针药联合治疗肾虚痰瘀型多囊卵巢综合征伴胰岛素抵抗的临床研究

发布时间：2018-03-28 07:38

本文选题：多囊卵巢综合征　切入点：胰岛素抵抗　出处：《南京中医药大学》2017年硕士论文

【摘要】：目的:探讨并阐述针药联合治疗肾虚痰瘀型多囊卵巢综合征(polycystic ovarian syndrome,PCOS)伴胰岛素抵抗(insulinresistance,IR)的临床疗效与单纯使用西药以及中西药结合治疗肾虚痰瘀型PCOS-IR的临床疗效的对比;证实针药联合治疗肾虚痰瘀型PCOS-IR具有良好的效果与优势。方法:按诊断标准收集肾虚痰瘀型PCOS-IR患者,分为三组,即对照组、治疗1组、治疗2组,分别给予二甲双胍,首乌僵芪汤加减联合二甲双胍,首乌僵芪汤加减联合针灸、二甲双胍治疗,分别治疗3个月经周期。观察三组患者治疗前后的月经周期、多毛及痤疮情况,血清T、LH、FSH、E2值的变化,空腹血糖、空腹胰岛素及胰岛素抵抗情况,体重指数(body mass index,BMI)变化,基础体温(basal body temperature,BBT)的变化。结果:(1)在改善中医证候方面,治疗1组与治疗2组疗效相当,但都优于对照组。(2)治疗1组、治疗2组治疗后月经周期、多毛、痤疮情况较治疗前均有明显改善(P值均0.05),对照组治疗前后对比均无明显改善(P值均0.05)。在改善月经周期、多毛方面,治疗1组与治疗2组疗效相当(P0.05);在改善痤疮方面,治疗2组的疗效优于治疗 1 组(P0.05)。(3)三组均能降低T、LH水平(P值均0.05),但三组的FSH、E2值治疗后均无明显改善(P值均0.05)。在降低T、LH水平方面,治疗2组的疗效优于另外两组,另两组疗效相当。(4)三组的空腹血糖治疗后均无明显改善(P值均0.05),但三组均能降低空腹胰岛素水平及HOMA-IR(P值均0.05)。在降低空腹胰岛素水平及HOMA-IR方面,治疗2组的疗效优于治疗1组,且治疗1组优于对照组。(5)三组均能降低BMI(P值均0.05)。在降低BMI方面,治疗2组的疗效优于治疗1组,且治疗1组优于对照组。(6)三组均能改善BBT情况(P值均0.05)。在改善BBT方面,治疗2组的疗效优于治疗1组,且治疗1组优于对照组。(7)三组总疗效比较,治疗2组的疗效优于另外两组,另两组疗效相当。结论:首乌僵芪汤联合二甲双胍及针刺的方法治疗肾虚痰瘀型PCOS-IR,能有效改善中医症候、月经周期、多毛及痤疮情况,调节性激素水平,改善胰岛素抵抗,降低体重指数,恢复BBT双相,效果显著。表明针药联合治疗肾虚痰瘀型PCOS-IR疗效确切,效果优于中西药结合治疗或单纯使用西药治疗肾虚痰瘀型PCOS-IR。
[Abstract]:Objective: to explore the clinical efficacy of acupuncture and medicine combined with acupuncture and medicine in the treatment of polycystic ovarian syndrome (PCOS) with insulin resistance (IRR) in patients with kidney deficiency and phlegm stasis syndrome, and to compare the clinical efficacy of traditional Chinese medicine and western medicine in the treatment of PCOS-IR with kidney deficiency and phlegm stasis. Methods: according to the diagnostic criteria, the patients with PCOS-IR with kidney deficiency and phlegm stasis were divided into three groups: control group, treatment group 1, treatment group 2, respectively, given metformin. The patients in the three groups were treated with acupuncture and moxibustion and metformin respectively. The changes of menstrual cycle, hirsutism and acne were observed before and after treatment. Fasting blood glucose, fasting insulin and insulin resistance, body mass index (BMI), body mass index (BMI), and basic body temperature (BBT) were changed. Results: in improving TCM syndromes, the curative effect of treatment group 1 was equal to that of treatment group 2. The menstrual cycle, hirsutism and acne in the treatment group were all significantly improved than before, and the P value in the control group was not significantly improved before and after treatment, and the menstrual cycle was improved by 0.05% in the control group before and after treatment, and the menstrual cycle was improved in the control group, and there was no significant improvement in the menstrual cycle in the control group before and after treatment. In terms of hirsutism, the curative effect of treatment group 1 was comparable to that of treatment group 2 (P0.05A); in improving acne, The therapeutic effect of treatment group 2 was better than that of group 1 (P 0.05, P = 0.05), but the value of FSHE _ 2 was not significantly improved after treatment. In reducing the level of TLH, the curative effect of treatment group 2 was better than that of other two groups, and the effect of treatment group was better than that of other two groups, and the effect of treatment group was better than that of other two groups. There was no significant improvement in fasting blood glucose after treatment in the other two groups (P < 0.05), but the fasting insulin level and the HOMA-IR(P value were all decreased in the three groups. The curative effect of the two groups was better than that of the first group in decreasing the fasting insulin level and the HOMA-IR level, and the effect of the treatment group was better than that of the control group (P < 0.05), which was better than that of the control group (P < 0.05). The treatment group 1 was better than the control group (P < 0.05). In the aspect of decreasing BMI, the curative effect of treatment group 2 was better than that of treatment group 1, and treatment group 1 was superior to control group. The curative effect of the treatment group 2 was better than that of the treatment group 1, and the treatment group 1 was superior to the control group. Conclusion: the treatment of kidney deficiency and phlegm stasis type PCOS-IRs can effectively improve the symptoms of TCM, menstrual cycle, hair and acne, regulate the level of sex hormone, and improve insulin resistance, conclusion: the treatment of Shouwujiangqi decoction combined with metformin and acupuncture can effectively improve the symptoms of TCM, menstrual cycle, hair and acne, regulate sex hormone level, and improve insulin resistance. The results showed that the combination of acupuncture and medicine was effective in the treatment of kidney deficiency and phlegm stasis type PCOS-IR, and the effect was better than that of traditional Chinese medicine combined with western medicine or western medicine alone in the treatment of kidney deficiency phlegm stasis type PCOS-IRR.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R271.9

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