针刺联合二甲双胍治疗青春期PCOS肝经郁热证的临床观察

发布时间：2018-06-10 15:33

本文选题：青春期 + 多囊卵巢综合征　；参考：《湖南中医药大学》2014年硕士论文

【摘要】：目的观察针刺联合二甲双胍治疗肝经郁热型青春期多囊卵巢综合征在中医症状、高雄激素体征及性激素等方面的影响,评价该疗法的临床有效性及安全性,探讨其作用机理。方法收集60例肝经郁热型青春期多囊卵巢综合征患者,随机分为治疗组、对照组各30例。治疗组予针刺联合口服二甲双胍,对照组予口服二甲双胍,均治疗三个月。在治疗前及治疗3个月后,于月经第3天采集空腹静脉血,测定血清睾酮(T)、黄体生成素(LH)、卵泡刺激素(FSH)、空腹胰岛素(FINS)、空腹血糖(FPG),并观察中医证候、高雄激素体征、B超等变化。结果两组月经异常、痤疮、中医证候总积分、卵巢体积、卵泡数目前后比较均有显著统计学差异(P0.01),多毛无统计学差异(P0.05)。治疗后比较,痤疮、中医证候总积分有统计学差异(P0.05),月经异常积分、卵巢体积、卵泡数目无统计学差异(P0.05)。中医证候疗效比较,针药组总有效率为83.33%,西药组总有效率为63.33%,差异具有统计学意义(P0.05)。两组T值治疗前后比较,有显著统计学差异(P0.01),两组治疗后比较,有统计学差异(P0.05)。两组治疗后LH、LH/FSH值比治疗前均明显降低,有显著统计学差异(P0.01),两组治疗后比较,有显著统计学差异(P0.01)；血清FSH、FPG值两组治疗前后均无统计学差异(P0.05)。针药组FINS治疗前后比较有统计学差异(P0.05),西药组FINS、两组HOMA-IR直治疗前后有显著统计学差异(P0.01)；两组FINS、HOMA-IR治疗后比较差异无统计学意义(P0.05)。结论针刺联合二甲双胍对肝经郁热型青春期PCOS是安全、有效的治疗方法,可降低患者血清T、LH、LH/FSH、FINS、HOMA-IR,使患者月经规则、高雄激素症状减轻,卵巢体积、卵泡数减小,总体疗效优于单纯口服二甲双胍。
[Abstract]:Objective to observe the effects of acupuncture combined with metformin on the symptoms, signs of hyperandrogen and sex hormones in the treatment of liver meridian and heat type puberty polycystic ovary syndrome (PCOS), and to evaluate the clinical efficacy and safety of the therapy. Methods 60 patients with PCOS were randomly divided into treatment group (n = 30) and control group (n = 30). The treatment group was treated with acupuncture combined with metformin and the control group with metformin for 3 months. Before and after 3 months of treatment, fasting venous blood was collected on the 3rd day of menstruation. Serum testosterone, luteinizing hormone (LHN), follicle stimulating hormone (FSH), fasting insulin (FINSN), fasting blood glucose (FPG), and Chinese medicine syndrome (TCM) were measured. Results there were significant differences between the two groups in menstrual abnormality, acne, the total integral of TCM syndromes, the volume of ovary and the number of follicles. After treatment, the total score of acne and TCM syndromes were statistically different (P0.05N), the abnormal menstruation score, ovarian volume, follicle number had no statistical difference (P0.05G). The total effective rate of acupuncture and medicine group was 83.33, the total effective rate of western medicine group was 63.33, the difference was statistically significant (P 0.05). There was a significant difference in T value between the two groups before and after treatment (P 0.01), and there was a significant difference between the two groups after treatment (P 0.05). After treatment, the LHH / FSH value of the two groups was significantly lower than that of the pre-treatment group (P 0.01), and there was no significant difference between the two groups before and after treatment (P 0.05). There were significant differences in fins between acupuncture and medicine group before and after treatment (P 0.05), in western medicine group (fins), there was significant difference between the two groups before and after direct treatment of HOMA-IR (P 0.01), and there was no significant difference between the two groups after FINSX HOMA-IR treatment. Conclusion there is no significant difference between acupuncture and metformin in the treatment of liver depression. Hot puberty PCOS is safe, The effective treatment method can reduce the serum TLHH / FSHH / FSHINSHOMA-IRR, reduce the symptoms of hyperandrogen, ovarian volume and follicle number, and the overall curative effect is better than that of metformin alone.
【学位授予单位】：湖南中医药大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.75

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