针药结合治疗多囊卵巢综合征的临床疗效及对血清IL-6的影响

Clinical effect of acupuncture combined with Chinese medicine in treatment of polycystic ovary syndrome and its influence on serum IL-6

目的与单纯西药治疗比较,探讨针药结合、中西医结合治疗多囊卵巢综合征(PCOS)的临床疗效,及其对患者血清白介素-6(IL-6)水平的影响。方法纳入PCOS患者90例,随机分为对照组、针药结合组、中西医结合组,每组30例。对照组患者给予盐酸二甲双胍片口服,针药结合组患者给予针刺结合补肾化痰活血方口服,中西医结合组患者给予前述两组联合的治疗方法,3组疗程均为6个月。评价3组患者的PCOS体征评分;检测所有患者的血清IL-6及性激素睾酮(T)、卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_(2))、催乳素(PRL)水平,计算LH/FSH比值;比较3组患者的体质量、体质量指数(BMI)、腰围、腰臀比(WHR)的变化。结果①治疗后,3组患者的PCOS体征评分较治疗前均明显降低(P<0.05),且中西医结合组患者的评分低于对照组(P<0.05)。②治疗后,3组患者的血清IL-6水平较治疗前均明显降低(P<0.05),且中西医结合组患者的血清IL-6水平低于对照组、针药结合组(P<0.05)。③治疗后,3组患者的体质量、BMI、腰围、WHR较治疗前均明显下降(P<0.05),且针药结合组、中西医结合组患者的WHR低于对照组(P<0.05)。④治疗后,3组患者的LH、T水平及LH/FSH比值较治疗前均明显降低(P<0.05),但各项性激素水平及LH/FSH比值的组间差异均无统计学意义(P>0.05)。结论中医针药结合的补肾化痰活血法能有效改善PCOS患者的临床体征及肥胖指标,改善性激素水平,降低炎症因子水平,且与二甲双胍结合使用疗效更优。

Objective To explore the clinical effects of acupuncture combined with Chinese medicine and traditional Chinese medicine combined with western medicine in the treatment of polycystic ovary syndrome(PCOS)compared with western medicine treatment only,and its influence on the level of serum interleukin-6(IL-6).Methods A total of 90 patients with PCOS were included and randomly divided into the control group,acupuncture combined with Chinese medicine group and traditional Chinese medicine combined with western medicine group,30 cases in each group.The patients in the control group were treated with metformin hydrochloride tablets orally,the patients in the acupuncture combined with Chinese medicine group were treated with acupuncture combined with Bushen Huatan Huoxue Formula orally,and the patients in the traditional Chinese medicine combined with western medicine group were treated with the treatment methods of the above two groups.The treatment course of the three groups was 6 months.The PCOS sign scores of the three groups were evaluated.The levels of serum IL-6 and sex hormones including testosterone(T),folliclestimulating hormone(FSH),luteinizing hormone(LH),estradiol(E_(2))and prolactin(PRL)of all the patients were detected,and the LH/FSH ratio was calculated.The changes of body mass,body mass index(BMI),waist circumference and waist-to-hip ratio(WHR)in the three groups were compared.Results①After treatment,the PCOS sign scores of the three groups were significantly decreased compared with those before treatment(P<0.05),and the score of the traditional Chinese medicine combined with western medicine group was lower than that of the control group(P<0.05).②After treatment,the level of serum IL-6 in the three groups was significantly decreased compared with that before treatment(P<0.05),and the level of serum IL-6 in the traditional Chinese medicine combined with western medicine group was lower than that in the control group and the acupuncture combined with Chinese medicine group(P<0.05).③After treatment,the body mass,BMI,waist circumference and WHR of the three groups were significantly decreased compared with those before treatment(P<0.05),and the WHR of the acupuncture combined with Chinese medicine group and traditional Chinese medicine combined with western medicine group was lower than that of the control group(P<0.05).④After treatment,the levels of LH and T and the LH/FSH ratio in the three groups were significantly decreased compared with those before treatment(P<0.05),but there were no statistically significant differences in the levels of sex hormones and the LH/FSH ratio among the three groups(P>0.05).Conclusion The tonifying kidney,resolving phlegm and promoting blood circulation methods of acupuncture combined with Chinese medicine can effectively improve the clinical signs and obesity indicators,improve the levels of sex hormones,and reduce the levels of inflammatory factors,which has better effect combined with metformin.