

英文摘要：

Objective To explore the efficacy on obesity of spleen deficiency and damp blockage pattern and hyperlipemia treated with warm needling therapy and auricular acupuncture and the effect mechanism of the combined treatment.Methods One hundred and ten patients of obesity of spleen deficiency and damp blockage pattern and hyperlipemia were randomized into an observation group and a control group,55 cases in each one.Additionally,a healthy group（52cases）was set up as the control.In the control group,the warm needling therapy was applied to Taibai（SP 3）,Chongyang（ST 42）,Yinlingquan（SP 9）,Zusanli（ST 36）,etc.,once every two days.In the observation group,on the basic treatment as the control group,the auricular acupuncture was applied to Pi（CO13）,Wei（CO4）,Fei（CO14）,Shen（CO10）,etc.,once every 2to 3days.The efficacy was evaluated after 3-month treatment in the two groups.The observation was conducted on the obesity outcomes[body mass,obesity degree（A）,body mass index（BMI）,body fat percentage（F%）],blood-lipoids indicators[such as serum total cholesterol（TC）,triacylglycerol（TG）,low density lipoprotein cholesterol（LDL-C）,high density lipoprotein cholesterol（HDL-C）],fat-islet endocrine axis outcomes [such as fasting plasma glucose（FPG）,fasting leptin（FLP）,fasting insulin（FINS）,insulin sensitivity index（ISI）,insulin resistance index（Homa-IR）and insulinβcell function index（Homa-β）],as well as autonomic nerve function index（Y）before and after treatment in the patients of the two groups.The efficacy was assessed in the two groups.Results The total effective rate was 96.4%（53/55）in the observation group,better than 87.3%（48/55,P〈0.01）in the control group.For the improvements of the obesity indices,the differences were not significant between the two groups（all P〈0.05）.Before treatment,the levels of TC,TG,LDL-C,FLP,FPG,FINS and Homa-IR in the two groups were all significantly higher than those in the healthy group（all P〈0