非药物矫正进食行为在青少年肥胖患者中



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详细

背景。进入21世纪以来，儿童肥胖已呈现出全球性非传染性流行趋势。现代研究证实，肥胖的发生与认知对进食控制能力的受损密切相关，表现为进食行为紊乱。已有研究表明，大脑背外侧前额叶皮层在进食行为调控中具有重要的整合作用。利用预设的物理因子对上述脑区进行非侵入性神经刺激，成为治疗肥胖和代谢综合征的前景方向。

目的。 评估经颅磁疗及联合经颅磁激光疗法在矫正青少年肥胖患者进食行为中的疗效。

材料与方法。本研究为一项前瞻性、随机、对照的观察性研究，纳入60名12–15岁原发性肥胖青少年。评估内容包括身体与性发育状况、糖脂代谢参数、激素水平、进食行为类型及主观食欲感评分。所有受试者均接受饮食与运动干预培训，随后采用简单随机法分为三组：第1组共25名青少年接受10次经颅磁疗；第2组共25名青少年接受10次联合经颅磁激光疗法；对照组共10名青少年未接受任何物理治疗。所有患者于治疗3个月后接受同样项目的复查评估。

结果。初次就诊时，40%（共24人）的青少年患有高胰岛素血症，28%（17人）存在胰岛素抵抗，30%（18人）存在高胆固醇血症。根据DEBQ量表，84%的患者存在进食行为异常，其中以混合型为主。根据视觉模拟评分法评估，肥胖青少年在空腹时饥饿感明显，餐后饱腹感及胃部充盈感不足。3个月后，接受经颅磁疗或经颅磁激光疗法等仪器性进食行为干预的患者，在视觉模拟评分中表现出食欲下降和饱腹感持续时间延长。这促进了患者体质指数的下降及代谢状态的改善。

结论。在肥胖患者的综合治疗中应用经颅刺激方法，有助于增强对进食的认知控制，从而消除暴食这一肥胖发生与发展的促进因素。

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作者简介

Kseniya A. Cherednikova

Saratov State Medical University named after V.I. Razumovsky

编辑信件的主要联系方式.
Email: iw.nazarenko2012@yandex.ru
ORCID iD: 0000-0001-8119-0405
SPIN 代码: 5609-0099

MD, Cand. Sci. (Medicine)

俄罗斯联邦, 112 Bolshaya Kazachya st, Saratov, 410012

Nina V. Bolotova

Saratov State Medical University named after V.I. Razumovsky

Email: kafedranv@mail.ru
ORCID iD: 0000-0002-8148-526X
SPIN 代码: 5061-1600

MD, Dr. Sci. (Medicine), Professor

俄罗斯联邦, 112 Bolshaya Kazachya st, Saratov, 410012

Natalia Yu. Filina

Saratov State Medical University named after V.I. Razumovsky

Email: natalya-filina@rambler.ru
ORCID iD: 0000-0002-1613-4156
SPIN 代码: 3390-1811

MD, Dr. Sci. (Medicine), Associate Professor

俄罗斯联邦, 112 Bolshaya Kazachya st, Saratov, 410012

Maria G. Petrova

Saratov State Medical University named after V.I. Razumovsky

Email: 383852280@mail.ru
ORCID iD: 0009-0002-1290-443X
SPIN 代码: 3400-7142

MD, Cand. Sci. (Medicine)

俄罗斯联邦, 112 Bolshaya Kazachya st, Saratov, 410012

Olga A. Logacheva

Saratov State Medical University named after V.I. Razumovsky

Email: olya.logacheva2015@yandex.ru
ORCID iD: 0009-0004-2878-4561
SPIN 代码: 3999-3251
俄罗斯联邦, 112 Bolshaya Kazachya st, Saratov, 410012

Elena G. Dronova

Saratov State Medical University named after V.I. Razumovsky

Email: eldronova@mail.ru
ORCID iD: 0000-0003-3290-9705
SPIN 代码: 9703-4760

MD, Cand. Sci. (Medicine)

俄罗斯联邦, 112 Bolshaya Kazachya st, Saratov, 410012

Elizabeth A. Ponomareva

Saratov State Medical University named after V.I. Razumovsky

Email: ponomarewaeliz@gmail.com
ORCID iD: 0009-0002-3968-5142
SPIN 代码: 2329-7443
俄罗斯联邦, 112 Bolshaya Kazachya st, Saratov, 410012

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2. Fig. 1. Comparative analysis of the sensation of appetite according to the visual analog scale in patients of group 1. * The significance of differences between the initial and 3 months later data of patients within the group according to the Wilcoxon criterion at р <0.05.

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3. Fig. 2. Comparative analysis of appetite sensation according to the visual analog scale in patients of group 2. * The significance of differences between the initial and three months later data of patients within the group according to the Wilcoxon criterion at p <0.05.

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4. Fig. 3. Comparative analysis of appetite sensation according to visual analog scale data in patients of the comparison group. * The significance of differences between the initial and three-month-later patient data within the Wilcoxon test group at p <0.05.

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