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Catgut Embedding Therapy for Obesity
Catgut embedding therapy, also known as acupoint catgut embedding(ACE) therapy or thread-embedding therapy combines concepts of traditional Chinese medicine with modern medical instruments. It has been famous as a body acupuncture and moxibustion therapy and applied under many conditions, such as perimenopausal syndrome, chronic urticaria, depressive neurosis, refractory insomnia, obesity, and sciatica. Especially has prominent function on assisting overweight people to tackle their healthy problem. This sort of acupoint stimulation therapy is an effective and safe approach to lose weight in a short term.

Mechanism and Process
The mechanism of catgut embedding therapy considers the catgut is the combination of heterogeneous protein. Before starting the therapy, it must be warned that the whole process is under aseptic precautions. Then the steps of cutting catgut requires a sharp and bioclean knife of scissor to slice 10 to 15 surgical chromic catgut into 1 cm segments, with a permitted length deviation of 0.5 cm. After that, these catgut will be inserted into patients' substance tissues of the extremities and abdomen with an internal diameter of o.6 mm specialised needle with. After experiencing the process of softening, decomposition, liquidation and finally absorption, the function of metabolism would be promoted and accelerated.

For simple obesity
Some authorized medical investigations and studies( assigned by the Oxford Centre for Evidence Based Medicine 2011 levels of evidence) demonstrate the usefulness of catgut embedding therapy on controlling obesity. The experiment involved the comparison between three medical methods, which is electroacupuncture, acupuncture and catgut embedding therapy respectively by recording their decreasing in waistline, hip circumference, and waist-to-hip ratio. There are eight groups as the randomised controlled trial(RCL). The result showed that five of eight controlled trial from embedding group obtained more significant effect through this therapy, with difference between groups (P＜0.05)

Polycystic ovary syndrome (PCOS) -endocrine disease
PCOS is described as a female metabolic syndrome with low menstruation, amenorrhea and obesity. There is a rising trend about more and more female patients are suffering the metal and physical damage due to PCOS. This phenomenon has attracted tremendous attention in the medical profession. Medical specialists then examined and compared the effect by adopting acupuncture-drug(21 cases), catgut embedding therapy(21 cases) and chinese medicine(20 cases) on PCOS patients respectively.

postoperative complication
Although the catgut embedding therapy has long history in traditional Chinese medicine for thousands of years, but the potential risk of being unsuccessful still exists. There is a failed case emphasizing the possible complication of this sort of operation.

case information
This case comes from a 27-year-old woman who did not have medical history about systemic disease and accepted the three courses of catgut embedding therapy with seven days intervals between each courses for obesity. However, after the second course,she found an eythematous swelling and became worsen after finishing three courses.

cardinal symptom
Dermatological examination disclosed multiple itchy and tender skin lesions and bean-sized erythematous nodules with central darkened points in a linear arrangement over medial thighs and over the lower abdomen.

investigation
After tissue cultures for bacteria, fungus and mycobacterium examination. The evident foreign body reaction was observed, the major histopathological changes are mixed acute and chronic xanthogranulomatous inflammatory infiltration with the result were all negative.

treatment
The medical treatment adopted was using excisional biopsy approach to excise large and painful lesions.

recovery
Six month later, the appearance of itchy skin lesions on her abdomen and thighs regressed spontaneously.

conclusion
Although this treatment of obesity has been developed, improved and revolutionized greatly in Chinese medical history, but the potential risk and some unpredictable side effect still exist. So there are some important instructions and preparations require people's attention.


 * 1) Iatrognic infection is the side effect most likely to occur, doctors must do some examinations before implementation.
 * 2) The patients have responsibilities to check their medical history carefully before receiving the treatment.
 * 3) Periodic review is extremely important after the treatment.

limitations
There is no doubt that catgut embedding therapy has prominent advantages on improving anthropometric and biochemical parameters compared with other distinct methods. However, some identifiable limitations cannot be ignored.

=== gender limitations === Gender limitation means some studies only focus on female subjects because of the metabolic rate differences between male and female. Consequently, even a lot of experiments and investigations compare the effectiveness of variable chinese acuputure medicine apart from catgut embedding therapy, such as electroacupture and acupuncture-drug, whereas they only tested women.

follow-up limitations
There is a typical phenomenon that after six-week therapy, it is hard to acquire some accurate follow-up information, this is due to patients' anticipation of losing more weight and thus except the pure catgut embedding therapy, some of them undertake Chinese herbal medicine which will influence the final result.