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目的:观察针刺对肥胖伴胰岛素抵抗患者血清酪酪肽(PYY)和nesfatin-1的影响.方法:将98例肥胖伴胰岛素抵抗患者按随机数字表法分为对照组及观察组,每组49例.对照组予运动和饮食干预,观察组在对照组干预基础上加用针刺治疗.比较两组治疗前后的体质量指数(BMI)、体脂率、空腹血清胰岛素(FINS)、空腹血糖(FPG)、胰岛素抵抗指数(HOMA-IR),以及血清甘油三酯(TG)、总胆固醇(TC)、PYY和nesfatin-1水平,并评价其疗效.结果:观察组有效率高于对照组(P<0.05).治疗后,两组BMI、体脂率、血清TG及TC水平均降低,与本组治疗前比较差异均有统计学意义(P<0.05),且观察组低于对照组(P0.05).观察组治疗后FINS、FPG和HOMA-IR均较治疗前降低(P<0.05),且低于对照组(P<0.05);观察组治疗后血清PYY和nesfatin-1水平均升高(P<0.05),且高于对照组(P<0.05).结论:在运动及饮食干预基础上加用针刺治疗肥胖伴胰岛素抵抗疗效肯定,可降低患者的BMI、体脂率及血脂、血糖和血清胰岛素水平,改善胰岛素抵抗.这可能与其提升患者血清PYY和nesfatin-1水平有关.“,”Objective: To observe the effect of acupuncture on serum peptide YY (PYY) and nesfatin-1 in obese patients with insulin resistance. Methods: Ninety-eight obese patients with insulin resistance were divided into a control group and an observation group by the random number table method, with 49 cases in each group. The control group received exercise and dietary interventions, and the observation group received additional acupuncture treatment to the exercise and dietary interventions. The body mass index (BMI), body fat percentage, fasting insulin (FINS), fasting plasma glucose (FPG), homeostasis model assessment for insulin resistance (HOMA-IR), triglyceride (TG), total cholesterol (TC), and serum PYY and nesfatin-1 levels were compared before and after treatment. The efficacy was evaluated after treatment. Results: The total effective rate was significantly higher in the observation group than in the control group (P<0.05). After treatment, the BMI, body fat percentage, and serum TG and TC levels decreased significantly in both groups (P<0.05), and were significantly lower in the observation group than those in the control group (P0.05). The FINS, FPG and HOMA-IR of the observation group decreased significantly after treatment (P<0.05), and were lower than those in the control group (P<0.05). The serum PYY and nesfatin-1 levels of the observation group increased significantly after treatment (P<0.05), and were higher than those in the control group (P<0.05). Conclusion: Based on exercise and dietary interventions, acupuncture is effective for obese patients with insulin resistance. It can reduce the BMI, body fat percentage, blood lipids, blood glucose, and serum insulin levels and improve insulin resistance. The action may be associated with the up-regulation of serum PYY and nesfatin-1.