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Article(id=1322928110554972808, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926740955341011, articleNumber=null, orderNo=null, doi=10.13193/j.issn.1673-7717.2025.10.018, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=null, receivedDateStr=null, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793340240372, onlineDateStr=2026-10-30, pubDate=1760025600000, pubDateStr=2025-10-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793340240372, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793340240372, creator=13701087609, updateTime=1793340240372, updator=13701087609, issue=Issue{id=1322926740955341011, tenantId=1146029695717560320, journalId=1255847919539208197, year='2025', volume='43', issue='10', pageStart='1', pageEnd='258', issueExtLink='null', onlineDate='null', pubDate='1760025600000', pubDateStr='2025-10-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793339913834, creator='13701087609', updateTime=1793340753123, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322930261259846420, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926740955341011, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322930261259846421, tenantId=1146029695717560320, journalId=1255847919539208197, issueId=1322926740955341011, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=85, endPage=89, ext={EN=ArticleExt(id=1322928112085893769, articleId=1322928110554972808, tenantId=1146029695717560320, journalId=1255847919539208197, language=EN, title=Clinical Study on Treatment of Simple Obesity in Children（Spleen Deficiency and Dampness-Blocking Syndrome）with Fangji Huangqi Decoction（防己黄芪汤）Combined with Acupuncture and Tuina Based on“Correspondence of Prescription and Syndrome”, columnId=1256183361521967297, journalTitle=Chinese Archives of Traditional Chinese Medicine, columnName=Target on National Project, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the effect of Fangji Huangqi Decoction（防己黄芪汤）combined with acupuncture and Tuina on simple obesity in children with spleen deficiency and dampness-blocking syndrome based on“correspondence of prescription and syndrome”.

Method

A total of 80 children with simple obesity with spleen deficiency and dampness-blocking syndrome treated in the hospital from January 2023 to December 2024 were included as the study objects.They were divided into two groups by random number table method.Forty cases in the control group were given basic sports nutrition treatment，and the other forty cases in the observation group were combined with acupuncture and Tuina treatment based on“prescription and syndrome corresponding”.The treatment effect and obesity indexes including weight，waist circumference，body mass index，TCM syndrome score，blood lipid level and glucose metabolism related indexes were compared between the two groups.

Results

The total effective rate of the observation group was 95.0%（38/40），which was much higher than that of the control group（72.5%，29/40），and the difference was significant（P<0.05）.After treatment，the scores of obesity，edema，body weight，fatigue，waist circumference，hip circumference，body mass index（BMI）and waist-hip ratio in the observation group were lower than those in the control group（P<0.05）.After treatment，the levels of total cholesterol（TC），triglycerides（TG）and low-density lipoprotein cholesterol（LDL-C）in the observation group were lower than those in the control group，and high-density lipoprotein cholesterol（HDL-C）was higher than that in the control group（P<0.05）.After treatment，the levels of fasting plasma glucose（FPG），fasting insulin（FINS）and homeostatic model assessment of insulin resistance（HOMA-IR）in the observation group were lower than those in the control group（P<0.05）.

Conclusion

For simple obesity children with spleen deficiency and dampness-blocking syndrome，Fengji Huangqi Decoction combined with acupuncture and Tuina based on“correspondence of prescription and syndrome”can effectively reduce body fat parameters such as body mass，waist circumference and BMI，regulate blood lipid levels，improve glucose and lipid metabolism，and help to reduce health risks brought by obesity，improve the quality of life and overall health level.

, authors=Haixu LONG, Hongyan ZHAN, Wenwen DI, Meimei TANG, authorsList=Haixu LONG, Hongyan ZHAN, Wenwen DI, Meimei TANG, authorCompany=null, correspAuthors=Hongyan ZHAN, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322928113847501460, articleId=1322928110554972808, tenantId=1146029695717560320, journalId=1255847919539208197, language=CN, title=基于“方证相应”防己黄芪汤联合针灸推拿治疗儿童单纯性肥胖（脾虚湿阻证）的临床研究, columnId=1256183362172142382, journalTitle=中华中医药学刊, columnName=国家项目点击, runingTitle=null, highlight=null, articleAbstract=
目的

分析基于“方证相应”的防己黄芪汤联合针灸推拿治疗儿童单纯性肥胖脾虚湿阻证的效果。

方法

纳入2023年1月—2024年12月医院收治的脾虚湿阻证单纯性肥胖儿童80例为研究对象，随机数字表法分为两组，40例对照组予以运动营养基础治疗，40例观察组在此基础上予以基于“方证相应”的防己黄芪汤联合针灸推拿治疗。对比两组治疗效果，肥胖指标包括体质量、腰围、体质量指数，中医证候积分及血脂水平、糖代谢相关指标变化情况等。

结果

观察组治疗总有效率为95.0%（38/40），高于对照组的72.5%（29/40），组间比较差异有统计学意义（P<0.05）；治疗后观察组肥胖浮肿、肢体沉重、疲倦乏力三项中医症状积分及腰围、臀围、BMI、腰臀比均低于对照组（P<0.05）；治疗后观察组总胆固醇（Total Cholesterol，TC）、甘油三酯（Triglycerides，TG）、低密度脂蛋白胆固醇（Low-Density Lipoprotein Cholesterol，LDL-C）水平低于对照组，高密度脂蛋白胆固醇（High-Density Lipoprotein Cholesterol，HDL-C）高于对照组（P<0.05）；治疗后观察组空腹血糖（Fasting Plasma Glucose，FPG）、空腹胰岛素（Fasting Insulin，FINS）、胰岛素抵抗稳态模型评估指数（Homeostatic Model Assessment of Insulin Resistance，HOMA-IR）水平低于对照组（P<0.05）。

结论

对脾虚湿阻证单纯性肥胖儿童予以基于“方证相应”的防己黄芪汤联合针灸推拿治疗能有效降低患儿体质量、腰围、BMI等体脂参数，调节血脂水平，改善糖脂代谢情况，有助于降低肥胖带来的健康风险，改善患儿的生活质量，提高其整体健康水平。

, authors=龙海旭, 詹红艳, 狄雯雯, 唐美美, authorsList=龙海旭, 詹红艳, 狄雯雯, 唐美美, authorCompany=null, correspAuthors=詹红艳, authorNote=

龙海旭（1988-），女，湖南邵阳人，主治医师，硕士，研究方向：中医儿科、儿童生长发育。

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詹红艳（1979-），女，湖南益阳人，副主任医师，学士，研究方向：中医儿科疾病诊疗。E-mail：。
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龙海旭（1988-），女，湖南邵阳人，主治医师，硕士，研究方向：中医儿科、儿童生长发育。

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龙海旭（1988-），女，湖南邵阳人，主治医师，硕士，研究方向：中医儿科、儿童生长发育。

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rfNumber=［26］, rfOrder=25, authorNames=姜健, 胡春平, 陈见纺, journalName=中医药信息, refType=null, unstructuredReference=姜健，胡春平，陈见纺，等. 防己黄芪汤联合穴位埋线治疗脾虚痰湿型单纯性肥胖的回顾性队列研究［J］. 中医药信息，2024，41（4）：55-60., articleTitle=防己黄芪汤联合穴位埋线治疗脾虚痰湿型单纯性肥胖的回顾性队列研究, refAbstract=null), Reference(id=1322928123255325411, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928110554972808, doi=null, pmid=null, pmcid=null, year=2020, volume=39, issue=4, pageStart=152, pageEnd=154, url=null, language=null, rfNumber=［27］, rfOrder=26, authorNames=叶薇, journalName=中外医疗, refType=null, unstructuredReference=叶薇. 中药加味温胆汤治疗小儿单纯性肥胖效果分析［J］. 中外医疗，2020，39（4）：152-154., articleTitle=中药加味温胆汤治疗小儿单纯性肥胖效果分析, refAbstract=null), Reference(id=1322928123318239972, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928110554972808, doi=null, pmid=null, pmcid=null, year=2023, volume=38, issue=11, pageStart=2443, pageEnd=2453, url=null, language=null, rfNumber=［28］, rfOrder=27, authorNames=姜健, 严军, journalName=中医学报, refType=null, unstructuredReference=姜健，严军. 基于网络药理学和分子对接技术探讨防己黄芪汤治疗单纯性肥胖的作用机制［J］. 中医学报，2023，38（11）：2443-2453., articleTitle=基于网络药理学和分子对接技术探讨防己黄芪汤治疗单纯性肥胖的作用机制, refAbstract=null), Reference(id=1322928123389543141, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928110554972808, doi=null, pmid=null, pmcid=null, year=2019, volume=13, issue=13, pageStart=145, pageEnd=146, url=null, language=null, rfNumber=［29］, rfOrder=28, authorNames=梁炳君, 沈维增, 廖圣榕, journalName=中国现代药物应用, refType=null, unstructuredReference=梁炳君，沈维增，廖圣榕. 俞募配穴法穴位埋线联合加味苓桂术甘汤治疗脾虚痰浊型单纯性肥胖的临床研究［J］. 中国现代药物应用，2019，13（13）：145-146., articleTitle=俞募配穴法穴位埋线联合加味苓桂术甘汤治疗脾虚痰浊型单纯性肥胖的临床研究, refAbstract=null), Reference(id=1322928123452457702, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928110554972808, doi=null, pmid=null, pmcid=null, year=2020, volume=29, issue=26, pageStart=2924, pageEnd=2927, url=null, language=null, rfNumber=［30］, rfOrder=29, authorNames=李亚娟, 沈小璇, 袁婕, journalName=现代中西医结合杂志, refType=null, unstructuredReference=李亚娟，沈小璇，袁婕. 防己黄芪汤联合循经推腹法治疗脾虚湿阻型单纯性肥胖疗效观察［J］. 现代中西医结合杂志，2020，29（26）：2924-2927., articleTitle=防己黄芪汤联合循经推腹法治疗脾虚湿阻型单纯性肥胖疗效观察, refAbstract=null), Reference(id=1322928123523760871, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928110554972808, doi=null, pmid=null, pmcid=null, year=2022, volume=33, issue=2, pageStart=194, pageEnd=200, url=null, language=null, rfNumber=［31］, rfOrder=30, authorNames=陈浩, 易玉柳, 钟凌云, journalName=中药新药与临床药理, refType=null, unstructuredReference=陈浩，易玉柳，钟凌云，等. 固本化湿降脂汤调节脾虚湿阻型单纯性肥胖大鼠代谢异常的相关性研究［J］. 中药新药与临床药理，2022，33（2）：194-200., articleTitle=固本化湿降脂汤调节脾虚湿阻型单纯性肥胖大鼠代谢异常的相关性研究, refAbstract=null), Reference(id=1322928123578286824, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928110554972808, doi=null, pmid=null, pmcid=null, year=2013, volume=20, issue=2, pageStart=112, pageEnd=114, url=null, language=null, rfNumber=［32］, rfOrder=31, authorNames=柯斌, 师林, 张俊杰, journalName=中国中医药科技, refType=null, unstructuredReference=柯斌，师林，张俊杰，等. 加味苓桂术甘汤联合短期禁食治疗单纯性肥胖患者的安全性研究［J］. 中国中医药科技，2013，20（2）：112-114., articleTitle=加味苓桂术甘汤联合短期禁食治疗单纯性肥胖患者的安全性研究, refAbstract=null)], funds=[Fund(id=1322928121325945542, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928110554972808, awardId=国中医药人教函〔2022〕76号, language=CN, fundingSource=国家中医药管理局第七批全国老中医药专家学术经验继承项目(国中医药人教函〔2022〕76号), fundOrder=null, country=null), Fund(id=1322928121393054407, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928110554972808, awardId=W20243267, language=CN, fundingSource=湖南省卫生健康委员会科研项目(W20243267), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1322928114317263509, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928110554972808, xref=null, ext=[AuthorCompanyExt(id=1322928114338235030, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928110554972808, 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组别例数显效有效无效总有效
观察组4027（67.5）11（27.5）2（5.0）38（95.0）
对照组4016（40.0）13（32.5）11（27.5）29（72.5）
χ2值5.792 3
P值0.000 0
), ArticleFig(id=1322928119019078333, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928110554972808, language=CN, label=表1, caption=

两组脾虚湿阻证单纯性肥胖儿童治疗效果比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数显效有效无效总有效
观察组4027（67.5）11（27.5）2（5.0）38（95.0）
对照组4016（40.0）13（32.5）11（27.5）29（72.5）
χ2值5.792 3
P值0.000 0
), ArticleFig(id=1322928119081992894, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928110554972808, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数肥胖浮肿肢体沉重疲倦乏力
治疗前治疗后治疗前治疗后治疗前治疗后
观察组404.59±1.261.26±0.25*3.58±1.271.19±0.42*3.29±1.021.17±0.29*
对照组404.61±1.272.35±0.14*3.59±1.242.17±0.27*3.17±1.272.38±0.17*
t值0.708 09.717 10.189 313.587 40.357 713.489 7
P值0.480 60.000 00.248 90.000 00.194 30.000 0
), ArticleFig(id=1322928119149101759, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928110554972808, language=CN, label=表2, caption=

两组脾虚湿阻证单纯性肥胖儿童中医症状积分变化情况比较（）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数肥胖浮肿肢体沉重疲倦乏力
治疗前治疗后治疗前治疗后治疗前治疗后
观察组404.59±1.261.26±0.25*3.58±1.271.19±0.42*3.29±1.021.17±0.29*
对照组404.61±1.272.35±0.14*3.59±1.242.17±0.27*3.17±1.272.38±0.17*
t值0.708 09.717 10.189 313.587 40.357 713.489 7
P值0.480 60.000 00.248 90.000 00.194 30.000 0
), ArticleFig(id=1322928120881349312, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928110554972808, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数腰围/（cm）臀围/（cm）BMI/（kg/m2）腰臀比
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
观察组4096.25±5.2885.26±8.43*105.95±9.52 92.25±6.24*25.21±2.1717.55±3.48*0.93±0.090.82±0.04*
对照组4096.35±5.4791.25±7.95*105.72±9.73 99.27±7.48*25.25±2.1523.58±4.72*0.92±0.070.89±0.05*
t值1.130 542.110 70.817 73.604 50.774 49.356 50.247 38.484 2
P值0.262 10.028 30.416 50.011 20.441 30.021 00.248 70.000 0
), ArticleFig(id=1322928120948458177, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928110554972808, language=CN, label=表3, caption=

两组脾虚湿阻证单纯性肥胖儿童肥胖相关指标变化情况比较（）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数腰围/（cm）臀围/（cm）BMI/（kg/m2）腰臀比
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
观察组4096.25±5.2885.26±8.43*105.95±9.52 92.25±6.24*25.21±2.1717.55±3.48*0.93±0.090.82±0.04*
对照组4096.35±5.4791.25±7.95*105.72±9.73 99.27±7.48*25.25±2.1523.58±4.72*0.92±0.070.89±0.05*
t值1.130 542.110 70.817 73.604 50.774 49.356 50.247 38.484 2
P值0.262 10.028 30.416 50.011 20.441 30.021 00.248 70.000 0
), ArticleFig(id=1322928121015567042, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928110554972808, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数TCTGLDL-CHDL-C
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
观察组405.38±0.583.85±0.24*2.48±0.261.59±0.25*3.27±0.242.51±0.42*0.91±0.251.43±0.25*
对照组405.37±0.424.73±0.27*2.47±0.251.86±0.37*3.29±0.272.85±0.52*0.92±0.271.13±0.27*
t值0.148 29.474 40.297 211.262 50.341 28.482 60.185 311.284 3
P值0.248 30.000 00.182 60.000 00.276 20.000 00.248 20.000 0
), ArticleFig(id=1322928121082675907, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928110554972808, language=CN, label=表4, caption=

两组脾虚湿阻证单纯性肥胖儿童血脂指标变化情况比较（）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数TCTGLDL-CHDL-C
治疗前治疗后治疗前治疗后治疗前治疗后治疗前治疗后
观察组405.38±0.583.85±0.24*2.48±0.261.59±0.25*3.27±0.242.51±0.42*0.91±0.251.43±0.25*
对照组405.37±0.424.73±0.27*2.47±0.251.86±0.37*3.29±0.272.85±0.52*0.92±0.271.13±0.27*
t值0.148 29.474 40.297 211.262 50.341 28.482 60.185 311.284 3
P值0.248 30.000 00.182 60.000 00.276 20.000 00.248 20.000 0
), ArticleFig(id=1322928121166561988, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928110554972808, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数FPG/（mmol/L）FINS/（mU/mL）HOMA-IR
治疗前治疗后治疗前治疗后治疗前治疗后
观察组406.17±0.234.16±0.35*17.24±2.489.27±1.27*4.79±0.322.21±0.21*
对照组406.19±0.245.17±0.21*17.25±2.4711.35±2.48*4.81±0.252.63±0.59*
t值0.357 19.472 20.248 211.357 10.234 88.264 7
P值0.189 50.000 00.354 70.000 00.148 40.000 0
), ArticleFig(id=1322928121229476549, tenantId=1146029695717560320, journalId=1255847919539208197, articleId=1322928110554972808, language=CN, label=表5, caption=

两组脾虚湿阻证单纯性肥胖儿童血糖指标水平变化情况比较（）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数FPG/（mmol/L）FINS/（mU/mL）HOMA-IR
治疗前治疗后治疗前治疗后治疗前治疗后
观察组406.17±0.234.16±0.35*17.24±2.489.27±1.27*4.79±0.322.21±0.21*
对照组406.19±0.245.17±0.21*17.25±2.4711.35±2.48*4.81±0.252.63±0.59*
t值0.357 19.472 20.248 211.357 10.234 88.264 7
P值0.189 50.000 00.354 70.000 00.148 40.000 0
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基于“方证相应”防己黄芪汤联合针灸推拿治疗儿童单纯性肥胖（脾虚湿阻证）的临床研究
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龙海旭 , 詹红艳 , 狄雯雯 , 唐美美
中华中医药学刊 | 国家项目点击 2025,43(10): 85-89
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中华中医药学刊 |国家项目点击 2025 , 43 (10) : 85 -89
基于“方证相应”防己黄芪汤联合针灸推拿治疗儿童单纯性肥胖（脾虚湿阻证）的临床研究
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龙海旭, 詹红艳 , 狄雯雯, 唐美美
作者信息
  • 湖南中医药大学第二附属医院，湖南 长沙 410005
通讯作者:
詹红艳（1979-），女，湖南益阳人，副主任医师，学士，研究方向：中医儿科疾病诊疗。E-mail：。
作者简介:

龙海旭（1988-），女，湖南邵阳人，主治医师，硕士，研究方向：中医儿科、儿童生长发育。

Clinical Study on Treatment of Simple Obesity in Children（Spleen Deficiency and Dampness-Blocking Syndrome）with Fangji Huangqi Decoction（防己黄芪汤）Combined with Acupuncture and Tuina Based on“Correspondence of Prescription and Syndrome”
Haixu LONG, Hongyan ZHAN , Wenwen DI, Meimei TANG
Affiliations
  • Second Affiliated Hospital of Hunan University of Chinese Medicine，Changsha 410005，Hunan，China
出版时间: 2025-10-10 doi: 10.13193/j.issn.1673-7717.2025.10.018
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摘要
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目的

分析基于“方证相应”的防己黄芪汤联合针灸推拿治疗儿童单纯性肥胖脾虚湿阻证的效果。

方法

纳入2023年1月—2024年12月医院收治的脾虚湿阻证单纯性肥胖儿童80例为研究对象，随机数字表法分为两组，40例对照组予以运动营养基础治疗，40例观察组在此基础上予以基于“方证相应”的防己黄芪汤联合针灸推拿治疗。对比两组治疗效果，肥胖指标包括体质量、腰围、体质量指数，中医证候积分及血脂水平、糖代谢相关指标变化情况等。

结果

观察组治疗总有效率为95.0%（38/40），高于对照组的72.5%（29/40），组间比较差异有统计学意义（P<0.05）；治疗后观察组肥胖浮肿、肢体沉重、疲倦乏力三项中医症状积分及腰围、臀围、BMI、腰臀比均低于对照组（P<0.05）；治疗后观察组总胆固醇（Total Cholesterol，TC）、甘油三酯（Triglycerides，TG）、低密度脂蛋白胆固醇（Low-Density Lipoprotein Cholesterol，LDL-C）水平低于对照组，高密度脂蛋白胆固醇（High-Density Lipoprotein Cholesterol，HDL-C）高于对照组（P<0.05）；治疗后观察组空腹血糖（Fasting Plasma Glucose，FPG）、空腹胰岛素（Fasting Insulin，FINS）、胰岛素抵抗稳态模型评估指数（Homeostatic Model Assessment of Insulin Resistance，HOMA-IR）水平低于对照组（P<0.05）。

结论

对脾虚湿阻证单纯性肥胖儿童予以基于“方证相应”的防己黄芪汤联合针灸推拿治疗能有效降低患儿体质量、腰围、BMI等体脂参数，调节血脂水平，改善糖脂代谢情况，有助于降低肥胖带来的健康风险，改善患儿的生活质量，提高其整体健康水平。

单纯性肥胖儿童  /  脾虚湿阻证  /  防己黄芪汤  /  针灸  /  推拿  /  血脂血糖  /  中西医结合治疗
Objective

To analyze the effect of Fangji Huangqi Decoction（防己黄芪汤）combined with acupuncture and Tuina on simple obesity in children with spleen deficiency and dampness-blocking syndrome based on“correspondence of prescription and syndrome”.

Method

A total of 80 children with simple obesity with spleen deficiency and dampness-blocking syndrome treated in the hospital from January 2023 to December 2024 were included as the study objects.They were divided into two groups by random number table method.Forty cases in the control group were given basic sports nutrition treatment，and the other forty cases in the observation group were combined with acupuncture and Tuina treatment based on“prescription and syndrome corresponding”.The treatment effect and obesity indexes including weight，waist circumference，body mass index，TCM syndrome score，blood lipid level and glucose metabolism related indexes were compared between the two groups.

Results

The total effective rate of the observation group was 95.0%（38/40），which was much higher than that of the control group（72.5%，29/40），and the difference was significant（P<0.05）.After treatment，the scores of obesity，edema，body weight，fatigue，waist circumference，hip circumference，body mass index（BMI）and waist-hip ratio in the observation group were lower than those in the control group（P<0.05）.After treatment，the levels of total cholesterol（TC），triglycerides（TG）and low-density lipoprotein cholesterol（LDL-C）in the observation group were lower than those in the control group，and high-density lipoprotein cholesterol（HDL-C）was higher than that in the control group（P<0.05）.After treatment，the levels of fasting plasma glucose（FPG），fasting insulin（FINS）and homeostatic model assessment of insulin resistance（HOMA-IR）in the observation group were lower than those in the control group（P<0.05）.

Conclusion

For simple obesity children with spleen deficiency and dampness-blocking syndrome，Fengji Huangqi Decoction combined with acupuncture and Tuina based on“correspondence of prescription and syndrome”can effectively reduce body fat parameters such as body mass，waist circumference and BMI，regulate blood lipid levels，improve glucose and lipid metabolism，and help to reduce health risks brought by obesity，improve the quality of life and overall health level.

simple obesity children  /  spleen deficiency and dampness-blocking syndrome  /  Fangji Huangqi Decoction（防己黄芪汤）  /  acupuncture  /  Tuina  /  blood lipid and blood glucose  /  integrated treatment of traditional Chinese and western medicine
龙海旭, 詹红艳, 狄雯雯, 唐美美. 基于“方证相应”防己黄芪汤联合针灸推拿治疗儿童单纯性肥胖（脾虚湿阻证）的临床研究. 中华中医药学刊, 2025 , 43 (10) : 85 -89 . DOI: 10.13193/j.issn.1673-7717.2025.10.018
Haixu LONG, Hongyan ZHAN, Wenwen DI, Meimei TANG. Clinical Study on Treatment of Simple Obesity in Children（Spleen Deficiency and Dampness-Blocking Syndrome）with Fangji Huangqi Decoction（防己黄芪汤）Combined with Acupuncture and Tuina Based on“Correspondence of Prescription and Syndrome”[J]. Chinese Archives of Traditional Chinese Medicine, 2025 , 43 (10) : 85 -89 . DOI: 10.13193/j.issn.1673-7717.2025.10.018
正文
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单纯性肥胖属于一种营养障碍性疾病，多是由于摄入过多热量和缺乏足够的运动而导致体内脂肪积累过多引起的肥胖。近年来，由于饮食结构的变化、生活环境的变化等，单纯性肥胖儿童的发生率呈逐年递增趋势，已成为危害儿童生长发育的一大健康问题[1]。这类肥胖儿童通常没有其他内分泌或代谢疾病的病因，往往表现为体质量超标，体型较同龄儿童更为丰满，甚至出现腹部脂肪堆积的现象。若不加以控制和干预，可能会对儿童的身心健康产生长期的负面影响，包括增加患心血管疾病、糖尿病等慢性疾病的风险，以及影响他们的自信心和社交能力[2]。目前临床对于单纯性肥胖儿童治疗不建议应用药物，多以饮食运动干预为主，但效果欠佳。防己黄芪汤为经典名方，出自张仲景《金匮要略》，在治疗成年单纯性肥胖中，防己黄芪汤已被广泛应用，有益气健脾、通利小便的功效[3]；针灸推拿为中医特色外治疗法，通过对局部穴位的刺激，可以调整经络虚实，具有健脾，促进气升降恢复的作用，达到调节体质量的目的[4]。鉴于此，本次研究对脾虚湿阻证单纯性肥胖儿童予以基于“方证相应”的防己黄芪汤联合针灸推拿治疗，获得较好效果。现报道如下。
1　临床资料
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1.1　一般资料
纳入2023年1月—2024年12月我院收治的脾虚湿阻证单纯性肥胖儿童80例为研究对象，随机数字表法分为两组。对照组40例包括22例男童与18例女童，年龄7～12岁，平均（8.59±1.25）岁；体质量为（58.92±25.62）kg，体质量指数（BMI）为（25.25±2.15）kg/m2。观察组40例包括21例男童与19例女童，年龄6～13岁，平均（8.63±1.27）岁；体质量为（59.36±26.35）kg，BMI为（25.21±2.17）kg/m2。两组患者上述资料比较差异无统计学意义（P>0.05），可比性较好。本研究经患儿及家属充分知情同意，并签署知情同意书，经单位伦理委员会审批通过。
1.2　诊断标准
1.2.1　西医诊断标准
符合《儿科学》[5]《中国儿童肥胖诊断评估与管理专家共识》[6]中关于儿童单纯肥胖症的相关诊断标准：实测体质量超过标准体质量的20%以上；其中20%～29%为轻度肥胖；30%～49%为中度肥胖；超过50%者为重度肥；6～14岁单纯性肥胖儿童BMI值参照中国肥胖问题工作组的《中国学龄儿童青少年超重、肥胖筛查体重指数值分类标准》[7]。
1.2.2　中医辨证标准
①参照《中药新药临床研究指导原则》[8]及《中医儿科学》[9]中关于儿童单纯肥胖症的相关诊断标准，辨证为脾虚湿阻证，主症表现为形态肥胖、浮肿、肢体沉重、疲倦乏力、脘腹胀满，次症表现为便溏尿少，脉细沉，舌苔白腻，舌质淡红。兼具上述主症及2项以上次症，结合舌、脉即可明确诊断。
1.3　纳入标准
①患者均符合上述中西医相关诊断标准；②患儿家属签署知情同意书；③临床资料完善；④年龄6～13岁。
1.4　排除标准
①甲状腺功能低下、垂体功能异常、生长激素缺乏等疾病导致的继发性肥胖；②由于长期服用精神类药物、糖皮质激素类药物或抗癫痫类药物等导致的继发性肥胖；③合并精神类疾病，无法配合研究者；④对本次药物过敏患者；⑤畏惧针刺、既往有过晕针或无法配合并坚持治疗者；⑥正在参加其他临床试验，或近3个月内曾经参加其他临床试验者。
2　方法
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2.1　治疗方法
2.1.1　对照组
予以运动营养基础治疗包括有氧运动、饮食调整和控制等。运动方案可根据儿童自身身体素质、喜好等选择中低强度、身体移动性的运动方式进行锻炼，如骑自行车、慢跑、登楼梯、步行、游泳等有氧运动，每天进行2次，每次30 min。饮食方案包括热量摄入的控制和膳食调整，参照《中国学龄前儿童膳食指南》，保持蛋白质、脂肪、碳水化合物摄入均衡，蛋白质、脂肪及碳水化合物分别占每日总热量的8%～15%、30%～50%、35%～65%，遵循少食多餐、粗细搭配的原则，同时多食用应季新鲜瓜果蔬菜，注意补充维生素、微量元素和水分，保证营养均衡。并少食或禁食甜食、油炸食品、饮料等高热量、高脂肪食物。
2.1.2　观察组
在此基础上基于“方证相应”予以防己黄芪汤联合针灸推拿治疗。1）防己黄芪汤方药组成如下：粉防己10 g，生黄芪15 g，白术10 g，生甘草5 g，生姜6 g，红枣10 g，将上述中药以水煎煮至250 mL，每天1剂，分早晚服用，每周持续服用5 d，停2 d。2）针灸：取双侧中脘、水分、天枢、阴陵泉、足三里、三阴交、丰隆、关元、脾俞、大肠俞等穴位，选用江苏医疗用品厂有限公司所生产的华佗牌针灸针（规格：0.35 mm×50 mm；0.25 mm×25 mm）。俯卧位，常规消毒后，在穴位处快速进针，以局部酸胀感适宜，进针得气后采用提插捻转手法，留针15 min。每周持续5 d，停2 d。3）推拿：采用循经推拿法，遵循脾经、肝经、胃经在腹部的走行部位进行推拿；首先按腹，以脾经、肝经、胃经在腹部的走行为中心，按压阑门、章门、梁门、石门等穴位，按至一定深度后停留片刻，并维持此力度和深度；揉腹：用指揉腹部，频率宜缓，每分钟10～20次，约5 min，然后再根据脾经、肝经、胃经在腹部的走行部位进行指推操作，交替操作10次；最后将双手指心搓热，根据脾经、肝经、胃经在腹部的走行部位进行快速摩动，使其出现温热感觉；掌擦督脉及两侧足太阳膀胱经，透热为度，按揉脾俞、胃俞、肾俞、大肠俞、肝俞各30 s，捏脊3～5遍。两组均持续治疗12周。
2.2　观察指标及方法
2.2.1　治疗效果
经过治疗后患儿体质量、腰围等肥胖指标显著改善，中医证候积分减少70%以上，则为治疗显效；经过治疗后患儿体质量、腰围等肥胖指标有所改善，中医证候积分减少30%～69%，则为治疗有效；治疗后患儿体质量、腰围等肥胖指标改善不明显，中医证候积分减少不足30%，则为治疗无效。总有效率＝临床缓解率+显效率+有效率。
2.2.2　中医证候积分
参照《中药新药临床研究指导原则》对主要症状肥胖浮肿、肢体沉重、疲倦乏力三项症状依据无、轻、中、重分别赋予0、2、4、6分，最高分18分，分值越高表示患者症状越为严重。
2.2.3　肥胖相关指标
于治疗前后测量患儿腰围、臀围、体质量指数及腰臀比变化情况，将其详细记录进行统计分析。
2.2.4　血脂指标
于治疗前后采集两组空腹肘静脉血3 mL，3000 r/min离心处理，离心半径为10 cm，离心时间为15 min，获得血清后，采用日本东芝公司所生产的全自动生化分析仪TAB-120FR检测两组血清总胆固醇（Total Cholesterol，TC）、甘油三酯（Triglycerides，TG）、低密度脂蛋白胆固醇（Low-Density Lipoprotein Cholesterol，LDL-C）、高密度脂蛋白胆固醇（High-Density Lipoprotein Cholesterol，HDL-C）变化情况。
2.2.5　血糖指标
抽取两组空腹肘静脉血3 mL，离心速度为3000 r/min，离心时间设置5 min。获得血清后，应用全自动生化分析仪，采用放射免疫法检测空腹血糖（Fasting Plasma Glucose，FPG）水平，并测定两组患儿空腹胰岛素（Fasting Insulin，FINS）、胰岛素抵抗稳态模型评估指数（Homeostatic Model Assessment of Insulin Resistance，HOMA-IR），观察其变化情况。
2.3　统计学方法
将采集数据采用SPSS 25.0处理分析，数据资料均符合正态分布，治疗效果用例（%）表示，采用χ2检验；中医症状评分、腰围、臀围、BMI、血脂血糖等指标采用表示，应用t检验。P<0.05为差异有统计学意义。
3　结果
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3.1　治疗效果比较
观察组治疗总有效率为95.0%，远高于对照组的72.5%，组间比较差异有统计学意义（P<0.05）。见表1。
3.2　中医症状积分变化情况比较
治疗前两组肥胖浮肿、肢体沉重、疲倦乏力三项中医症状积分比较差异无统计学意义（P>0.05）；治疗后两组上述症状积分均有所降低（P<0.05），且相较于对照组，观察组降低更为显著（P<0.05）。见表2。
3.3　肥胖相关指标变化情况比较
治疗前两组腰围、臀围、BMI及腰臀比变化比较差异无统计学意义（P>0.05）；治疗后两组上述指标均较治疗前降低，且相比于对照组，观察组降低更为显著，组间差异有统计学意义（P<0.05）。见表3。
3.4　血脂指标变化情况比较
治疗前两组TC、TG、LDL-C、HDL-C比较差异无统计学意义（P>0.05）；治疗后两组上述TC、TG、LDL-C指标水平均有降低，HDL-C提高，且较于对照组，观察组改善更为显著（P<0.05）。见表4。
3.5　血糖指标水平变化情况比较
治疗前两组FPG、FINS、HOMA-IR水平比较差异无统计学意义（P>0.05）；治疗后两组上述3项指标水平均有所降低，且相较于对照组，观察组水平降低更为显著，组间差异有统计学意义（P<0.05）。见表5。
4　讨论
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儿童单纯性肥胖是一种在生长发育过程中较为普遍的慢性代谢性疾病，多是由于能量摄入与能量消耗之间的不平衡所导致的，若不及时干预不仅影响儿童的生长发育及身心健康，还会在很大程度上增加其成年后罹患糖尿病、高血压、高脂血症等代谢性疾病的风险[10]。根据《中国居民营养与慢性病状况报告（2020年）》数据显示：6岁以下儿童中，1/10超重或肥胖，超重和肥胖率分别为6.8%和3.6%；6～17岁青少年中，近1/5超重或肥胖，超重和肥胖率分别为11.1%和7.9%[11-12]。可见儿童单纯性肥胖已成为威胁我国儿童健康的一大问题，而对于年龄不足12岁的小儿，一般不建议进行药物治疗，单纯靠控制饮食，满足不了儿童基本的代谢需求[13-14]。因此寻找一种积极有效的方式进行治疗干预，对改善患者肥胖情况，提高其生活质量具有积极作用。
肥胖症多与饮食不节、暴饮暴食对脾胃造成损伤有关，或由恣食肥甘、膏粱厚味，积蓄体内引起；或与先天气虚，肾主水，而先天肾气不足，则体内水湿运化不行，痰浊内生等有关，从而导致肥胖症的发生，中医学对肥胖症的记载可追溯至《黄帝内经》中的“肥贵人”名称，《素问·奇病论篇》指出“必数食甘美而多肥也”，可见肥胖与饮食存在十分密切的关系[15]。小儿因其脏腑娇嫩，形气未充，具有肺脾肾三脏不足的特点[16]。脾乃后天之本，气血生化之源，小儿脾胃功能与其快速生长发育需求常不相适应，加之寒温不能自调，饥饱不能自节，极容易对脾胃造成损伤致使运化失常，日久则脾气虚，动则乏力，不愿活动，如此又致气机不畅而影响脾胃功能，导致肥胖加重[17]。因此脾虚运化不足引起湿邪停聚为本病主要病机，故对其的治疗应遵循健脾化湿、祛风消肿、利水通利的原则[18]。本次研究对脾虚湿阻证单纯性肥胖儿童基于“方证相应”予以防己黄芪汤联合针灸推拿治疗，结果发现治疗后观察组肥胖浮肿、肢体沉重、疲倦乏力三项中医症状积分及腰围、臀围、BMI、腰臀比均低于对照组，可见该种治疗方式能改善患儿肥胖、疲倦乏力等症状，降低腰围、臀围、体质量等。这是由于方证相应是“经方”临床应用的核心思想，防己黄芪汤作为经典的中医方剂，运用方证相应的原则，方中防己性味苦辛，具有利水消肿、除湿祛风的功效[19]；黄芪为补气要药，具有补气升阳、固表止汗、利水消肿、生津养血、行滞通痹的功效，防己和黄芪共为方中君药，二者攻补兼施，共奏益气利水之功效[20]；白术具有益气健脾、燥水利湿的功效，可助防己利水消肿，又协黄芪，补气与健脾结合，益卫固表[21]；甘草既能调和诸药，又能协助黄芪、白术补气[22]；加之生姜和大枣能增强益气健脾，宣发水气之功，诸药合用，益气健脾以扶正，祛风利水以攻邪，达到健脾化湿、祛风消肿的功效[23]。针灸推拿为中医特色外治疗法，研究所选取的脾俞穴属足太阳膀胱经，具有和胃健脾、化湿的功效；中脘属任脉，具有和胃健脾、通调腑气等功效，为胃之募穴；天枢属足阳明胃经，有清利湿热，疏调肠腑的功效；足三里、三阴交、丰隆、关元等穴位补脾肾，和胃通腑，振奋阳气[24]。通过针刺结合穴位功效，能更充分激发穴位经气和调整全身脏腑气血，使气血经脉畅通，共行健脾和胃、通畅气机的作用[25]。推拿则遵循的循经推拿法，以肝经、脾经、胃经为中心对腹部循行范围施以按、揉、推、运、摩等手法，可以有效地促进人体的气血运行，增强脾胃的功能[26]。脾胃作为后天之本，通过腹部按摩，可以刺激脾胃，促进运化正常，从而调节机体气机升降。相关研究也表明，运腹、推腹、揉腹等手法，通过有规律的按摩动作，作用于腹部的各个部位，有助于促进胃气的下降和脾气的上升[27]。此外在进行推拿按摩的过程中，对腹部的特定穴位进行精准刺激，可以进一步发挥其健脾化湿、理气和胃、消积化滞的功效[28-29]。同时本次研究还发现，治疗后观察组血脂指标及空腹血糖、FINS、HOMA-IR水平均低于对照组，可见该种治疗方式能改善患儿血脂水平，调节糖脂代谢情况，避免肥胖导致的血脂异常。这是由于现代药理研究表明，防己可以有效地提高肾脏的能力，促进身体内多余水分的排出，具有消除水肿的功效；黄芪具有胃肠道免疫调节的作用，黄芪素可以降低血液中的胆固醇和甘油三酯水平，起到辅助降脂的作用[30]。白术中含有的多糖可以提高人体内白细胞的活性，增强清除氧自由基的作用，减少氧自由基对机体的损害，从而降低组织脂质过氧化物的含量，避免有害物质对组织细胞结构和功能的破坏，发挥“化湿降脂”的作用[31]。针灸通过调节气血平衡，促进新陈代谢，从而帮助减少体质量。推拿则通过按摩和手法操作，刺激穴位和经络，加速脂肪分解和代谢，进一步促进体质量的减轻。推拿不仅能改善局部脂肪堆积的问题，还能缓解因肥胖引起的肌肉紧张和疲劳，提高身体的柔韧性和活力[32]。故通过内外结合的方式，对单纯性肥胖患儿体质量进行减轻，同时调节血脂、血糖，减少肥胖带来的健康风险，保障儿童生长发育健康。
综上所述，对脾虚湿阻证单纯性肥胖儿童予以基于“方证相应”的防己黄芪汤联合针灸推拿治疗能有效降低患儿体质量、腰围、BMI等体脂参数，调节血脂水平，改善糖脂代谢情况，有助于降低肥胖带来的健康风险，改善患儿的生活质量，提高患儿的整体健康水平。
基金
收起
  • 国家中医药管理局第七批全国老中医药专家学术经验继承项目(国中医药人教函〔2022〕76号)
  • 湖南省卫生健康委员会科研项目(W20243267)
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2025年第43卷第10期
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doi: 10.13193/j.issn.1673-7717.2025.10.018
  • 首发时间：2026-10-30
  • 出版时间：2025-10-10
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基金
国家中医药管理局第七批全国老中医药专家学术经验继承项目(国中医药人教函〔2022〕76号)
湖南省卫生健康委员会科研项目(W20243267)
作者信息
    湖南中医药大学第二附属医院，湖南 长沙 410005

通讯作者:

詹红艳（1979-），女，湖南益阳人，副主任医师，学士，研究方向：中医儿科疾病诊疗。E-mail：。
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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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