董氏针灸治疗肥胖型多囊卵巢综合征疗效及对卵巢储备功能的影响

Effect of Dong′s Acupuncture on Obese Polycystic Ovary Syndrome and Ovarian Reserve Function

目的观察董氏针灸治疗肥胖型多囊卵巢综合征(Polycystic ovarian syndrome,PCOS)疗效及对卵巢储备功能的影响。方法选取2019年12月—2020年12月期间于天津中医药大学第一附属医院妇科治疗的104例PCOS患者,按随机数字表法分为对照组和治疗组,每组各52例。对照组给予盐酸二甲双胍片联合炔雌醇环丙孕酮片治疗,治疗组在对照组基础上给予董氏针灸治疗。治疗3个月后,观察比较两组患者治疗前后抗苗勒管激素(Anti-Müllerian hormone,AMH)、抑制素B(Inhibin B,INHB)、雌二醇(Estradiol 2,E)、促卵泡刺激素(Follicle-stimulating hormone,FSH)、人白脂素(Asprosin)、视黄醇结合蛋白4(Retinol BindingProtein4,RBP-4)、胆固醇(Total Cholesterol,TC)、餐后2 h血糖(2-hour postprandial blood glucose,2 h PG)、甘油三酯(triglyceride,TG)、空腹血糖(Fasting plasma glucose,FPG)水平,卵泡数目和卵巢体积,搏动指数(Pulsatility,PI)、收缩期最大流速(Peak systolic velocity,PSV)、舒张末期流速(End-diastolic volume,EDV)、阻力指数(Resistance index,RI)水平。结果治疗后两组患者INHB、FSH、AMH、EDV、RI水平较治疗前降低,E、PSV、PI水平较治疗前升高,差异有统计学意义(P<0.05);且治疗组INHB、FSH、AMH、EDV、RI水平低于对照组,E、PSV、PI水平高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者Asprosin、RBP-4、FPG、2 h PG、TC、TG水平及卵巢体积、卵泡数目均较治疗前降低,差异有统计学意义(P<0.05);且治疗组Asprosin、RBP-4、FPG、2 h PG、TC、TG水平及卵巢体积、卵泡数目均低于对照组,差异有统计学意义(P<0.05)。结论给予肥胖型PCOS患者董氏针灸治疗,可改善患者多囊样改变状态及卵巢储备功能,调节内分泌功能,改善患者代谢指标及卵巢基质血流动力学。

Objective To observe the effect of Dong′s acupuncture on obese polycystic ovary syndrome(PCOS)and ovarian reserve function.Methods A total of 104 patients with PCOS who were treated in the Gynecology Department of the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from December 2019 to December 2020 were selected and divided into a reference group and a exploration group by the random number table method,with 52 cases in each group.The reference group was given metformin hydrochloride tablets combined with ethinyl estradiol and cyproterone tablets.The exploration group was given Dong′s acupuncture treatment on the basis of the reference group.After 3 months of treatment,the anti-Müllerian hormone(AMH),inhibin B(INHB),estradiol 2(E),follicle-stimulating hormone(FSH),asprosin,retinol binding protein 4(RBP-4),total cholesterol(TC),2-hour postprandial blood glucose(2 h PG),triglyceride(TG),fasting plasma glucose(FPG)levels,follicle number and ovarian volume,pulsatility index(PI),peak systolic velocity(PSV),end-diastolic volume(EDV),and resistance index(RI)levels of the two groups were compared.Results After treatment,the levels of INHB,FSH,AMH,EDV,and RI in the two groups were lower than those before treatment,while the levels of E,PSV,and PI were higher than those before treatment(P<0.05).The levels of INHB,FSH,AMH,EDV,and RI in the exploration group were lower than those in the reference group,and the levels of E,PSV,and PI were higher than those in the reference group(P<0.05).After treatment,the levels of asprosin,RBP-4,FPG,2 h PG,TC,TG,ovarian volume,and follicle number in the two groups were all lower than those before treatment(P<0.05),and the exploration group was lower than the reference group(P<0.05).Conclusion Dong′s acupuncture treatment for obese patients with PCOS improves the polycystic state and ovarian reserve function,regulates the endocrine function,and improves the metabolic indicators and ovarian stromal hemodynamics.