针刺加TDP对绝经后肝肾亏虚证患者雌激素及骨代谢的影响

Effect of acupuncture combined with TDP on estrogen and bone metabolism in postmenopausal patients with deficiency of liver and kidney syndrome

目的:观察针刺加TDP治疗绝经后肝肾亏虚证患者的临床疗效并探讨其作用机制。方法:将112例患者随机分为针刺组、西药组,每组各56例。针刺组采用针刺配合TDP照射,穴取肾俞、命门、关元为主,每日1次;西药组口服乙炔雌二醇戊醚(维尼安)每月2次,谷维素每日3次。两组均治疗3个月后评定疗效,并观察治疗前后患者雌激素、骨密度及子宫内膜的变化。结果:针刺组总有效率94.6%优于西药组的75.0%(P<0.01);在升高骨密度、减少子宫内膜厚度方面针刺组优于西药组(P<0.05,P<0.01);在降低血清促卵泡激素(FSH)、促黄体生成素(LH)及升高雌二醇(E2)水平方面西药组优于针刺组(均P<0.01)。结论:针刺加TDP治疗绝经后肝肾亏虚患者临床疗效显著,可升高骨密度,减少子宫内膜厚度,对雌激素水平有明显的调节作用。

Objective To observe the clinical effect of acupuncture combined with TDP for treatment of postmenopausal patients with deficiency of liver and kidney syndrome and to explore its mechanism. Methods One hundred and twelve cases were randomly divided into an acupuncture group and a medication group, 56 cases in each group. The acupuncture group was treated with acupuncture combined with TDP, Shenshu （BL 23）, Mingmen （GV 4） and Guanyuan （CV4） were selected as main points; the medication group was treated with oral administra tion of Nylestriol and Oryzanol. The therapeutic effects were evaluated after treatment of 3 months in the two groups, and the changes of estrogen, bone mineral density and endometrium of patients were observed before and after treatment. Results The total effective rate of 94.6% in acupuncture group was superior to 75.0% in medication group （P〈0.01）, the acupuncture group was better than the medication group in increasing bone mineral density and decreasing the endometrial thickness （P〈0.05, P〈0.01）, the medication group was better than the acupunc ture group in decreasing the levels of serum follicular stimulating hormone （FSH） and luteinizing hormone （LH） and increasing the estradiol （E2） level （all P〈0.01）. Conclusion The clilnical effect of acupuncture combined with TDP for treatment of postmenopausal patients with deficiency of liver and kidney syndrome is significant, and it can increase bone mineral density,decrease endometrial thickness and obviously regulate the estrogen level.