针药并用治疗多囊卵巢综合征不孕症的疗效观察

Therapeutic observation of acupuncture combined with medication for infertility due to polycystic ovary syndrome

目的 观察针药并用治疗多囊卵巢综合征(polycystic ovary syndrome, PCOS)不孕症的临床疗效。方法 将60例PCOS不孕症患者随机分为观察组和对照组,每组30例。两组均予基础治疗,对照组采用口服中药治疗,观察组在对照组的基础上采用电针治疗。观察两组治疗前后排卵情况、体表测量学指标[身体质量指数(body mass index, BMI)、腰臀比(waist-to-hip ratio, WHR)]、血清生殖激素[促卵泡生成素(follicle-stimulating hormone, FSH)、促黄体生成素(luteinizing hormone, LH)、催乳素(prolactin, PRL)、雌二醇(estradial, E2)、睾酮(testosterone, T)和雄烯二酮(androstenedione, AND)]及糖脂代谢指标[空腹血糖(fasting plasma glucose, FPG)、空腹胰岛素(fasting insulin, FINS)、甘油三酯(triglyceride, TG)、总胆固醇(total cholesterol, TC)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol, HDL)、低密度脂蛋白胆固醇(low-densitylipoproteincholesterol,LDL)及稳态模型胰岛素抵抗指数(homeostasismodel assessment-insulin resistance, HOMA-IR)]的变化,并比较两组临床疗效。结果 两组治疗后BMI较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组治疗后WHR较治疗前降低,差异有统计学意义(P<0.05)。观察组治疗后血清LH水平及LH/FSH较治疗前降低(P<0.05);两组治疗后血清T和AND水平较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。观察组治疗后血清FPG水平和HOMA-IR较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);观察组治疗后血清FINS水平较治疗前降低(P<0.05)。观察组治疗后血清TC水平较治疗前降低(P<0.05),且低于对照组(P<0.05);观察组治疗后TG较治疗前降低(P<0.05)。观察组总有效率为93.3%,对照组为73.3%,两组总有效率比较差异有统计学意义(P<0.05)。结论 在基础治疗的基础上,针药并用能更有效地改善PCOS不孕症患者的排卵情况,有效降低血清生殖激素和糖脂代谢指标水平。

Objective To observe the clinical efficacy of acupuncture combined with medication in treating infertility due to polycystic ovary syndrome(PCOS)Method Sixty patients with PCOS-induced infertility were randomized into an observation group and a control group,with 30 cases in each group.Both groups were received basic treatment,the control group received oral Chinese medicine treatment,and the observation group additionally received eletroacupuncture treatment.Before and after the treatment,ovulation,body surface measurements[body mass index(BMI)and waist-to-hip ratio(WHR)],serum reproductive hormones[follicle-stimulating hormone(FSH),luteinizing hormone(LH),prolactin(PRL),estradial(E2),testosterone(T),and androstenedione(AND)],glycolipid metabolism indicators[fasting plasma glucose(FPG),fasting insulin(FINS),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL),and low-density lipoprotein cholesterol(LDL)],and homeostasis model assessment-insulin resistance(HOMA-IR)were observed.The clinical efficacy was compared between the two groups.Result Both groups showed decreases in BMI after the treatment,and the observation group was lower than the control group,showing statistical significance(P<0.05).The WHR dropped significantly after the intervention in the observation group(P<0.05).The serum LH and LH/FSH levels decreased after the intervention in the observation group(P<0.05);the serum T and AND levels dropped after the treatment in both groups and were lower in the observation group than in the control group,showing statistical significance(P<0.05).The serum FPG and HOMA-IR declined in the observation group after the treatment(P<0.05)and were lower than those in the control group(P<0.05);the serum FINS dropped in the observation group after the intervention(P<0.05).The serum TC level dropped after the treatment in the observation group(P<0.05)and was lower than that in the control group(P<0.05);the observation group also showed a decrease in the level of TG after the intervention(P<0.05).The total effective rate was 93.3%in the observation group versus 73.3%in the control group,and the between-group difference was statistically significant(P<0.05).Conclusion Based on the basic treatment,acupuncture combined with medication can effectively improve ovulation and down-regulate serum levels of reproductive hormones and glycolipid metabolism indicators in treating patients with infertility due to PCOS.