朱琏针法对肥胖型多囊卵巢综合征患者性激素和代谢水平及卵巢形态和功能的影响

Effect of ZHU Lian′s Acupuncture on sex hormone and metabolic levels and ovarian morphology and function in polycystic ovary syndrome patients with obesity

目的探讨朱琏针法对肥胖型多囊卵巢综合征(PCOS)患者性激素和代谢水平、卵巢形态和功能的影响。方法将120例肥胖型PCOS患者随机分为朱琏针法组、常规针刺组及西药(达英-35)组各40例,采用相应的方法治疗3个月经周期。对比治疗前及治疗3个周期后3组的体质指数、性激素水平、卵巢形态、行经周期天数,以及治疗后的妊娠情况。结果(1)治疗后,朱琏针法组的体质指数低于治疗前及其他两组(均P<0.05),其他两组治疗前后体质指数差异无统计学意义(均P>0.05)。(2)治疗后,朱琏针法组和西药组黄体生成素(LH)、LH/促卵泡激素比值、睾酮水平较治疗前下降,常规针刺组LH较治疗前下降而泌乳素水平较治疗前升高(均P<0.05)。(3)治疗后,朱琏针法组的卵巢体积较治疗前及常规针刺组小(P<0.05);西药组及朱琏针法组<10 mm的卵泡数量均较治疗前少(P<0.05),且朱琏针法的小卵泡数量少于其他组(P<0.05)。(4)治疗后3组的行经天数均较治疗前有改善(P<0.05),但3组之间差异无统计学意义(P>0.05)。(5)朱琏针法组、常规针刺组、西药组的妊娠率分为25.0%、15.0%、15.0%。结论与西药及常规针刺相比,朱琏针法在改善肥胖型PCOS患者的性激素水平方面效果相当,但其可更好地改善代谢水平,以及卵巢形态和功能,能让患者综合获益更大。

Objective To explore the effect of ZHU Lian′s Acupuncture on sex hormone and metabolic levels and ovarian morphology and function in polycystic ovary syndrome(PCOS)patients with obesity.Methods Totally 120 PCOS patients with obesity were randomized to ZHU Lian′s Acupuncture group(n=40),routine acupuncture group(n=40)and western medicine(Diane-35)group(n=40),and were treated for three menstrual cycles by using corresponding approaches.Related indicators were compared among the three groups,including body mass index,sex hormone level,ovarian morphology,and duration of menstruation before treatment and after three menstrual cycles of treatment,as well as the occurrence of pregnancy after treatment.Results(1)After treatment,the ZHU Lian′s Acupuncture group had lower body mass index compared with the pre-therapy and the other two groups(all P<0.05),but there was no statistically significant difference between the pre-therapeutic and post-therapeutic body mass indexes in the other two groups(all P>0.05).(2)Compared with the pre-therapeutic levels,the post-therapeutic luteotropic hormone(LH),LH/follicle-stimulating hormone(FSH)ratio and testosterone levels were decreased in the ZHU Lian′s Acupuncture group and the western medicine group,while LH level was lower and prolactin level was higher in the routine acupuncture group(all P<0.05).(3)After treatment,ovarian volume was smaller in the ZHU Lian′s Acupuncture group than the pre-therapeutic volume and that in the routine acupuncture group(P<0.05);the western medicine group and the ZHU Lian′s Acupuncture group exhibited decreased number of follicles smaller than 10 mm as compared with the pre-therapy(P<0.05),and the ZHU Lian′s Acupuncture group obtained fewer small follicles than the other groups(P<0.05).(4)After treatment,duration of menstruation was improved in the three groups as compared with the pre-therapeutic(P<0.05),but no statistically significant difference was found among the three groups(P>0.05).(5)The pregnancy rates were 25.0%,15.0%and 15.0%in the ZHU Lian′s Acupuncture group,the routine acupuncture group and the western medicine group,respectively.Conclusion Compared with western medicine and routine acupuncture,ZHU Lian′s Acupuncture achieves similar efficacy for improvements in sex hormone level in PCOS patients with obesity,furthermore,it can better improve metabolic level as well as ovarian morphology and function,and patients can benefit from that approach comprehensively.