肥胖講課課件

肥胖的診斷方法

Thediagnosticmethodofobesity最常用的指標(biāo)是體質(zhì)指數(shù)（BMI）ThecommonindexisBMI.BMI=體重weight（kg）／身高2（m2）height腰髖周徑比值：腰部周徑是指在第12肋下緣水平，髖部周徑是指臀部最大周徑，此值大于0.72可診為肥胖Ratioofwaist-coxagirth:thisratiowhichisbiggerthan0.72canbediagnosedasObesity.lumbargirthreferstothegirthencirclingthelowerof12thrib.Thesciaticgirthreferstothelongestgirthofbuttocks.肥胖按發(fā)病機(jī)制和病因可以分為單純性（占95％）和繼發(fā)性兩類：單純性肥胖包括體質(zhì)性和獲得性兩類Obesitycanbeclassifiedassimpleobesityandsecondaryobesityaccordingtoetiologyandpathogenesis.Thesimpleobesityincludesconstitutionaltypeandobtainingtype.體質(zhì)性肥胖是自童年起發(fā)病Theconstitutionalobesitycomesonfromchildhood.獲得性肥胖包括產(chǎn)后肥胖，更年期肥胖（性腺功能減退）等Theobtainingobesityincludespostpartumfatnessandmenopausefatness(hypogonadism)etc.繼發(fā)性肥胖分為下丘腦病、垂體病、胰島病、甲狀腺功能減退癥、腎上腺皮質(zhì)功能亢進(jìn)癥、性腺功能減弱癥等Thesecondaryobesityreferstofatnessaccompanyingwithhypothalamusdisease,pituitarydisease,pancreasdisease,hypothyroiddisease,-----,hypogonadismdisease.取得良好療效的就診者情況是thesituationofpatientswhotookgoodeffectisthefactthat:①單純性肥胖者中的體質(zhì)性肥胖占10.2％,獲得性肥胖者占35.2％；產(chǎn)后肥胖患者占5.7％Theconstitutionalobesityaccountsfor10.2％andtheobtainingobesityaccountsfor35.2％ofsimpleobesitypatients,postpartumfatnessaccountsfor5.7％.②繼發(fā)性肥胖者中的更年期肥胖患者占10.3％Themenopausefatnessaccountsfor10.3％ofsecondaryobesitypatients.③超重者占33.5％，正常體重追求瘦身者，占10％Theoverweight-patientsaccountfor33.5％,thenaturalweightpatientswhowanttoloseweightaccountfor10％.⑤其它占5.3％theothersaccountfor5.3％減肥機(jī)理-內(nèi)分泌功能調(diào)整

themechanismoflosingweight---regulatingthefunctionofincretion單純性肥胖多有內(nèi)分泌紊亂，各種激素，尤其是胰島素、性激素、腎上腺皮質(zhì)激素、瘦素等異常Thesimpleobesityhasturbulenceofincretionmostlyandabnormityofeveryincretionespeciallyforinsulin,sexhormone,adrenaline,---.減肥有一個(gè)過程，治療時(shí)從調(diào)節(jié)食欲、調(diào)節(jié)體脂動(dòng)員機(jī)制、建立和鞏固新建的代謝平衡點(diǎn)3個(gè)方面入手Losingweighthasalongterm.Westartswiththreefactorsasregulatingappetite,regulatingmechanismoffatmobilization,establishingandconsolidatingnewmetabolismbalancewhentreating.制定一個(gè)循序漸進(jìn)、療效逐漸積累的方案是實(shí)現(xiàn)這一目的的可靠保證Formulatingaschemewhichproceedsinanorderlyway,----theeffectaccumulatesgraduallyisreliableguaranteethatachievethegoal.針刺減肥療效是一個(gè)累積的過程，治療前后體重變化可分為三期:Theeffectoflosingweightwithacupunctureisaaccumulativecourse.Thechangeofweightcanbeclassifiedasthreestagesaroundthetreatment.①快速減重期（l－4周）：迅速減少原體重的5％thestageoflosingweightquickly(1-4week):losing5％offormerweightquickly②平臺(tái)調(diào)整期（4－12周）：體重變化不大，但其體內(nèi)的脂肪分布會(huì)有所變化，脂肪會(huì)減少thestageofflatregulation(4-12week):Thechangeofweightisnotbig,butdistributionofbodyfatcanhavethechangeandthefatcanreduce.③穩(wěn)定緩慢減重期（12周以后）：緩慢減少原體重的5％thestageoflosingweightsteadilyandtardily(after12week):losing5％offormerweighttardily.

初期治療

earliertreatment針刺動(dòng)員了機(jī)體的能量利用機(jī)制，使攝入的能量不再積聚，機(jī)體為了維持原有的代謝平衡，動(dòng)員了積存的脂肪，使體重快速下降Theacupuncturehadmobilizedusingmechanismofbodyenergy,maketheenergynotaccumulate.thebodymobilizesaccumulatedfattomakeweightlosequicklyformaintainingformermetabolismbalance.穩(wěn)定期

steadystage機(jī)體形成較高的代謝平衡點(diǎn)，進(jìn)一步動(dòng)員積存的脂肪，從而進(jìn)入穩(wěn)定緩慢減重期，收到持久的治療效果。Thebodyformulatesthehighermetabolismbalanceandmobilizesaccumulatingfatfarther,sogoesthestageoflosingweightsteadilyandtardilyandreceivescontinuingeffectfinally.辨證取穴

acupointselection經(jīng)脈meridian軀干穴pointoftrunk四肢穴pointoflimb胃經(jīng)天樞、歸來、水道梁丘、足三里、豐隆、Stomachmeridian石門、滑肉門、上巨虛、下巨虛、內(nèi)庭脾經(jīng)腹結(jié)、大橫陰陵泉、三陰交、血海Spleenmeridian肝經(jīng)期門太沖、曲泉livermeridian任脈中脘、關(guān)元、氣海、Renmeridian中極、水分督脈肺俞、脾俞、胃俞、Dumeridian膏盲俞大腸經(jīng)曲池Largemeridian心包經(jīng)內(nèi)關(guān)Pericardiummeridian膽經(jīng)帶脈、日月、Gallbladdermeridian

電針方案

Electro-acupuncturescheme腹部電針穴位：帶脈、天樞、水道、歸來Thepointofabdomenwithelectro-acupuncture:GB26,ST25,ST29,ST28疏密波，留針30分鐘sparse-densewave,theneedlesareretainedfor30minutes.耳針

earacupuncture耳針是維持針刺治療期間有效刺激量的最佳措施之一Earacupuncturetherapyisoneofbestmeasuresthatcanmaintaineffectivestimulationattheperiodoftreatment.具體方法：每次針刺完畢后，在雙側(cè)的饑點(diǎn)、三焦、內(nèi)分泌、神門、脾等耳穴點(diǎn)貼壓王不留行籽，囑患者每次進(jìn)餐前半小時(shí)自行按壓各穴50次concretemethod:stickandpress-----tohungerpoints,sanjiaopoints,Shenmen,Spleen,Endocrinepointsoftwosidesafteracupunctureeverytimeandtellthepatientstopresspoints50timeshalfhourbeforeeating.穴位埋線

imbeddingthreadtopoints專用一次性埋線器具，將蛋白線埋入相應(yīng)的穴位，產(chǎn)生持久而溫和的物理、生理、生化刺激thespecialandone-offapparatusofimbeddingthread.imbedproteinthreadintocorresponding