补肾化痰方联合二甲双胍治疗肥胖型多囊卵巢综合征的临床研究

发布时间：2018-04-28 12:11

本文选题：补肾化痰方 + 二甲双胍　；参考：《南京中医药大学》2017年硕士论文

【摘要】：目的:：通过临床研究,观察补肾化痰方联合二甲双胍治疗肥胖型PCOS的临床疗效,并对其作用机理进行初步探讨。方法:收集中医辨证为肾虚痰湿证的肥胖PCOS病例随机分成两组,治疗组(中药加二甲双胍)20例,对照组(二甲双胍)20例,两组各治疗3个月,同时运用减脂-健身软件指导患者合理饮食与有氧运动。对比两组患者治疗前后中医证候评分、体重指数(BMI)、腰臀比(WHR)、性激素指标(LH、FSH、T、LH/FSH)、性激素结合球蛋白(SHBG)、空腹血糖(FPG)、空腹胰岛素(FINS)以及基础体温(BBT)的变化,综合评估两组治疗效果。结果:治疗组的临床综合疗效总有效率(95%)高于对照组(70%),临床综合疗效比较差异有统计学意义(P0.05)。在改善中医症候方面,治疗组愈显率达70%,有效率90%,对照组愈显率35%,有效率65%,治疗组疗效优于对照组;组间治疗后中医症候积分比较,疗效有统计学差异(P0.05)。两组均能降低患者BMI、WHR,治疗后组间比较,差异有统计学意义(P=0.037、0.0170.05)。治疗后治疗组LH、T、LH/FSH明显低于对照组,SHBG水平明显高于对照组,治疗后组间比较疗效有统计学差异(P分别为 0.033、0.025、0.001、0.015 均0.05)。两组均能有效改善 FPG、FINS、HOMA-IR,在改善FPG上,差异无统计学意义(P=0.7040.05);在降低FINS、HOMA-IR上,差异有统计学意义(P分别为0.045、0.049均0.05)。两组在改善基础体温(BBT)上有统计学差异(P0.05);治疗组妊娠率(16.67%)高于对照组(9.09%)。结论:补肾化痰方联合二甲双胍治疗肥胖型PCOS能明显改善患者中医证候,减轻体重,降低LH、T、LH/FSH比值、FINS,升高SHBG水平,从而改善患者的内分泌及糖代谢,使患者月经规律,症状改善,临床综合疗效优于单一二甲双胍组,说明补肾化痰方可以提高二甲双胍治疗肥胖型PCOS的临床疗效,且无明显不良反应,临床运用安全有效。
[Abstract]:Objective: to observe the clinical effect of Bushen Huatan recipe combined with metformin in the treatment of obese PCOS and to explore its mechanism. Methods: the obese PCOS cases with syndrome differentiation of kidney deficiency and phlegm dampness were randomly divided into two groups: the treatment group (20 cases with Chinese medicine plus metformin) and the control group (20 cases with metformin for 3 months each). At the same time, the use of fat-reducing-fitness software to guide patients reasonable diet and aerobic exercise. The changes of TCM syndrome score, body mass index (BMI), waist to hip ratio (WHR), sex hormone index (LHH) FSHT, sex hormone binding globulin (SHBGG), fasting blood glucose (FPG), fasting insulin (FINS) and basal body temperature (BBT) were compared before and after treatment in the two groups, and the therapeutic effects of the two groups were evaluated. Results: the total effective rate (95%) of the treatment group was higher than that of the control group (70%), and the difference of the clinical comprehensive curative effect was statistically significant (P 0.05). In the aspect of improving TCM symptoms, the more obvious rate of treatment group is 70, the effective rate is 90, the more obvious rate of control group is 35, the effective rate is 65. The curative effect of treatment group is better than that of control group. The BMI-WHR of the two groups was significantly lower than that of the control group (P 0.037, 0.0170.05, P < 0.05). After treatment, the level of LHH / FSH in the treatment group was significantly lower than that in the control group (P < 0.05), and there was a significant difference between the two groups (P = 0.033, P = 0.025, P = 0.025, P = 0.015). Both groups were able to improve FINSHOMA-IRR effectively, but there was no significant difference in improving FPG (P = 0.7040.05), but there was significant difference in decreasing FINSN HOMA-IR (P = 0.045) and 0.05% (P < 0.05), respectively. There was a significant difference between the two groups in improving the basic body temperature (BBT), and the pregnancy rate in the treatment group was 16.67%, which was higher than that in the control group (9.09%). Conclusion: Bushen Huatan recipe combined with metformin can obviously improve TCM syndrome, reduce weight, decrease the ratio of LHH / FSH / FSH, increase the level of SHBG, improve the endocrine and glucose metabolism, and improve the menstrual regularity and symptoms of obese PCOS. The comprehensive clinical curative effect was better than that of metformin group, which indicated that Bushen Huatan prescription could improve the clinical efficacy of metformin in the treatment of obese PCOS, and had no obvious adverse effects, so it was safe and effective in clinical application.
【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】：R711.75

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