穴位埋线联合盐酸二甲双胍片治疗肾虚痰湿型多囊卵巢综合征胰岛素抵抗50例临床观察

Observation of acupoint catgut implantation combined with metformin hydrochloride tablets on renal deficiency and phlegm- damp type polycystic ovarian syndrome with insulin resistance

目的观察穴位埋线联合二甲双胍治疗肾虚痰湿型多囊卵巢综合征(PCOS)胰岛素抵抗的临床疗效。方法将100例PCOS患者随机分为治疗组和对照组,各50例。对照组予盐酸二甲双胍片治疗,治疗组在对照组基础上在非月经期加用穴位埋线治疗。观察比较2组治疗前后体质量指数(BMI)、血糖和胰岛素相关指标[空腹血糖(FPG)、餐后2 h血糖(2 hPG)、空腹胰岛素、餐后2 h胰岛素、稳态模型的胰岛素抵抗指数(HOMA-IR)、稳态模型的胰岛素β细胞分泌指数(HOMA-β)]、血脂相关指标[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A(Apo-A)及载脂蛋白B(Apo-B)]及性激素相关指标[促黄体生成激素(LH)、卵泡刺激素(FSH)、雌二醇(E2)、睾酮(T)、LH/FSH比值]的水平变化。结果 2组治疗后BMI均明显下降(P<0.05),且组间比较差异有统计学意义(P<0.05);治疗组治疗后FPG、空腹胰岛素、2 hPG、餐后2 h胰岛素、HOMA-IR指数及HOMA-β指数均明显降低(P<0.05),对照组治疗后仅FPG、空腹胰岛素、HOMA-IR指数及HOMA-β指数明显降低(P<0.05),且治疗组治疗后空腹胰岛素、餐后2 h胰岛素及HOMA-IR指数水平变化与对照组治疗后比较差异有统计学意义(P<0.05);治疗组治疗后TG、LDL-C及Apo-A均降低、HDL-C升高(P<0.05),对照组治疗后仅TG及LDL-C降低、HDL-C升高(P<0.05),且治疗组治疗后TG、HDL-C、LDL-C及Apo-A水平变化与对照组治疗后比较差异有统计学意义(P<0.05);治疗组治疗后LH、LH/FSH及T水平均明显降低(P<0.05),对照组治疗后仅LH及T水平明显降低(P<0.05),且治疗组治疗后LH及LH/FSH水平变化与对照组治疗后比较差异有统计学意义(P<0.05)。结论穴位埋线联合二甲双胍片治疗肾虚痰湿型PCOS胰岛素抵抗可以明显改善患者临床症状,降低患者BMI,纠正患者血糖、血脂代谢异常,改善患者胰岛素抵抗,调整性激素水平,可有效治疗PCOS。

Objective To observe the effect of acupoint catgut implantation combined with metformin hydro -chloride tablets on renal deficiency and phlegm -damp type polycystic ovarian syndrome （ PCOS） with insulin resist-ance （ IR） .Methods 100 PCOS patients were randomly divided into two groups .50 patients in control group were treated by metformin hydrochloride tablets .50 cases in treatment group were treated by acupoint catgut implantation in the non-menstrual period on the basis of control group treatment .The changes of BMI, FPG, 2 hPG, fasting insulin, postprandial 2h insulin, Homeostasis model of insulin resistance index （HOMA-IR）, HOMA-β, T, TG, HDLC,＆amp;nbsp;LDL-C, ApoA, APOB,LH, FSH, E2 , T and LH/FSH levels were observed and compared in two groups .Results The levels of BMI after treatment were decreased signif-icantly in two groups （P 〈0.05）, there was difference between groups （P〈0.05）.The levels of FPG, fasting insulin, 2 hPG, postprandial 2 h insulin, HOMA-IR and HOMA-βafter treatment were obviously decreased in treatment group （P〈0.05）, but the levels of FPG, fasting insulin, HOMA-IR and HOMA-βafter treatment were decreased in control group （P〈0.05）.And there were significant differences between two groups on the levels of FPG, fasting insulin and HOMA-IR after treatment （P〈0.05）.The levels of TG, LDL-C and Apo-A after treat-ment were decreased and the level of HDL -C was increased in treatment group （P〈0.05）.But in control group the levels of TG and LDL -C were reduced and the level of HDL -C was increased after treatment （ P〈0.05 ） .And there were significant differences between two groups on the changes of levels of TG , LDL-C, HDL-C and Apo-A after treatment （P〈0.05）.The levels of LH, LH/FSH and T after treatment were significantly decreased in treat-ment group （P〈0.05）.But in control group the levels of LH and T were significantly reduced after treatment （P〈0.05）.And there was significant difference between two groups on the levels of LH and LH /FSH after treatment （P〈0.05）.Conclusion Acupoint catgut implantation combined with metformin hydrochloride tablets on renal defi -ciency and phlegm -damp type PCOS with IR can obviously improve clinical symptoms of patients , reduce BMI , cor-rect blood sugar and blood lipid metabolic disturbance , improve IR, regulate levels of hormone and effectively treat P-COS.