董氏针灸改善多囊卵巢综合征患者卵巢功能:随机对照预试验

DONG's extraordinary acupoints for the ovarian function of polycystic ovary syndrome: a randomized controlled pilot trial

目的:初步评价董氏针灸改善多囊卵巢综合征(polycystic ovary syndrome,PCOS)患者卵巢功能的疗效。方法:将56例患者随机分为针刺组和药物组,针刺组穴取"妇科""还巢""天皇"(阴陵泉)、"人皇"(三阴交)、关元、子宫,一周2次,连续治疗12周;药物组口服达英-35片,1次/d,服药21 d,停药7 d,继续下一疗程,共治疗3个月经周期。以血清LH/FSH比值为主要指标,血清睾酮(T)、促卵泡刺激素(FSH)、促黄体生成素(LH)水平、体质量指数(BMI)、卵巢及月经情况为次要指标进行疗效评价。结果:(1)治疗后,针刺组和药物组血清LH/FSH比值均较治疗前下降(P<0.05,P<0.01),LH/FSH比值降低幅度两组间比较差异无统计学意义(P>0.05)。(2)针刺组和药物组BMI及血清T、LH水平均较治疗前下降(P<0.05,P<0.01),但组间差值比较差异均无统计学意义(均P>0.05)。(3)针刺组和药物组卵巢大小与治疗前比较差异均无统计学意义(均P>0.05),针刺组卵巢大小的缩小幅度大于药物组(P<0.05);针刺组卵巢单一切面卵泡数量>10个的卵巢数量较治疗前减少(P<0.05),减少程度两组间比较差异无统计学意义(P>0.05)。(4)针刺组和药物组治疗后3个月内来潮次数及行经天数均较治疗前提高(均P<0.01),但两组间差值比较差异均无统计学意义(均P>0.05)。结论:董氏针灸能明显改善多囊卵巢综合征患者的卵巢功能,可达到与药物达英-35相当的疗效。

Objective To preliminary assess the efficacy of DONG＇s extraordinary acupoints for the ovarian function of polycystic ovary syndrome. Methods Fifty-six patients were randomized into an acupuncture group and a western medication group. In the acupuncture group, the acupoints were Fuke, Huanchao, Tianhuang（Yinlingquan, SP 9）, Renhuang（Sanyinjiao, SP 6）, Guanyuan（CV 4）, Zigong（EX-CA 1）. The treatment was used twice a week for continuous 12 weeks. In the western medication group, patients were given diane-35 for 3 menstrual cycles, once a day for 21 days with 7 days between the two sessions. The ratio of luteinizing hormone/flitropin（LH/FSH） was taken as the primary index, while the secondary indices were serum testosterone（T）, FSH, LH, body mass index（BMI）, the condition of ovary and menstruation. Results（1）After treatment, the ratio of LH/FSH declined in both the two groups（P〈0.05, P〈0.01）. The decreasing values of the two groups were not significantly different（P〈0.05）.（2）T, LH and BMI dropped in the two groups（P〈0.05, P〈0.01）. The decreasing values of the three indices between the two groups were not significantly different（all P〈0.05）.（3）The size of ovary did not change significantly after treatment in the two groups（both P〈0.05）, but the reduction degree of ovary size of the acupuncture group was larger than that of the western medication group（P〈0.05）. The ovary number of more than 10 foliiculi in single ovary in the acupuncture group reduced compared with that before treatment（P〈0.05）. The reduction degree of ovary number with the above feature was not significantly different between the two groups（P〈0.05）.（4）The times and days of menstruation within 3 months increased significantly in the two groups（all P〈0.01）,without significance of different valves between the two groups（both P〈0.05）. Conclusion DONG＇s extraordinary acupoints could improve the ovarian function of polycystic ovary syndrome, whose effect is similar as diane-35.