肥胖型PCOS内分泌代谢特征及中医药治疗研究

发布时间：2018-04-24 16:02

本文选题：PCOS + 肥胖　；参考：《山东中医药大学》2016年硕士论文

【摘要】：目的:探讨肥胖型PCOS的内分泌代谢特征;观察调经毓麟加味方治疗肥胖型PCOS所致月经后期(肾虚痰湿证)的临床疗效,并探讨其作用机理。方法:90例研究对象均来源于山东中医药大学附属医院妇科门诊。其中,肥胖型PCOS患者30例作为治疗组;非肥胖型PCOS患者30例及月经正常者30例分别为对照1组和对照2组。比较三组的初潮年龄及内分泌指标,并比较治疗组与对照1组的代谢指标;治疗组自月经或黄体酮撤药性出血第7天服用调经毓麟加味方,连续治疗6个月后,观察其临床疗效,并进行统计学分析。结果:(1)治疗组、对照1组平均初潮年龄与对照2组比较,差异均有极显著性(P0.01);(2)治疗组、对照1组LH、LH/FSH、T值与对照2组比较,差异均有极显著性(P0.01);治疗组LH值与对照1组比较,差异有极显著性(P0.01);治疗组E2值与对照2组比较,差异有极显著性(P0.01);治疗组TC、TG、HDL、LDL、INS值与对照1组比较,差异均有极显著性(P0.01);(3)治疗组患者疾病疗效痊愈率20%,显效率33.33%,有效率26.67%,无效率20%,总有效率80%;(4)头晕耳鸣的中医证候积分与治疗前比较差异有显著性(P0.05),其余症状的中医证候积分与治疗前比较差异均有极显著性(P0.01);(5)治疗组患者中医证候总分治疗前后比较,差异有极显著性(P0.01);(6)治疗组患者中医证候疗效痊愈率20%,显效率16.67%,有效率43.33%,无效率20%,总有效率80%;(7)治疗组患者BBT与治疗前比较有显著变化,经治疗患者排卵率明显升高;(8)治疗组患者治疗前后BMI比较,差异有极显著性(P0.01)。结论:PCOS患者平均初潮年龄大于月经正常者;肥胖型PCOS患者的内分泌代谢紊乱程度更为严重;调经毓麟加味方具有温肾化痰,调经助孕之功,治疗肥胖型PCOS月经后期(肾虚痰湿证)安全有效,值得临床推广及进一步研究。
[Abstract]:Objective: To investigate the endocrine and metabolic characteristics of obesity type PCOS, and to observe the clinical effect of regulating menstruation Yulin Jiawei Recipe on the late menstrual period (kidney deficiency dampness syndrome) caused by obesity type PCOS and explore its mechanism. Methods: 90 subjects were all derived from the gynecologic outpatient of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine. Among them, 30 cases of obese PCOS patients were treated as the treatment. Group: 30 cases of non obese PCOS patients and 30 cases with normal menstruation were compared 1 groups and 2 control groups respectively. Compare the age of menarche and endocrine index in the three groups and compare the metabolic indexes of the treatment group and the control 1 groups; the treatment group took the menstruation or progesterone withdrawal bleeding for seventh days to take the Yulin Jiawei recipe for 6 months after continuous treatment and observed the clinical effect. Results and statistical analysis. Results: (1) in the treatment group, the average age of menarche in the 1 groups was significantly higher than that of the control group (P0.01). (2) the treatment group, the control 1 groups of LH, LH/FSH, T and the control 2 groups were significantly different (P0.01); the LH value of the treatment group was significantly different from that of the control group (P0.01); the E2 value of the treatment group was E2. Compared with the control group, the difference was very significant (P0.01), and the value of TC, TG, HDL, LDL and INS in the treatment group was significantly different from that of the control group (P0.01); (3) the cure rate of the treatment group was 20%, the effective rate was 33.33%, the effective rate was 26.67%, the inefficiency was 20%, the total effective rate was 80%, and (4) the TCM syndrome score of the dizziness tinnitus was different from that before the treatment. (4) the difference of the TCM syndrome score of the dizziness tinnitus was different from before the treatment. Significance (P0.05), the other symptoms of TCM syndrome scores and the difference before treatment were very significant (P0.01); (5) before and after the treatment group of TCM syndromes before and after treatment, the difference was very significant (P0.01); (6) the treatment group of TCM syndrome curative effect recovery rate of 20%, significant efficiency of 16.67%, effective rate of 43.33%, the total efficiency of 80%; (7) There was a significant change in the BBT in the treatment group and before the treatment, and the rate of ovulation was significantly higher in the treated patients. (8) the difference in the BMI in the treatment group was very significant (P0.01). Conclusion: the average age of the menarche in the PCOS patients was greater than that of the normal menstruation; the degree of endocrine and metabolic disorders in the obese PCOS patients was more serious; the adjustment of Yulin Jiawei prescription in the treatment of the patients was more serious. It has the function of warming kidney and eliminating phlegm, regulating menstruation and helping pregnant women. It is safe and effective in treating obese PCOS menstrual period (kidney deficiency and phlegm dampness syndrome), which is worthy of clinical promotion and further study.

【学位授予单位】：山东中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R271.9

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