针刺对多囊卵巢综合征痰湿证患者血清代谢组分的影响机制研究

Study on Mechanism of Effects of Acupuncture on Serum Metabolic Components of Phlegm-dampness Type of Polycystic Ovary Syndrome

目的探索针刺对多囊卵巢综合征(PCOS)痰湿证患者血清代谢组分影响的作用机制。方法采用随机数字表法将PCOS痰湿证患者分为针刺组和西药组各20例。针刺组予针灸治疗,每日1次,周末及经期暂停;西药组予炔雌醇环丙孕酮片,每日1片,口服,自月经来潮或撤退性出血第5日起连续治疗21 d。2组均连续治疗3个月。观察2组治疗前后卵泡刺激素(FSH)、黄体生成素(LH)、睾酮(T)水平,比较LH/FSH、体质量指数(BMI);检测2组治疗前后血清内源性小分子代谢物,比较2组代谢图谱差异,分析针刺对患者血清小分子代谢物的影响,确定其与人体生化代谢通路异常的内在联系。结果与本组治疗前比较,2组治疗后FSH、LH、T、LH/FSH、BMI明显改善(P<0.05);2组治疗后比较,针刺组BMI优于西药组(P<0.05)。2组均对酮类合成降解、生物素代谢、赖氨酸合成降解等代谢通路产生影响,针刺组对PCOS痰湿证生物标志物柠檬酸及其上游糖代谢相关小分子代谢物所在通路影响更为显著。结论针刺可能通过影响柠檬酸循环改善糖酵解和糖异生,恢复PCOS痰湿证患者的能量代谢。

Objective To explore the mechanism of acupuncture on serum metabolic components of phlegm-dampness type of polycystic ovary syndrome(PCOS).Methods Patients with phlegm-dampness type of PCOS were divided into acupuncture group and Western medicine group according to random number table method,with 20 patients in each group.Acupuncture group was treated with acupuncture,once a day,resting during weekends and menstrual periods;Western medicine group was treated with ethinylestradiol cyproterone tablets,one tablet a day,orally,taking 21 days from the 5th day of menstrual cramps(or withdrawal bleeding).Treatment for both groups lasted for three months.The levels of follicle stimulating hormone(FSH),luteinizing hormone(LH)and testosterone(T)were observed before and after treatment.The LH/FSH and body mass index(BMI)were compared.The serum endogenous small molecule metabolites of the two groups were detected before and after treatment.The differences of metabolic profiles were compared.The effects of acupuncture on serum small molecule metabolites were analyzed to determine its intrinsic link with abnormalities of human biochemical metabolic pathways.Results Compared with before treatment,the FSH,LH,T,LH/FSH and BMI of the two groups were significantly improved(P<0.05).After treatment,BMI in the acupuncture group was better than that in the Western medicine group(P<0.05).Both groups had effects on metabolic pathways such as ketone synthesis degradation,biotin metabolism,lysine synthesis and degradation. But acupuncture group had a more significant effect on the pathway of biomarkercitric acid of phlegm-dampness type of PCOS and its upstream sugar metabolism-related small moleculemetabolites. Conclusion Acupuncture may improve glycolysis and gluconeogenesis by affecting the citric acid cycle,and restore the energy metabolism of phlegm-dampness type of PCOS.