针灸周期疗法配合俞募配穴治疗肥胖型多囊卵巢综合征的回顾性分析

Retrospective Analysis of Acupuncture Cycle Therapy Combined with Shu-mu Points in Treatment of Obese Polycystic Ovary Syndrome

【目的】分析针灸周期疗法配合俞募配穴治疗肥胖型多囊卵巢综合征(PCOS)的临床疗效。【方法】采用回顾性研究方法,选取2018年10月至2020年10月在广东省中医院总院及分院就诊的94例肥胖型PCOS患者,根据是否运用针灸周期疗法配合俞募配穴治疗分为治疗组48例和对照组46例,2组均给予健康宣教,对照组给予口服盐酸二甲双胍及炔雌醇环丙孕酮片治疗,治疗组在对照组治疗的基础上,给予针灸周期疗法配合俞募配穴治疗。疗程为3个月。观察2组患者治疗前后体质量指数(BMI)、腰围、腰臀比水平的变化情况,以及黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)、睾酮(T)水平的变化情况,计算LH/FSH比值,并评价2组患者的临床疗效。比较胰岛素抵抗及糖脂代谢指标空腹血糖、空腹胰岛素、甘油三酯、总胆固醇水平以及胰岛素抵抗指数(HOMA-IR)的变化情况。【结果】(1)治疗3个月后,治疗组总有效率为89.58%(43/48),对照组为73.91%(34/46)。治疗组疗效优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的BMI、腰围、腰臀比水平均明显改善(P<0.05),且治疗组在改善BMI、腰围、腰臀比水平方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者的LH/FSH、T水平均明显改善,与治疗前比较,差异有统计学意义(P<0.05),但2组比较,差异无统计学意义(P> 0.05)。2组患者的E2水平稍有改善,但与治疗前比较,差异无统计学意义(P> 0.05),治疗组患者的E2水平,与对照组比较,差异无统计学意义(P> 0.05)。(4)治疗后,2组患者的空腹血糖、空腹胰岛素、HOMA-IR、甘油三酯、总胆固醇水平均明显改善(P<0.05),且治疗组在改善空腹血糖、空腹胰岛素、HOMA-IR、甘油三酯、总胆固醇水平方面明显优于对照组,差异有统计学意义(P<0.05)。【结论】针灸周期疗法配合俞募配穴治疗肥胖型多囊卵巢综合征疗效显著,其疗效优于单纯西药治疗。

Objective To analyze the clinical efficacy of acupuncture cycle therapy combined with Shu-mu points in the treatment of obese polycystic ovary syndrome(PCOS). Methods A restrosperctive study was carried out,and ninety-four cases of PCOS patients who were admitted to General Hospital and Branch Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine from October 2018 to October 2020 were divided into treatment group(48 cases)and control group(46 cases)according to whether or not acupuncture cycle therapy combined with Shu-mu points treatment was recieved. Both groups were given health education,while the control group was given oral use of Metformin hydrochloride and Ethinylestrel cycloproterone tablets,and the treatment group was given acupuncture cycle therapy combined with Shu-mu points on the basis of the control group. One menstrual cycle as one course of treatment and the treatment lasted for 3 months. The changes of body mass index(BMI), waist circumference, waist-hip ratio(WHR), luteinizing hormone(LH), follicle stimulating hormone(FSH),estradiol(E2)and testosterone(T)were observed before and after treatment,LH/FSH was calculated,and the clinical efficacy of the two groups was evaluated. The changes of insulin resistance and glucose and lipid metabolism indicators were compared:the changes of fasting blood glucose,fasting insulin,triglyceride,total cholesterol levels and insulin resistance index(HOMA-IR). Results(1)After 3 months of treatment,the total effective rate was 89.58%(43/48)in the treatment group and 73.91%(34/46)in the control group. The curative effect of the treatment group was superior to that of the control group,and the difference was statistically significant(P < 0.05).(2)After treatment,BMI,waist circumference and WHR ratio of the two groups were significantly improved(P < 0.05),and the improvement of the treatment group was significantly superior to that of the control group,the difference was statistically significant(P < 0.05).(3)After treatment,the LH/FSH and T levels in the two groups were significantly improved, and the difference was statistically significant as compared with those before treatment(P < 0.05),but there was no statistically significant difference between the two groups(P > 0.05).The level of E2 in the two groups was slightly improved, and the difference was not statistically significant as compared with that before treatment(P > 0.05). The level of E2 in the treatment group was not statistically significant compared with that in the control group(P > 0.05).(4)After treatment, the fasting blood glucose,fasting insulin,HOMA-IR,triglyceride,total cholesterol levels of the two groups were significantly improved(P < 0.05),and the treatment group in improving the fasting glucose,fasting insulin,HOMA-IR,triglyceride,total cholesterol level is superior to the control group, the difference being statistically significant(P < 0.05).Conclusion Acupuncture cycle therapy combined with Shu-mu points is effective for the treatment of obese PCOS,and its therapeutic effect is superior to western medicine alone.