The Effectiveness of Polydioxanone (PDO) Thread-Embedding Acupuncture in Adult Patients with Obesity: Case reports
Article Sidebar
Published:
Feb 28, 2023
Keywords:
Obesity, thread embedding acupuncture, PDO, plum blossom, cupping therapy, moxibustion
Main Article Content
Abstract
Background: Obesity is a chronic condition defined as excess body fat which is diagnosed based on body mass index, abdominal circumference, and is associated with an increased risk of various diseases. Conservative management is often hard to comply with, unsuccessfully, and expensive, while acupuncture with its variety of modalities can be an option.
Case: A therapy with polydioxanone thread embedding on acupuncture points along with other acupuncture modalities were performed in three cases of obese patients according to their etiology and conditions.
Results: Based on the three cases of obese patients with PDO thread embedding acupuncture alone or combined with cupping, plum blossom and moxibustion modalities are beneficial in decreasing abdominal circumference. The effect after 2 months follow up respectively using abdominal circumference measurement 5 cm above the umbilicus -2 cm ( from 110 to 99cm);- 3 cm (from 90 to 87 cm); -8 cm (from 88 to 80 cm), umbilicus to umbilicus -6 cm (from 107 to 101 cm); 10 cm (from 103 to 93 cm); 7 cm (from 93 to 86 cm), 5 cm below umbilicus -1 cm (from 106 to 105 cm); -5 cm (from 107.5 to 102.5 cm); -6 cm (from 104 to 98 cm). No serious side effects occurred in the three cases.
Conclusion: PDO thread embedding can be beneficial in treating obese patients. However, these results require further research.
Case: A therapy with polydioxanone thread embedding on acupuncture points along with other acupuncture modalities were performed in three cases of obese patients according to their etiology and conditions.
Results: Based on the three cases of obese patients with PDO thread embedding acupuncture alone or combined with cupping, plum blossom and moxibustion modalities are beneficial in decreasing abdominal circumference. The effect after 2 months follow up respectively using abdominal circumference measurement 5 cm above the umbilicus -2 cm ( from 110 to 99cm);- 3 cm (from 90 to 87 cm); -8 cm (from 88 to 80 cm), umbilicus to umbilicus -6 cm (from 107 to 101 cm); 10 cm (from 103 to 93 cm); 7 cm (from 93 to 86 cm), 5 cm below umbilicus -1 cm (from 106 to 105 cm); -5 cm (from 107.5 to 102.5 cm); -6 cm (from 104 to 98 cm). No serious side effects occurred in the three cases.
Conclusion: PDO thread embedding can be beneficial in treating obese patients. However, these results require further research.
Downloads
Download data is not yet available.
Article Details
Section
Articles
This work is licensed under a Creative Commons Attribution 4.0 International License.
World Nutrition Journal is an open acces journal and under the licence of
References
1. Delaet D, Schauer D. Obesity in adults. BMJ Clin Evid [Internet]. 2011 Mar 17;2011(September 2010):1–25. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21411021
2. Aronne LJ, Kumar RB. Obesity Management: A Clinical Casebook [Internet]. Springer; 2018. Available from: https://link.springer.com/content/pdf/10.1007%2F978-3-030-01039-3.pdf
3. Dobbs R, Manyika J. The Obesity Crisis. In: The Road to Good Nutrition [Internet]. Basel: KARGER; 2015. p. 44–57. Available from: https://www.thecairoreview.com/essays/the-obesity-crisis/
4. Prasad DS, Kabir Z, Revathi Devi K, Peter PS, Das BC. Gender differences in central obesity: Implications for cardiometabolic health in South Asians. Indian Heart J [Internet]. 2020 May;72(3):202–4. Available from: https://doi.org/10.1016/j.ihj.2020.04.008
5. Kanter R, Caballero B. Global Gender Disparities in Obesity: A Review. Adv Nutr [Internet]. 2012 Jul 1;3(4):491–8. Available from: https://academic.oup.com/advances/article/3/4/491/4591492
6. Wang L-H, Huang W, Wei D, Ding D-G, Liu Y-R, Wang J-J, et al. Mechanisms of Acupuncture Therapy for Simple Obesity: An Evidence-Based Review of Clinical and Animal Studies on Simple Obesity. Evidence-Based Complement Altern Med [Internet]. 2019 Feb 3;2019:1–12. Available from: https://www.hindawi.com/journals/ecam/2019/5796381/
7. Chooi YC, Ding C, Magkos F. The epidemiology of obesity. Metabolism [Internet]. 2019 Mar;92:6–10. Available from: https://linkinghub.elsevier.com/retrieve/pii/S002604951830194X
8. Riskesdas LN. Kementerian Kesehatan Republik Indonesia. Badan Penelit dan Pengemb Kesehat. 2018;
9. RSCM. Data Rekam Medik RSCM. Published online 2020.
10. Weisell RC. Body mass index as an indicator of obesity. Asia Pac J Clin Nutr [Internet]. 2002 Dec;11:S681–4. Available from: http://doi.wiley.com/10.1046/j.1440-6047.11.s8.5.x
11. Aktar N, Qureshi NK, Ferdous HS. Obesity: A Review of Pathogenesis and Management Strategies in Adult. Delta Med Coll J [Internet]. 2017 Feb 4;5(1):35–48. Available from: https://www.banglajol.info/index.php/DMCJ/article/view/31436
12. Apovian CM. Obesity: definition, comorbidities, causes, and burden. Am J Manag Care [Internet]. 2016;22(7):s176–85. Available from: http://ajmc.s3.amazonaws.com/_media/_pdf/ACE0042_05_2016_Obesity_Article01.pdf
13. Oken E, Taveras EM, Popoola FA, Rich-Edwards JW, Gillman MW. Television, Walking, and DietAssociations with Postpartum Weight Retention. Am J Prev Med [Internet]. 2007 Apr;32(4):305–11. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0749379706005629
14. Hung Y-C, Hung I-L, Hu W-L, Tseng Y-J, Kuo C-E, Liao Y-N, et al. Reduction in postpartum weight with laser acupuncture. Medicine (Baltimore) [Internet]. 2016 Aug;95(34):e4716. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0749379706005629
15. Endres LK, Straub H, McKinney C, Plunkett B, Minkovitz CS, Schetter CD, et al. Postpartum Weight Retention Risk Factors and Relationship to Obesity at 1 Year. Obstet Gynecol [Internet]. 2015 Jan;125(1):144–52. Available from: https://journals.lww.com/00006250-201501000-00023
16. Heymsfield SB, Wadden TA. Mechanisms, Pathophysiology, and Management of Obesity. Longo DL, editor. N Engl J Med [Internet]. 2017 Jan 19;376(3):254–66. Available from: http://www.nejm.org/doi/10.1056/NEJMra1514009
17. Bray GA, Frühbeck G, Ryan DH, Wilding JPH. Management of obesity. Lancet [Internet]. 2016 May;387(10031):1947–56. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0140673616002713
18. Gadde KM, Martin CK, Berthoud H-R, Heymsfield SB. Obesity: Pathophysiology and Management. J Am Coll Cardiol [Internet]. 2018 Jan 2;71(1):69–84. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC7958889
19. Guo T, Ren Y, Kou J, Shi J, Tianxiao S, Liang F. Acupoint Catgut Embedding for Obesity: Systematic Review and Meta-Analysis. Evidence-Based Complement Altern Med [Internet]. 2015;2015:1–20. Available from: http://www.hindawi.com/journals/ecam/2015/401914/
20. Kim S-Y, Shin I-S, Park Y-J. Effect of acupuncture and intervention types on weight loss: a systematic review and meta-analysis. Obes Rev [Internet]. 2018 Nov;19(11):1585–96. Available from: https://onlinelibrary.wiley.com/doi/10.1111/obr.12747
21. Shixi H, Yu C. Cupping Therapy. J Chinese Med. 2006;(82):52–8.
22. Deng H, Shen X. The Mechanism of Moxibustion: Ancient Theory and Modern Research. Evidence-Based Complement Altern Med [Internet]. 2013;2013:1–7. Available from: http://www.hindawi.com/journals/ecam/2013/379291/
23. Thambirajah R. Cosmetic Acupuncture: A Traditional Chinese Medicine Approach to Cosmetic and Dermatological Problems. Singing Dragon; 2015.
24. Qian X, You Y, Shu S, Zhou S. Treatment of cervical spondylotic radiculopathy: acupuncture at neck Jiáj points and blood-letting puncture with the plum-blossom needle. World J Acupunct - Moxibustion [Internet]. 2012 Dec;22(4):1–4. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1003525713600185
25. Liu Z, Wang Q, Fu B, Li X-Y. Effect of plum-blossom needle tapping with different stimulation intensities on hair regrowth in hair removal mice. J Acupunct Tuina Sci [Internet]. 2017 Jun 21;15(3):184–90. Available from: http://link.springer.com/10.1007/s11726-017-0998-7
26. Cho WC, Li C, Chen H. Clinical efficacy of acupoint embedment in weight control. Medicine (Baltimore) [Internet]. 2018 Sep;97(36):e12267. Available from: https://journals.lww.com/00005792-201809070-00107
27. Huang J, Liang J, Xu X, Xu Y, Chen G. Safety of Thread Embedding Acupuncture Therapy: A Systematic Review. Chin J Integr Med [Internet]. 2021 Apr 24;1–9. Available from: https://link.springer.com/10.1007/s11655-021-3443-1
28. Jun P, Zhi-Yong H, Richardson F. Point-penetration acupuncture: Historical development and clinical application. Acupunct Med [Internet]. 1999;17(1):36–41. Available from: http://aim.bmj.com/
29. Hislop S. The degradation of electrospun polydioxanone patches for rotator cuff repair. 2012; Available from: https://ora.ox.ac.uk/objects/uuid:02cae588-1f87-4213-a1da-17fc2dddd076/download_file?file_format=application/pdf&safe_filename=THESIS01&type_of_work=Thesis
30. Yoon JH, Kim SS, Oh SM, Kim BC, Jung W. Tissue changes over time after polydioxanone thread insertion: An animal study with pigs. J Cosmet Dermatol [Internet]. 2019 Jun 29;18(3):885–91. Available from: https://onlinelibrary.wiley.com/doi/10.1111/jocd.12718
31. Xavier Pi-Sunyer F. Obesity: criteria and classification. Proc Nutr Soc [Internet]. 2000 Nov 24;59(4):505–9. Available from: https://www.cambridge.org/core/product/identifier/S0029665100000732/type/journal_article
32. Shagana JA, Dhanraj M, Jain AR, Nirosa T. Physiological Changes in Pregnancy. Vol 10. Sixth Edit. Elsevier Ltd; 2018. doi:10.5005/jp/books/12974_8.
33. Xinnong C, Bing Z, Hongcai W. Acupuncture Therapeutics. People’s Mil Med Press Sing Dragon, USA. 2011;
34. Tajirian AL, Goldberg DJ. A review of sutures and other skin closure materials. J Cosmet Laser Ther [Internet]. 2010 Dec 10;12(6):296–302. Available from: http://www.tandfonline.com/doi/full/10.3109/14764172.2010.538413
35. Fan X, Yu M, Fu S-P, Zhuang Y, Lu S. Effectiveness of acupuncture in treatment of simple obesity in animal models: a systematic review and meta-analysis. Evidence-Based Complement Altern Med. 2019;2019.
36. An-he C, Xi-ping D, Hai-bo Z. Clinical observation of 40 cases of acne treated by acupuncture plus herbal drugs. J Acupunct Tuina Sci [Internet]. 2003 Aug;1(4):45–7. Available from: http://link.springer.com/10.1007/BF02874750
37. Wang X, Yin J. Complementary and Alternative Therapies for Chronic Constipation. Evidence-Based Complement Altern Med [Internet]. 2015;2015(d):1–11. Available from: http://www.hindawi.com/journals/ecam/2015/396396/
38. Tanudjaja CP, Simadibrata C, Srilestari A, Kresnawan T. Effects of acupoint catgut embedding therapy paired with dietary intervention on tumour necrosis factor-α levels and abdominal circumference in patients with obesity. J Phys Conf Ser [Internet]. 2018 Aug;1073(6):062032. Available from: https://iopscience.iop.org/article/10.1088/1742-6596/1073/6/062032
39. González-González Roberto G-VJ. Effects of Acupuncture on Obesity and Adipokines Involved in Body Weight Control. J Homeopath Ayurvedic Med [Internet]. 2013;02(03). Available from: https://www.omicsgroup.org/journals/effects-of-acupuncture-on-obesity-and-adipokines-involved-in-body-weight-control-2167-1206.1000129.php?aid=17335
40. Chen I-J, Yeh Y-H, Hsu C-H. Therapeutic effect of acupoint catgut embedding in abdominally obese women: a randomized, double-blind, placebo-controlled study. J women’s Heal. 2018;27(6):782–90.
41. Gao L, Kong XJ, Shi X. Effects of electroacupuncture and acupoint catgut-embedding on mRNA expression of lipid metabolism gene PPAR-gamma and related lipase of rats with simple obesity. Zhongguo zhen jiu= Chinese Acupunct moxibustion. 2011;31(6):535–8.
42. Xie J, Liu G, Qiao J, Gu Q, Gai Y, Huang S, et al. [Multi-central randomized controlled study on electroacupuncture at Fenglong (ST 40) for regulating blood lipids]. Zhongguo Zhen Jiu [Internet]. 2009 May;29(5):345–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19489487
43. Lee FY, Huo ZJ, Zhang L, Guo J, Chen H, Liu T, et al. The Effects of Needling Fenglong (ST40) and Neiguan (PC6) on IL-17 of ApoE-Gene-Knockout Mice’s Liver. Evidence-Based Complement Altern Med [Internet]. 2014;2014:1–5. Available from: http://dx.doi.org/10.1155/2014/691863
44. Djajadi RM, Barasila AC HD. Perbandingan efektivitas laser akupunktur dengan elektroakupunktur pada titik ST40 Fenglong dalam memperbaiki kadar kolesterol total , indeks aterogenik , dan berat lemak dinding abdomen pada tikus model diet tinggi. Available from: https://perpustakaan.fk.ui.ac.id/opac/index.php?p=show_detail&id=26859&keywords=
45. Chen L-S, Li Y-Y, Chen H, Liu B-W, Wang D-W, Zhao Y-H. Polyglycolic acid sutures embedded in abdominal acupoints for treatment of simple obesity in adults: a randomized control trial. Chin Med [Internet]. 2019 Dec 18;14(1):32. Available from: https://cmjournal.biomedcentral.com/articles/10.1186/s13020-019-0258-5
46. Wei J, Lai L, Lin Z. Acupoint Catgut Embedding versus Acupuncture for Simple Obesity A Systematic Review and Meta- Analysis of Randomized Controlled Trials. :1–19. Available from: https://doi.org/10.21203/rs.3.rs-145339/v1
47. Sheng J, Jin X, Zhu J, Chen Y, Liu X. The Effectiveness of Acupoint Catgut Embedding Therapy for Abdominal Obesity: A Systematic Review and Meta-Analysis. Evidence-Based Complement Altern Med [Internet]. 2019 Jun 23;2019:1–12. Available from: https://www.hindawi.com/journals/ecam/2019/9714313/
48. Shi Y, Zhang L, Zhao C, He C. [Comparison of therapeutic effects of acupuncture-cupping plus acupoint catgut embedding and electroacupuncture on simple obesity of stomach and intestine excess-heat type]. Zhongguo Zhen Jiu [Internet]. 2006 Aug;26(8):547–50. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16941970
49. Al-Bedah AMN, Elsubai IS, Qureshi NA, Aboushanab TS, Ali GIM, El-Olemy AT, et al. The medical perspective of cupping therapy: Effects and mechanisms of action. J Tradit Complement Med [Internet]. 2019 Apr;9(2):90–7. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2225411018300191
50. Mehta P, Dhapte V. Journal of Traditional and Complementary Medicine Cupping therapy : A prudent remedy for a plethora of medical ailments. J Tradit Chinese Med Sci [Internet]. 2015;5(3):127–34. Available from: http://dx.doi.org/10.1016/j.jtcme.2014.11.036
51. Su YS, Xin JJ, Yang ZK, et al. Effects of different Local Moxibustion-Like Stimuli at Zusanli (ST36) and Zhongwan (CV12) on gastric motility and its underlying receptor mechanism. Evidence-based Complement Altern Med. 2015;2015. doi:10.1155/2015/486963.
52. Tomiyama AJ. Stress and Obesity. Annu Rev Psychol [Internet]. 2019 Jan 4;70(1):703–18. Available from: https://www.annualreviews.org/doi/10.1146/annurev-psych-010418-102936.
2. Aronne LJ, Kumar RB. Obesity Management: A Clinical Casebook [Internet]. Springer; 2018. Available from: https://link.springer.com/content/pdf/10.1007%2F978-3-030-01039-3.pdf
3. Dobbs R, Manyika J. The Obesity Crisis. In: The Road to Good Nutrition [Internet]. Basel: KARGER; 2015. p. 44–57. Available from: https://www.thecairoreview.com/essays/the-obesity-crisis/
4. Prasad DS, Kabir Z, Revathi Devi K, Peter PS, Das BC. Gender differences in central obesity: Implications for cardiometabolic health in South Asians. Indian Heart J [Internet]. 2020 May;72(3):202–4. Available from: https://doi.org/10.1016/j.ihj.2020.04.008
5. Kanter R, Caballero B. Global Gender Disparities in Obesity: A Review. Adv Nutr [Internet]. 2012 Jul 1;3(4):491–8. Available from: https://academic.oup.com/advances/article/3/4/491/4591492
6. Wang L-H, Huang W, Wei D, Ding D-G, Liu Y-R, Wang J-J, et al. Mechanisms of Acupuncture Therapy for Simple Obesity: An Evidence-Based Review of Clinical and Animal Studies on Simple Obesity. Evidence-Based Complement Altern Med [Internet]. 2019 Feb 3;2019:1–12. Available from: https://www.hindawi.com/journals/ecam/2019/5796381/
7. Chooi YC, Ding C, Magkos F. The epidemiology of obesity. Metabolism [Internet]. 2019 Mar;92:6–10. Available from: https://linkinghub.elsevier.com/retrieve/pii/S002604951830194X
8. Riskesdas LN. Kementerian Kesehatan Republik Indonesia. Badan Penelit dan Pengemb Kesehat. 2018;
9. RSCM. Data Rekam Medik RSCM. Published online 2020.
10. Weisell RC. Body mass index as an indicator of obesity. Asia Pac J Clin Nutr [Internet]. 2002 Dec;11:S681–4. Available from: http://doi.wiley.com/10.1046/j.1440-6047.11.s8.5.x
11. Aktar N, Qureshi NK, Ferdous HS. Obesity: A Review of Pathogenesis and Management Strategies in Adult. Delta Med Coll J [Internet]. 2017 Feb 4;5(1):35–48. Available from: https://www.banglajol.info/index.php/DMCJ/article/view/31436
12. Apovian CM. Obesity: definition, comorbidities, causes, and burden. Am J Manag Care [Internet]. 2016;22(7):s176–85. Available from: http://ajmc.s3.amazonaws.com/_media/_pdf/ACE0042_05_2016_Obesity_Article01.pdf
13. Oken E, Taveras EM, Popoola FA, Rich-Edwards JW, Gillman MW. Television, Walking, and DietAssociations with Postpartum Weight Retention. Am J Prev Med [Internet]. 2007 Apr;32(4):305–11. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0749379706005629
14. Hung Y-C, Hung I-L, Hu W-L, Tseng Y-J, Kuo C-E, Liao Y-N, et al. Reduction in postpartum weight with laser acupuncture. Medicine (Baltimore) [Internet]. 2016 Aug;95(34):e4716. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0749379706005629
15. Endres LK, Straub H, McKinney C, Plunkett B, Minkovitz CS, Schetter CD, et al. Postpartum Weight Retention Risk Factors and Relationship to Obesity at 1 Year. Obstet Gynecol [Internet]. 2015 Jan;125(1):144–52. Available from: https://journals.lww.com/00006250-201501000-00023
16. Heymsfield SB, Wadden TA. Mechanisms, Pathophysiology, and Management of Obesity. Longo DL, editor. N Engl J Med [Internet]. 2017 Jan 19;376(3):254–66. Available from: http://www.nejm.org/doi/10.1056/NEJMra1514009
17. Bray GA, Frühbeck G, Ryan DH, Wilding JPH. Management of obesity. Lancet [Internet]. 2016 May;387(10031):1947–56. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0140673616002713
18. Gadde KM, Martin CK, Berthoud H-R, Heymsfield SB. Obesity: Pathophysiology and Management. J Am Coll Cardiol [Internet]. 2018 Jan 2;71(1):69–84. Available from: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=PMC7958889
19. Guo T, Ren Y, Kou J, Shi J, Tianxiao S, Liang F. Acupoint Catgut Embedding for Obesity: Systematic Review and Meta-Analysis. Evidence-Based Complement Altern Med [Internet]. 2015;2015:1–20. Available from: http://www.hindawi.com/journals/ecam/2015/401914/
20. Kim S-Y, Shin I-S, Park Y-J. Effect of acupuncture and intervention types on weight loss: a systematic review and meta-analysis. Obes Rev [Internet]. 2018 Nov;19(11):1585–96. Available from: https://onlinelibrary.wiley.com/doi/10.1111/obr.12747
21. Shixi H, Yu C. Cupping Therapy. J Chinese Med. 2006;(82):52–8.
22. Deng H, Shen X. The Mechanism of Moxibustion: Ancient Theory and Modern Research. Evidence-Based Complement Altern Med [Internet]. 2013;2013:1–7. Available from: http://www.hindawi.com/journals/ecam/2013/379291/
23. Thambirajah R. Cosmetic Acupuncture: A Traditional Chinese Medicine Approach to Cosmetic and Dermatological Problems. Singing Dragon; 2015.
24. Qian X, You Y, Shu S, Zhou S. Treatment of cervical spondylotic radiculopathy: acupuncture at neck Jiáj points and blood-letting puncture with the plum-blossom needle. World J Acupunct - Moxibustion [Internet]. 2012 Dec;22(4):1–4. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1003525713600185
25. Liu Z, Wang Q, Fu B, Li X-Y. Effect of plum-blossom needle tapping with different stimulation intensities on hair regrowth in hair removal mice. J Acupunct Tuina Sci [Internet]. 2017 Jun 21;15(3):184–90. Available from: http://link.springer.com/10.1007/s11726-017-0998-7
26. Cho WC, Li C, Chen H. Clinical efficacy of acupoint embedment in weight control. Medicine (Baltimore) [Internet]. 2018 Sep;97(36):e12267. Available from: https://journals.lww.com/00005792-201809070-00107
27. Huang J, Liang J, Xu X, Xu Y, Chen G. Safety of Thread Embedding Acupuncture Therapy: A Systematic Review. Chin J Integr Med [Internet]. 2021 Apr 24;1–9. Available from: https://link.springer.com/10.1007/s11655-021-3443-1
28. Jun P, Zhi-Yong H, Richardson F. Point-penetration acupuncture: Historical development and clinical application. Acupunct Med [Internet]. 1999;17(1):36–41. Available from: http://aim.bmj.com/
29. Hislop S. The degradation of electrospun polydioxanone patches for rotator cuff repair. 2012; Available from: https://ora.ox.ac.uk/objects/uuid:02cae588-1f87-4213-a1da-17fc2dddd076/download_file?file_format=application/pdf&safe_filename=THESIS01&type_of_work=Thesis
30. Yoon JH, Kim SS, Oh SM, Kim BC, Jung W. Tissue changes over time after polydioxanone thread insertion: An animal study with pigs. J Cosmet Dermatol [Internet]. 2019 Jun 29;18(3):885–91. Available from: https://onlinelibrary.wiley.com/doi/10.1111/jocd.12718
31. Xavier Pi-Sunyer F. Obesity: criteria and classification. Proc Nutr Soc [Internet]. 2000 Nov 24;59(4):505–9. Available from: https://www.cambridge.org/core/product/identifier/S0029665100000732/type/journal_article
32. Shagana JA, Dhanraj M, Jain AR, Nirosa T. Physiological Changes in Pregnancy. Vol 10. Sixth Edit. Elsevier Ltd; 2018. doi:10.5005/jp/books/12974_8.
33. Xinnong C, Bing Z, Hongcai W. Acupuncture Therapeutics. People’s Mil Med Press Sing Dragon, USA. 2011;
34. Tajirian AL, Goldberg DJ. A review of sutures and other skin closure materials. J Cosmet Laser Ther [Internet]. 2010 Dec 10;12(6):296–302. Available from: http://www.tandfonline.com/doi/full/10.3109/14764172.2010.538413
35. Fan X, Yu M, Fu S-P, Zhuang Y, Lu S. Effectiveness of acupuncture in treatment of simple obesity in animal models: a systematic review and meta-analysis. Evidence-Based Complement Altern Med. 2019;2019.
36. An-he C, Xi-ping D, Hai-bo Z. Clinical observation of 40 cases of acne treated by acupuncture plus herbal drugs. J Acupunct Tuina Sci [Internet]. 2003 Aug;1(4):45–7. Available from: http://link.springer.com/10.1007/BF02874750
37. Wang X, Yin J. Complementary and Alternative Therapies for Chronic Constipation. Evidence-Based Complement Altern Med [Internet]. 2015;2015(d):1–11. Available from: http://www.hindawi.com/journals/ecam/2015/396396/
38. Tanudjaja CP, Simadibrata C, Srilestari A, Kresnawan T. Effects of acupoint catgut embedding therapy paired with dietary intervention on tumour necrosis factor-α levels and abdominal circumference in patients with obesity. J Phys Conf Ser [Internet]. 2018 Aug;1073(6):062032. Available from: https://iopscience.iop.org/article/10.1088/1742-6596/1073/6/062032
39. González-González Roberto G-VJ. Effects of Acupuncture on Obesity and Adipokines Involved in Body Weight Control. J Homeopath Ayurvedic Med [Internet]. 2013;02(03). Available from: https://www.omicsgroup.org/journals/effects-of-acupuncture-on-obesity-and-adipokines-involved-in-body-weight-control-2167-1206.1000129.php?aid=17335
40. Chen I-J, Yeh Y-H, Hsu C-H. Therapeutic effect of acupoint catgut embedding in abdominally obese women: a randomized, double-blind, placebo-controlled study. J women’s Heal. 2018;27(6):782–90.
41. Gao L, Kong XJ, Shi X. Effects of electroacupuncture and acupoint catgut-embedding on mRNA expression of lipid metabolism gene PPAR-gamma and related lipase of rats with simple obesity. Zhongguo zhen jiu= Chinese Acupunct moxibustion. 2011;31(6):535–8.
42. Xie J, Liu G, Qiao J, Gu Q, Gai Y, Huang S, et al. [Multi-central randomized controlled study on electroacupuncture at Fenglong (ST 40) for regulating blood lipids]. Zhongguo Zhen Jiu [Internet]. 2009 May;29(5):345–8. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19489487
43. Lee FY, Huo ZJ, Zhang L, Guo J, Chen H, Liu T, et al. The Effects of Needling Fenglong (ST40) and Neiguan (PC6) on IL-17 of ApoE-Gene-Knockout Mice’s Liver. Evidence-Based Complement Altern Med [Internet]. 2014;2014:1–5. Available from: http://dx.doi.org/10.1155/2014/691863
44. Djajadi RM, Barasila AC HD. Perbandingan efektivitas laser akupunktur dengan elektroakupunktur pada titik ST40 Fenglong dalam memperbaiki kadar kolesterol total , indeks aterogenik , dan berat lemak dinding abdomen pada tikus model diet tinggi. Available from: https://perpustakaan.fk.ui.ac.id/opac/index.php?p=show_detail&id=26859&keywords=
45. Chen L-S, Li Y-Y, Chen H, Liu B-W, Wang D-W, Zhao Y-H. Polyglycolic acid sutures embedded in abdominal acupoints for treatment of simple obesity in adults: a randomized control trial. Chin Med [Internet]. 2019 Dec 18;14(1):32. Available from: https://cmjournal.biomedcentral.com/articles/10.1186/s13020-019-0258-5
46. Wei J, Lai L, Lin Z. Acupoint Catgut Embedding versus Acupuncture for Simple Obesity A Systematic Review and Meta- Analysis of Randomized Controlled Trials. :1–19. Available from: https://doi.org/10.21203/rs.3.rs-145339/v1
47. Sheng J, Jin X, Zhu J, Chen Y, Liu X. The Effectiveness of Acupoint Catgut Embedding Therapy for Abdominal Obesity: A Systematic Review and Meta-Analysis. Evidence-Based Complement Altern Med [Internet]. 2019 Jun 23;2019:1–12. Available from: https://www.hindawi.com/journals/ecam/2019/9714313/
48. Shi Y, Zhang L, Zhao C, He C. [Comparison of therapeutic effects of acupuncture-cupping plus acupoint catgut embedding and electroacupuncture on simple obesity of stomach and intestine excess-heat type]. Zhongguo Zhen Jiu [Internet]. 2006 Aug;26(8):547–50. Available from: http://www.ncbi.nlm.nih.gov/pubmed/16941970
49. Al-Bedah AMN, Elsubai IS, Qureshi NA, Aboushanab TS, Ali GIM, El-Olemy AT, et al. The medical perspective of cupping therapy: Effects and mechanisms of action. J Tradit Complement Med [Internet]. 2019 Apr;9(2):90–7. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2225411018300191
50. Mehta P, Dhapte V. Journal of Traditional and Complementary Medicine Cupping therapy : A prudent remedy for a plethora of medical ailments. J Tradit Chinese Med Sci [Internet]. 2015;5(3):127–34. Available from: http://dx.doi.org/10.1016/j.jtcme.2014.11.036
51. Su YS, Xin JJ, Yang ZK, et al. Effects of different Local Moxibustion-Like Stimuli at Zusanli (ST36) and Zhongwan (CV12) on gastric motility and its underlying receptor mechanism. Evidence-based Complement Altern Med. 2015;2015. doi:10.1155/2015/486963.
52. Tomiyama AJ. Stress and Obesity. Annu Rev Psychol [Internet]. 2019 Jan 4;70(1):703–18. Available from: https://www.annualreviews.org/doi/10.1146/annurev-psych-010418-102936.