中药结合运动疗法对肥胖型多囊卵巢综合征BMI及IR指数的临床研究
发布时间：2019-06-02 10:26
【摘要】：目的:观察中药结合运动综合疗法治疗肥胖型PCOS的临床疗效,特别是对于该病BMI及IR指数的影响,并初步探讨中药益肾消脂方的作用机理,为该方的临床应用提供科学依据。方法:将90例肥胖型PCOS患者随机分为A、B、C三组,A组30例,口服益肾消脂方并结合运动疗法;B组30例,口服益肾消脂方及二甲双胍;C组30例,口服二甲双胍并结合运动疗法。治疗3个疗程后,观察3组患者的中医临床证候改善情况、卵巢体积变化情况、月经周期改善情况、BMI、血清促黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)、LH/FSH、空腹血糖(FPG)、空腹胰岛素(FINS)、IR指数、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平的变化情况。结果:(1)在改善中医证候及月经周期方面,A组疗效明显优于B、C两组,差异有统计学意义(P0.05),而B、C两组间疗效相当,差异无统计学意义(P0.05)。在卵巢体积的变化方面,三组均不能明显缩小卵巢体积,差异无统计学意义(P0.05)。(2)在降低BMI方面,A组疗效优于B、C两组,而C组疗效优于B组,差异有统计学意义(P0.05)。在降低空腹血糖和空腹胰岛素水平、改善胰岛素抵抗方面,A组优于B、C两组,而B组优于C组,差异有统计学意义(P0.05)。(3)在降低LH、T值及LH/FSH方面,A组优于B、C两组,差异有统计学意义(P0.05),而B、C两组则疗效相当,差异无统计学意义(P0.05)。在降低TG、TC及LDL-C水平方面,A组疗效优于B、C两组,差异有统计学意义(P0.05),而B、C两组疗效相当,差异无统计学意义(P0.05)。结论:中药结合运动疗法能有效改善肥胖型PCOS患者的临床症状,缩短月经周期,恢复月经来潮;且能减轻患者体重,有效降低BMI;降低血清LH、T、LH/FSH比值、FPG、FINS、IR指数、TC、TG、LDL-C的水平,明显改善肥胖型PCOS患者内分泌环境及糖脂代谢情况,从而改变肥胖型PCOS患者肾虚痰瘀的体质,临床疗效确切,值得推广应用。
[Abstract]:Objective: to observe the clinical efficacy of traditional Chinese medicine combined with exercise therapy in the treatment of obese PCOS, especially on the BMI and IR index of the disease, and to explore the mechanism of Yishen Xiaozhi recipe, so as to provide scientific basis for the clinical application of Yishen Xiaozhi recipe. Methods: 90 patients with obese PCOS were randomly divided into three groups: group A (n = 30), group B (n = 30) and group B (n = 30). Group C (n = 30) was treated with metformin combined with exercise therapy. After three courses of treatment, the improvement of TCM clinical syndrome, the change of ovarian volume, the improvement of menstrual cycle, and the serum LH (LH), follicular stimulating hormone (FSH), testosterone (T), LH/FSH, in the three groups were observed. Fasting blood glucose (FPG), fasting insulin (FINS), IR index, total cholesterol (TC), TG (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) levels. Results: (1) in improving TCM syndrome and menstrual cycle, the curative effect of group A was significantly better than that of group B. there was significant difference between group C and group C (P 0.05), but there was no significant difference between group C and group B (P 0.05). In the change of ovarian volume, all three groups could not significantly reduce the ovarian volume, the difference was not statistically significant (P 0.05). (2), the curative effect of group A was better than that of group B, and the curative effect of group C was better than that of group B, while the curative effect of group C was better than that of group B. The difference was statistically significant (P 0.05). Group A was superior to group B in reducing fasting blood glucose and fasting insulin level and improving insulin resistance, while group B was superior to group C, the difference was statistically significant (P 0.05). (3) in decreasing LH, T value and LH/FSH. Group A was better than B, C group, the difference was statistically significant (P 0.05), but B, C group was the same effect, the difference was not statistically significant (P 0.05). In reducing the level of TG,TC and LDL-C, the curative effect of group A was better than that of group B. there was significant difference between group C and group C (P 0.05), but there was no significant difference between group C and group B (P 0.05). Conclusion: traditional Chinese medicine combined with exercise therapy can effectively improve the clinical symptoms of obese PCOS patients, shorten the menstrual cycle and restore menstruation, and can reduce the body weight and BMI; of obese patients. The levels of serum LH,T,LH/FSH ratio, FPG,FINS,IR index and TC,TG,LDL-C were decreased, and the endocrine environment and glycolipid metabolism of obese PCOS patients were significantly improved, so as to change the physique of kidney deficiency, phlegm and blood stasis in obese PCOS patients. The clinical curative effect is accurate, and it is worth popularizing and applying.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R271.9
[Abstract]:Objective: to observe the clinical efficacy of traditional Chinese medicine combined with exercise therapy in the treatment of obese PCOS, especially on the BMI and IR index of the disease, and to explore the mechanism of Yishen Xiaozhi recipe, so as to provide scientific basis for the clinical application of Yishen Xiaozhi recipe. Methods: 90 patients with obese PCOS were randomly divided into three groups: group A (n = 30), group B (n = 30) and group B (n = 30). Group C (n = 30) was treated with metformin combined with exercise therapy. After three courses of treatment, the improvement of TCM clinical syndrome, the change of ovarian volume, the improvement of menstrual cycle, and the serum LH (LH), follicular stimulating hormone (FSH), testosterone (T), LH/FSH, in the three groups were observed. Fasting blood glucose (FPG), fasting insulin (FINS), IR index, total cholesterol (TC), TG (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) levels. Results: (1) in improving TCM syndrome and menstrual cycle, the curative effect of group A was significantly better than that of group B. there was significant difference between group C and group C (P 0.05), but there was no significant difference between group C and group B (P 0.05). In the change of ovarian volume, all three groups could not significantly reduce the ovarian volume, the difference was not statistically significant (P 0.05). (2), the curative effect of group A was better than that of group B, and the curative effect of group C was better than that of group B, while the curative effect of group C was better than that of group B. The difference was statistically significant (P 0.05). Group A was superior to group B in reducing fasting blood glucose and fasting insulin level and improving insulin resistance, while group B was superior to group C, the difference was statistically significant (P 0.05). (3) in decreasing LH, T value and LH/FSH. Group A was better than B, C group, the difference was statistically significant (P 0.05), but B, C group was the same effect, the difference was not statistically significant (P 0.05). In reducing the level of TG,TC and LDL-C, the curative effect of group A was better than that of group B. there was significant difference between group C and group C (P 0.05), but there was no significant difference between group C and group B (P 0.05). Conclusion: traditional Chinese medicine combined with exercise therapy can effectively improve the clinical symptoms of obese PCOS patients, shorten the menstrual cycle and restore menstruation, and can reduce the body weight and BMI; of obese patients. The levels of serum LH,T,LH/FSH ratio, FPG,FINS,IR index and TC,TG,LDL-C were decreased, and the endocrine environment and glycolipid metabolism of obese PCOS patients were significantly improved, so as to change the physique of kidney deficiency, phlegm and blood stasis in obese PCOS patients. The clinical curative effect is accurate, and it is worth popularizing and applying.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R271.9
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