【摘要】 目的:观察基于子午流注法的穴位埋线对代谢功能障碍相关脂肪性肝炎(MASH)患者代谢异常相关风险因素及中医临床症状的影响。方法:选取2023年6月至2024年4月收治的MASH患者84例，按照随机数字表法分为观察组(基于子午流注法的穴位埋线治疗)及对照组(常规穴位埋线治疗),每组42例，连续治疗3个月，分别于治疗前和治疗后比较代谢异常相关因素及中医临床症状积分。采用多因素二元Logistic回归分析疗效相关影响因素。结果:两组患者基线资料差异无统计学意义(P>0.05),治疗后体质量、腰围、BMI、空腹血糖、胰岛素水平、TC、TG、LDL-C、TyG指数及HOMA-IR均明显改善，观察组优于对照组，差异有统计学意义(P<0.05)。采用多因素二元Logistic回归分析发现治疗后TyG指数、HOMA-IR、常规穴位埋线及基于子午流注法理论的穴位埋线为临床治疗有效的预测因素(P<0.05)。其中基于子午流注法的穴位埋线治疗对MASH临床治疗有效的OR值为6.252,TyG指数、HOMA-IR水平越低提示临床治疗越有效。结论:基于子午流注法的穴位埋线治疗可改善MASH患者代谢异常相关风险因素及中医临床症状积分，动态监测TyG指数、HOMA-IR有助于临床疗效预测。更多还原

【Abstract】 Objective:To observe the effects of acupoint catgut embedding based on the Midnight-Noon Ebb-Flow theory on metabolic abnormalities and TCM clinical symptoms in patients with metabolic dysfunction-associated steatohepatitis(MASH).Methods:A total of 84 MASH patients treated at the Hepatology Outpatient and Inpatient Departments of Nantong Clinical College of Integrated Traditional Chinese and Western Medicine of Nanjing University of Chinese Medicine, and the Preventive Treatment Outpatient and Gastroenterology Inpatient Departments of Yining County Traditional Chinese Medicine Hospital from June 2023 to April 2024 were selected. They were randomly divided into an observation group(acupoint catgut embedding based on the Midnight-Noon Ebb-Flow theory) and a control group(conventional acupoint catgut embedding), with 42 cases in each group. After three months of continuous treatment, metabolic abnormality-related factors and TCM clinical symptom scores were compared before and after treatment. Multivariate binary logistic regression was used to analyze factors influencing therapeutic efficacy.Results:Baseline characteristics showed no significant differences between groups(P>0.05). After treatment, weight, waist circumference, BMI, fasting blood glucose, insulin levels, total cholesterol(TC), triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),triglyceride-glucose(TyG) index, and homeostasis model assessment of insulin resistance(HOMA-IR) significantly improved, with the observation group outperforming the control group(P<0.05). Multivariate binary logistic regression revealed that post-treatment TyG index, HOMA-IR, conventional acupoint catgut embedding, and Midnight-Noon Ebb-Flow-based acupoint catgut embedding were predictive factors for clinical efficacy(P<0.05). The OR value for Midnight-Noon Ebb-Flow-based acupoint catgut embedding was 6.252, indicating a stronger clinical effect. Lower TyG index and HOMA-IR levels were associated with better clinical outcomes.Conclusion:Acupoint catgut embedding based on the Midnight-Noon Ebb-Flow theory can improve metabolic abnormalities and TCM clinical symptom scores in MASH patients. Dynamic monitoring of TyG index and HOMA-IR may aid in predicting clinical efficacy.更多还原