温针刺结合健脾祛痰法治疗体重正常型多囊卵巢综合征效果及对性激素、胰岛素抵抗的影响

目的 探究温针刺结合健脾祛痰法对体重正常型多囊卵巢综合征治疗疗效及分子生物学指标变化.方法 选取2015年2月-2016年2月收治的多囊卵巢综合征患者90例,随机分为对照组与观察组,各45例.对照组采用苍附导痰汤治疗,观察组采用温针刺结合苍附导痰汤治疗,共治疗3个月.比较两组治疗前后子宫内膜及卵泡情况,空腹血糖(FPG)、空腹胰岛素(FINS)、餐后2h血糖,餐后2h胰岛素、胰岛素抵抗指数(HOMA-IR),性激素变化,血清肿瘤坏死因子-α(TNF-α)、抵抗素、脂联素水平及胰岛素受体底物-l(IRS-1)和细胞外信号调节激酶-2(ERK-2)基因相对表达情况.结果 治疗后对照组子宫内膜厚度、成熟卵泡数量、促卵泡生成素和脂联素水平高于治疗前,而FPG、FINS、HOMA-IR、睾酮、黄体酮、泌乳素、TNF-α及抵抗素水平低于治疗前(P＜0.05).治疗后观察组子宫内膜厚度、卵泡数量、促卵泡生成素、脂联素和IRS-1相对表达量均高于治疗前和对照组,而FPG、FINS、餐后2h血糖、餐后2h胰岛素、HOMA-1R、睾酮、黄体酮、泌乳素、TNF-α、抵抗素和ERK-2相对表达量均低于治疗前和对照组(P＜0.05).结论 温针刺结合健脾祛痰法治疗体重正常型多囊卵巢综合征患者疗效明显,能够调节体内性激素水平,增强胰岛素敏感性,推测其机制可能引血清TNF-α及抵抗素水平降低、脂联素水平升高有关,同时还可能与抑制MAPK/ERK通路激活,抑制IRS-1丝氨酸磷酸化有关.

Effect of Warm Acupuncture Treatment Combined with Strengthening Spleen and Expelling Phlegm Method in Treatment of Normal Body Weight Patients with Polycystic Ovary Syndrome and Tts Effects on Sexual Hormones and Insulin Resistance

Objective To investigate effect of warm acupuncture combined with strengthening spleen and expelling phlegm method on insulin resistance and changes of molecular biological indexes in treatment of normal body weight patients with polycystic ovary sy ndrome.Methods A total of 90 patients with polycystic ovary syndrome during February 2015 and February 2016 were randomly divided into control group and observation group (n =45 for each group).Control group received Cangfu Daotan (CFDT) decoction,while observation group received warm acupuncture combined with CFDT decoction,and the time of treatment was three months.Conditions of endometrial and ovarian follicles,fasting plasma glucose (FPG),fasting insulin (FINS),2h postprandial blood glucose and 2h postprandial insulin,insulin resistance index (HOMA-IR).sex hormone changes,serum tumor necrosis factor-α (TNF-α),resistin,adiponectin (APN) levels and relative expressions of iusulin receptor substrate-1 (IRS-1) and extracellular signal-regulated kinase-2 (ERK-2) genes were compared before and after treatment in two groups.Results After treatment,levels of endometrial thickness,follicle number,follicle stimulating hormone and APN were significantly higher,while FPG,FINS,HOMA-IR,testosterone,progesterone,prolactin,TNF-α and resistin levels were significantly lower than those before treatment in control group (P ＜ 0.05).After treatment,in observation group,levels of endometrial thickness,follicle number,follicle stimulating hormone,APN and IRS-1 relative expression were significantly higher,while FPG,FINS,2h postprandial blood glucose,2h postprandial insulin,HOMA-IR,testosterone,progesterone,prolactin,TNF-α,resistin and ERK-2 relative expression were significantly higher than those before treatment and in control group (P ＜ 0.05).Conclusion Warm acupuncture combined with strengthening spleen and expelling phlegm method in treatment of normal body weight patients with polycystic ovary syndrome can achieve obvious effect,adjust sex hormone levels in the body and increase insulin sensitivity.Its mechanism may be related to decreasing serum TNF-α and resistin levels,increasing APN levels and restraining MAPK/ERK pathway activation and IRS-1 phosphorylation meanwhile.