清胃健脾法治疗超重并胰岛素抵抗型多囊卵巢综合征52例

Curative Effect of Jianpiqingwei Therapeutic Effect in Treating 52 Cases of Overweight Women with Insulin-Resistant and Polycystic Ovary Syndrome

目的:观察清胃健脾法治疗超重胰岛素抵抗(Insulin Resistance,IR)型多囊卵巢综合征(Polycystic Ovary Syndrome,PCOS)的疗效。方法:选取52例BMI>23、证属胃热脾虚合并IR的PCOS患者作为研究对象,予半夏泻心汤加减治疗12周。分别统计治疗前及治疗后空腹和餐后1 h、2 h的血糖、胰岛素(INS)及雌二醇(E2)、促卵泡素(FSH)、黄体生成素(LH)、睾酮(T)、总胆固醇(CHO)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C),计算胰岛素和血糖曲线下面积;治疗4周、8周、12周的妊娠率、基础体温双相率。治疗前、治疗4周、8周、12周月经周期评分、身高、体重、腰围、臀围,计算体重指数(Body Mass Index,BMI)和腰臀比(WHR)。结果:1)治疗后胰岛素曲线下面积、餐后2 h INS和TG较治疗前明显降低(P<0.05);2)治疗前后E2、FSH、LH、LH/FSH、T无明显统计学意义;3)治疗后累计妊娠率18.2%,基础体温周期双相率53.1%;4)治疗4周、8周、12周后月经周期评分较治疗前均降低(P<0.05;P<0.01);5)治疗后4周、8周、12周后腰围较治疗前明显缩小(P<0.01),BMI及WHR无明显变化。结论:清胃健脾法可提高超重胰岛素抵抗型PCOS患者胰岛素敏感性,降低三酰甘油,促进自发排卵和自主月经的恢复。

Objective： To observe the curative effect of jianpiqingwei therapeutic in treating overweight women with insulin-resistant and polycystic ovary syndrome. Methods： Select 52 women of BMI 23 with IR and PCOS while spleen deficient and stomach heat and modified Banxiaxiexin Decoction were taken twice a day for 12 weeks. The oral glucose tolerance test and insulin release test were performed and the area under glucose and insulin curve were measure before and after 12 weeks＇ treatment,as well as hormone levels（ E2,FSH,LH,T）,CHO,TG,LDL-C,HDL-C. The rate of pregnancy and double phase of BBT were counted after 4 weeks,8weeks,12 weeks＇ treatment. The menstrual cycle score,height,weight,waist circumference,hip circumference,BMI,WHR were recorded before and after 4 weeks,8 weeks,12 weeks＇ treatment. Results： 1） Compared with before-treatment,area under insulin curve,2 hour post-meal insulin and TG were significantly lower after 12 weeks＇ treatment（ P〈0. 05）. 2） There was no significant difference in E2、FSH、LH、LH/FSH、T after 12 weeks＇ treatment. 3） After 12 weeks＇ treatment,the cumulative rate of pregnancy was 18. 2% and double phase of BBT was 53. 1%. 4） The menstrual cycle score was significantly lower after 4 weeks＇ treatment,8weeks＇ treatment,12 weeks＇ treatment compared with before-treatment（ P〈0. 05; P〈0. 01）. 5） Compared with before-treatment,the waist circumference was significantly reduced than after 4 weeks＇ treatment,8 weeks＇ treatment,12 weeks＇ treatment,while BMI and WHR had no significant changes. Conclusion： Jianpiqingwei therapeutic can improve insulin sensitivity in overweight women with insulin-resistant and polycystic ovary syndrome and lower triglyceride. Also it can promote spontaneous ovulation and autonomous menses recovery.