穴位埋线联合健脾祛痰中药对肥胖型多囊卵巢综合征患者胰岛素抵抗及血清脂联素水平的影响

目的:观察穴位埋线联合加减苍附导痰汤治疗肥胖型多囊卵巢综合征(PCOS)患者的临床疗效,并探讨其作用机制。方法:42例肥胖型PCOS患者随机分为2组,针药组22例(予穴位埋线联合加减苍附导痰汤),中药组20例(予加减苍附导痰汤)。观察两组治疗3个月前后月经情况;治疗前后测量患者的体质量指数(BMI),检测空腹血糖(FPG)、空腹胰岛素(FINS)及脂联素(APN)值,计算胰岛素敏感指数(ISI),记录胰岛素抵抗(IR)者例数。结果:①针药组治疗后月经改善者18例,总有效率81.8%;中药组治疗后月经改善者13例,总有效率65%;针药组治疗后月经改善疗效明显优于中药组(P<0.05)。②BMI、FINS两组治疗后较治疗前均明显降低(P<0.05),治疗后针药组明显低于中药组(P<0.05);ISI、APN两组治疗后较治疗前均明显升高(P<0.05),治疗后针药组明显高于中药组(P<0.05)。③IR例数两组治疗后均较治疗前明显减少(P<0.05),治疗后针药组明显少于中药组(P<0.05)。结论:穴位埋线联合中药治疗肥胖型PCOS患者疗效明显,其作用机制可能与提高APN的含量,降低BMI,提高胰岛素素敏感性,从而改善IR有关。

Effects of point catgut-embedding therapy combined Chinese medicinal herbs of invigorating spleen to remove phlegm on insulin resistance and serum adiponectin level in obese patients with polycystic ovary syndrome(PCOS)

ObjectiveTo observe the effects of acupuncture combined"Jia jian Chang fu Dao tan decoction"on insulin resistance and serum adiponectin level in obese polycystic ovary syndrome(PCOS),explore the mechanism.Methods42 obese PCOS patients were randomly divided into two groups: group PC(treated with point catgut-embedding therapy combined Chinese medicinal herbs),group TCM(treated with simple Jiajian CFDT decoction).The therapeutic effect in both groups and the change of body mass index(BMI),the fasting serum glucose(FPG),fasting serum insulin(FINS),and adiponectin(APN) were observed.Insulin sensitivity index(ISI) was calculated and the number of patients with insulin resistance(IR)was recorded.Results The therapeutic effect in group PC was better than that in group TCM(P<0.05).BMI,FINS decreased in both group after treatment P<0.05,BMI,FINS were lower in group PC than those in group TCM after treatmentP<0.05.ISI,APN increased in both group after treatmentP<0.05,ISI,APN were higher in group PC than those in group TCM after treatmentP<0.05.The patients with IR were less after treatment in both groupP<0.05.The patients with IR were less in group PC than in group TCM P<0.05.ConclusionsThe effects of point catgut-embedding therapy combined Chinese medicinal herbs on obsess PCOS was well.The mechanism possibly was due to increasing APN,decreasing BMI,increasing ISI,and improving IR.