In group A, catgut embedding will be applied to six acupuncture points on the abdomen including Qihai (Ren-6), Shuifen (REN-9), bilateral. Embedding is a method of acupuncture in which catgut is embedded in acupuncture points instead of needles. The current case report. 1School of Acupuncture-Moxibustion and Tuina and Rehabilitation, Acupoint catgut embedding (ACE) was applied widely to antiweight in.
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Obesity is a major health problem worldwide for which conventional therapy efficacy is limited. Traditional Chinese medicine, particularly body acupoint stimulation, provides an alternative, effective, and safe therapy for this medical challenge.
The present study was designed to compare the effects of distinct methods to stimulate the same set of acupoints, on anthropometric and biochemical parameters in obese women. Ninety-nine obese women were randomly assigned to six groups of treatment: Acupuncture with moxibustion, long needle acupuncture with moxibustion, electroacupuncture EAEA with moxibustion, embedded catgut with moxibustion CGM and sham acupuncture as control.
Acupoint catgut embedding therapy with moxibustion reduces the risk of diabetes in obese women
Body weight and BMI cxtgut significantly reduced in response to all treatments. Interestingly, acupoint catgut embedding therapy combined with moxibustion was the only treatment that produced a significant reduction in body weight 3.
Furthermore, this treatment was able to bring back obese women to a state of insulin sensitivity, indicating that acupoint catgut embedding therapy combined with moxibustion could be useful as a complementary therapy to reduce the risk of diabetes associated to obesity in women. Overall, our results confirmed the effectiveness of acupoints stimulation to assist in the control of body weight in women.
They also highlighted the more favorable effects of embedded catgut-moxibustion combination that may be due to the extended and consistent stimulation of acupoints. Obesity is a worldwide public health problem. Treatment of obesity requires a balanced diet and physical exercise. Pharmacological therapy and bariatric surgery represent an option in selected cases. In the last decade, many people have turned to complementary and alternative medicine to aid with weight loss.
Several reports showed the beneficial effects of acupoint stimulation for obesity control. Moreover, insulin sensitivity remained for a 1-year period, demonstrating the sustained effects of this method.
Here, we aimed to compare the effects of the stimulation of the same set of acupoints by distinct methods, namely, acupuncture, EA, moxibustion and catgut embedding, in obese women. Specifically, we evaluated changes in anthropometric and biochemical parameters related to obesity in response to each treatment.
The current study was designed as a randomized, placebo-controlled, clinical study. Smokers or alcoholic participants, pregnant or breast-feeding women, and patients with previous acupuncture or drug treatment for obesity in the last 6 months, were excluded. Patients who failed to attend at least one session were eliminated. The research was conducted in accordance with the last update of Helsinki declaration.
All selected participants signed the informed consent. The study was single blind, i. Acupuncture points were selected to cover the main syndromes related to obesity according to TCM as follows: For the AM group, sterile stainless-steel acupuncture needles Natural 1. For LNAM protocol, 1.
The main advantage of EA is that the insertion of needles does not require extreme precision because the current delivered through the needle stimulates a larger area than the needle itself. The catgut thread was later completely absorbed by the body about days.
BL20 and BL23 points were also stimulated with moxibustion. Finally, sham acupuncture involved the use of stainless-steel needles covered with a plastic film and a cap to avoid needle insertion, as previously described by Catgyt and Yajima. For CGM group, catgut was implanted each 3-week, for a total of 6-week, whereas moxibustion was applied enbedding a week. Patients were asked to keep their usual lifestyle, including their diet and physical activity. These recommendations were reinforced at each session all over the protocol.
A standard health questionnaire with a complete medical history was administered by a physician at the beginning of the protocol; age and anthropometric values were also assessed.
Height m was measured to the nearest centimeter using a rigid stadiometer. Embeddding was calculated and expressed in kilogram per meter square following World Health Organization recommendations. Waist circumference cm was measured midway between the lateral lower rib margin and the iliac crest, to the nearest 0.
A venous embdding sample was taken from the left cubital vein at Insulin acuouncture was determined by the homeostasis model of assessment – insulin resistance HOMA-IRusing the following formula: Prism 5 GraphPad Software, Inc. The paired Student’s t -test was used to compare initial and final data in each group.
ANOVA-Tukey’s multiple comparison test was used to compare mean age, baseline anthropometric and biochemical data, as well as mean changes of each parameter between groups. All treatments were very well-tolerated, and none of the obese women suspended the therapy due to adverse side-effects. Most patients reported a reduction of appetite and anxiety; some of them also reported an increase in energy.
Unfortunately, these data were not rigorously documented by the physician. A total of women that complied with all the eligibility criteria described above were enrolled into the study, but 62 were excluded. During the treatment period, several women were eliminated because they failed to attend at least one session and only 99 women completed the protocol [ Figure 1 ]. Mean age was Body weight range was Smokers or alcoholic women, pregnant or breast feeding women, and women with previous acupuncture or drug treatment for obesity in the last 6 months, were excluded.
The study was designed as a randomized, placebo-controlled and single blind study.
Evidence-Based Complementary and Alternative Medicine
Mean age and baseline anthropometric data are described in Table 1. Mean BMI was between Initial and final values of anthropometric parameters in the different groups of treatment. A comparative analysis between groups revealed that body weight was significantly reduced in response to all treatments in comparison with the sham group, according to ANOVA-Tukey’s test. Consequently, BMI was also significantly reduced in all groups when compared with sham group. In contrast, no changes were observed in waist circumference, hip circumference, or WHR in patients from all groups at the end of the protocol [ Table 1 ].
Comparative analyses of changes in weight abody mass index binsulin c and homeostasis model of assessment – insulin resistance d between groups of treatment.
Mean baseline biochemical data are described in Table 2. Patients in all groups have high triglycerides values, while cholesterol concentrations were in normal range except in EA group. Glucose and insulin concentrations were in normal range, indicating that subjects were not diabetic.
Initial and final values of biochemical parameters in the different groups of treatment. But these changes were not significant in comparison with sham and other groups, when data were compared using ANOVA test data not shown. In contrast, cholesterol was not affected [ Table 2 ].
Multiple comparison analysis revealed that changes in triglycerides and glucose were not significant in comparison with sham and other groups, when data were compared using ANOVA test data not shown.
In the last decade, there is an increasing interest for alternative medicine, such as the TCM, to help for obesity control, which represents a major public health problem worldwide. Notably, different acupuncture related methods involving the stimulation of body acupoints, have been reported as safe and efficient therapies to reduce body weight and associated parameters. The results of the present study confirm that 6-week treatments based on the stimulation of the same set of acupoints by AM, LNAM, EA, EAM, and embedded catgut with moxibustion CGM were able to significantly reduce body weight and BMI in obese women, as it has been previously reported by different groups.
Moreover, our data validate that CV6, CV12, ST25, ST36, and SP6, as well as BL20 and BL23 acupuncture points, are relevant for regulating anthropometric parameters, whatever the method used for stimulation, probably because these acupoints cover most syndromes that are related to obesity according to TCM. The fact that body weight and BMI were slightly reduced in sham group suggests a placebo effect, since patients claimed they did not modify their diet and physical activity.
Importantly, these slight changes were not associated with changes in biochemical parameters in this control group. In contrast, in most groups of treatment, body weight and BMI reduction was associated with a significant modulation of biochemical parameters, mainly triglycerides, glucose, and insulin, but not cholesterol.
Particularly, triglyceride reduction observed in patients from EA and EAM groups is in agreement with other reports that showed the effect of strong voltage V Hz and dense-disperse wave EA to efficiently reduce triglycerides.
However, our results evidence that their combination could be an interesting complementary strategy to control body weight. Interestingly, acupoint catgut embedding therapy with moxibustion was the only treatment that produced a significant reduction of triglycerides as previously reported,[ 202526 ] with a decrease of glucose, insulin and HOMA-IR index.
All treatments involved the stimulation of the same set of acupoints CV6, CV12, ST25, ST36, and SP6, as well as BL20 and BL23during the same number of weeks, which strongly suggests that the better effects observed in response to acupoint catgut embedding therapy with moxibustion were directly related to the method used to stimulate these acupoints.
Moreover, results evidenced a decrease in both serum and hypothalamic levels of leptin, an adipokine that suppresses appetite and promotes energy metabolism. Although acupoint catgut embedding therapy can be used alone to control obesity, it seems that its combination with another TCM method enhances the effects. Indeed, Tang et al. The better effects of acupoint catgut embedding therapy may be related to the persistent stimulation produced by the suture at the acupoints.
It has been reported that the combined effects of proteolytic enzymes and macrophage action against the absorbable surgical thread may improve and extend the acupoint stimulation during days as a consequence of the mild irritation in subcutaneous tissue.
Our comparative analysis confirmed the efficiency of acupoint stimulation to significantly reduce body weight, BMI, and several biochemical parameters in obese women, without producing adverse side-effects. Most importantly, our results highlighted that acupoint catgut embedding therapy with moxibustion was also able to reverse insulin resistance, which indicates that acupoint catgut embedding therapy may represent an interesting health strategy to control obesity and its associated comorbidities.
However, this study has some limitations, such as the small sample size of each group of treatment, the short duration of the treatment only 6-weekthe use of acupoints without considering the TCM syndromes of each patient, the lack of a systematic control of dietary and physical activity records, and the absence of an appropriate follow-up of possible body weight rebound.
Further studies including larger sample sizes, the stimulation of acupoints according to TCM syndromes of each patients, and a longer protocol are needed to demonstrate that acupoint catgut embedding therapy with moxibustion is able to control body weight and insulin resistance in obese women. JMGV collected and processed anthropometric and biochemical data, performed statistical analyses, participated in manuscript preparation.
CGH provided assistance in design of the study, data processing and manuscript preparation. FBC acupunctuee assistance in recruitment and treatment of patients, data collection and manuscript preparation. FLR provided assistance in the design of the study, analyzed data, and participated in manuscript preparation.
AZC provided assistance for data collection and statistical analyses, and participated in manuscript preparation. CLC provided assistance in the design of the study, and participated in datgut preparation. LAM carried out the design of the study, coordinated the study and wrote the manuscript.
All authors have read and approved the content of the final version. In addition, they all agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
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