自拟五子泄浊汤联合针刺治疗对肥胖型多囊卵巢综合征患者糖脂代谢和排卵率的影响

Effect of self-made Wuzi Xiezhuo decoction combined with acupuncture treatment on glucose and lipid metabolism and ovulation rate of obese polycystic ovary syndrome patients

目的观察自拟五子泄浊汤联合针刺治疗对肥胖型多囊卵巢综合征患者糖脂代谢和排卵率的影响。方法选取2018年6月—2020年6月在诸暨市妇幼保健院诊治的肥胖型多囊卵巢综合征患者118例为研究对象,遵循知情同意原则,按照随机数字表法分为对照组和观察组,每组各59例。对照组给予盐酸二甲双胍肠溶片治疗,观察组给予自拟五子泄浊汤联合针刺治疗。比较两组患者的肥胖指标[体质指数(BMI)],糖脂代谢指标[血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)及空腹胰岛素(FINS)],生殖激素水平[黄体生成素(LH)、卵泡刺激素(FSH)及睾酮(T)],促排卵情况(卵泡生长时间、卵泡数、优势卵泡数及排卵数)。结果治疗前两组患者BMI比较差异无统计学意义(P>0.05),治疗后两组BMI均显著下降(均P<0.05),且观察组降低更明显,与对照组比较差异有统计学意义(P<0.05)。治疗前两组患者的TC、TG、HDL-C、LDL-C、FBG及FINS比较差异均无统计学意义(均P>0.05),治疗后两组患者的TC、TG、LDL-C、FBG及FINS均显著降低,HDL-C均显著升高(均P<0.05),治疗后观察组TC、TG及LDL-C水平显著低于对照组,HDL-C水平显著高于对照组,差异均有统计学意义(均P<0.05),组间FBG、FINS比较差异均无统计学意义(均P>0.05)。治疗前两组患者的LH、FSH及T水平比较差异均无统计学意义(均P>0.05),治疗后两组患者的LH、FSH及T水平均显著降低(均P<0.05),且观察组均显著低于对照组(均P<0.05)。观察组患者的优势卵泡数和排卵数分别为(6.46±1.49)个和(6.35±1.32)个,均显著多于对照组[(4.12±1.35)个、(4.10±1.03)个],差异均有统计学意义(均P<0.05),两组卵泡数、卵泡生长时间比较差异均无统计学意义(均P>0.05)。结论自拟五子泄浊汤联合针刺治疗肥胖型多囊卵巢综合征患者的临床效果满意,能够改善患者的肥胖状况、调节机体糖脂代谢、降低生殖激素水平、促进排卵,具有较高的临床治疗价值。

Objective To observe the effect of self-made Wuzi Xiezhuo decoction combined with acupuncture treatment on glucose and lipid metabolism and ovulation rate of obese polycystic ovary syndrome patients.Methods From June 2018 to June 2020,118 obese polycystic ovary syndrome patients diagnosed and treated in Zhuji Municipal Maternal and Child Health Care Hospital were selected as study object,according to the principle of informed consent,the patients were divided into control group and observation group based on random number table,59 cases in each group.The patients in control group were treated with metformin hydrochloride enteric-coated tablets,the patients in observation group were treated with self-made Wuzi Xiezhuo decoction combined with acupuncture therapy.The obese indicators[body mass index(BMI)],glucose and lipid metabolism indicators[serum total cholesterol(TC),triacylglycerol(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),fasting blood glucose(FBG),and fasting insulin(FINS)J,reproductive hormones[luteinizing hormone(LH),follicle-stimulating hormone(FSH),and testosterone(T)],ovulation induction indicators(follicle growth time,the number of follicles,the number of dominant fllicles,and ovulation number)in the two groups were compared,the obese indicators were compared between the two groups.Results Before treatment,there was no statistically significant difference in BMI between the two groups(P>0.05),the levels of BMI in the two groups decreased after treatment(P<0.05),especially in observation group,there was statistically significant difference compared with control group(P<0.05).Before treatment,there was no statistically significant difference in the levels of TC,TG,HDL-C,LDL-C,FBG,and FINS between the two groups(P>0.05),after treatment,the levels of TC,TG,LDL-C,FBG,and FINS decreased significantly,HDL-C level increased significantly(P<O.05),the levels of TC,TG,and LDL-C in observation group after treatment were statistically significantly lower than those in control group,while the level of HDL-C was statistically significantly higher than that in control group,there were statistically significant differences(P<0.05),there was no statistically significant difference in the levels of FBG and FINS between the two groups(P>0.05).Before treatment,there was no statistically significant difference in the levels of LH,FSH,and T between the two groups(P>0.05),after treatment,the levels of LH,FSH,and T in the two groups decreased significantly(P<0.05),especially in observation group(P<0.05).The numbers of dominant follicles and ovulation in observation group were(6.46±1.49)and(6.35±1.32),respectively,which were statistically significantly higher than those in control group[(4.12±1.35)and(4.10±1.03)](P<0.05),there was no statistically significant difference in follicle growth time and the number of follicles between the two groups(P>0.05)..Conclusion The clinical effect of self-made Wuzi Xiezhuo decoction combined with acupuncture treatment for obese polycystic ovary syndrome patients is good,the therapy can improve obesity,regulate glucose and lipid metabolism,reduce the levels of reproductive hormones,promote ovulation,which has high clinical treatment value.