青春期多囊卵巢综合征中医治疗方案及疗效评价研究

发布时间：2018-07-11 12:32

本文选题：青春期多囊卵巢综合征 + 胰岛素抵抗　；参考：《南京中医药大学》2014年硕士论文

【摘要】：目的：通过对中医药干预青春期多囊卵巢综合征的大样本病例研究,探索早期干预青春期多囊卵巢综合征的中医治疗方案。方法：收集接受中药治疗的青春期多囊卵巢综合征患者,根据患者有无胰岛素抵抗分为两个队列,其中胰岛素抵抗组72例,非胰岛素抵抗组75例。分别用温肾化痰法、补肾调周法进行干预,其中年龄范围在15-19岁,病程最短6月,最长3年。观察和比较两组治疗前后月经情况、体重指数(BMI)、血清黄体生成素(LH)、卵泡刺激素(FSH)、LH/FSH,睾酮(T)、空腹血糖(FPG)、空腹胰岛素(FINS)水平、稳态模型评估(HOMA-IR)等指标。结果：胰岛素抵抗组治疗前后月经周期有显著差异(P0.05),治疗后周期较前明显缩短。LH, LH/FSH, T均下降,差异有显著性(P0.05),而FSH前后自身比较,均无统计学差异(P值为0.4410.05)。BMI治疗前后组内自身比较,P0.05,提示差异有显著性,治疗后FPG自身比较无统计学差异(P为0.1650.05), FINS、HOMA-IR较治疗前比较有显著降低(P0.01)。非胰岛素抵抗组治疗前后月经周期有显著差异(P0.05),治疗后周期较前明显缩短。治疗后LH, LH/FSH, T均下降,差异有显著性(P0.05), FSH前后自身比较,无统计学差异(P值为0.7920.05)。治疗后FPG、FINS、HOMA-IR自身比较无显著差异(P分别为0.265、0.096、0.224,P均0.05)。结论：中医药能有效治疗青春期多囊卵巢综合征。其中,温肾化痰法能显著改善胰岛素抵抗组患者的月经周期,降低LH、LH/FSH比值、T水平(P0.05),改善患者的胰岛素抵抗,降低FINS、HOMA-IR水平(P0.05),并可以有效改善患者肥胖状态,降低BMI值。补肾调周法能够改善非胰岛素抵抗组患者的月经周期,对于降低LH、LH/FSH比值、T水平(P0.05)疗效确切。
[Abstract]:Objective: to explore the treatment scheme of early intervention of puberty polycystic ovary syndrome (PCOS) by a large sample of Chinese medicine (TCM) intervention in pubertal polycystic ovary syndrome (PCOS). Methods: the patients with puberty polycystic ovary syndrome (PCOS) treated with traditional Chinese medicine were divided into two cohorts according to whether they had insulin resistance (n = 72) and non-insulin resistance (n = 75). The methods of warming kidney and resolving phlegm and tonifying kidney and regulating week were used to intervene. The age range was 15-19 years, the course of disease was shortest 6 months, and the longest was 3 years. Menstruation, body mass index (BMI), serum luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone (T), fasting blood glucose (FPG), fasting insulin (fins) and homeostasis model (HOMA-IR) were observed and compared before and after treatment. Results: there was significant difference in menstrual cycle before and after treatment in insulin resistance group (P0.05). After treatment, the menstrual cycle of insulin resistance group was significantly shorter than that of before and after treatment. LH / FSHT decreased significantly (P0.05), but FSH itself was compared before and after treatment. There was no statistical difference (P = 0.4410.05). There was no significant difference in FPG after treatment (P = 0.1650.05), and FINSHOMA-IR was significantly lower than that before and after treatment (P0.01). There was significant difference in menstrual cycle before and after treatment in non-insulin resistance group (P0.05). After treatment, LH, LH / FSH, T decreased significantly (P0.05), there was no significant difference in FSH before and after treatment (P = 0.7920.05). There was no significant difference in HOMA-IR between the two groups (P = 0.265, 0.096, P < 0.05). Conclusion: Chinese medicine can effectively treat pubertal polycystic ovary syndrome. The method of warming kidney and resolving phlegm can significantly improve the menstrual cycle, decrease the ratio of LHH / FSH to T (P0.05), improve the insulin resistance and decrease the level of FINSHOMA-IR (P0.05), and can effectively improve the obesity status of the patients and reduce the BMI value. The method of tonifying kidney and regulating week can improve the menstrual cycle of patients with non-insulin resistance, and it is effective to reduce the ratio of LHH / FSH to T (P0.05).
【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】：2014
【分类号】：R711.75

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