针灸对肥胖型多囊卵巢综合征患者脂联素、瘦素及胰岛素抵抗的影响

目的:探讨针灸治疗对肥胖型多囊卵巢综合征患者脂联素、瘦素及胰岛素抵抗的影响。方法:选取肥胖型多囊卵巢综合征患者128例,随机分为对照组和治疗组,每组64例。对照组给予二甲双胍缓释片每次0.5 g口服,每日1次;治疗组在对照组治疗基础上联合针灸进行治疗。两组均以30 d为1个疗程,共治疗3个疗程。对比患者临床有效率、脂联素(adiponectin,APN)、血清瘦素(leptin,LEP)、胰岛素抵抗指数(homeostasis model of assessment for insulin resistence index,HOMA-IR)水平、体质量指数(body mass index,BMI)指数及黄体生成激素(luteotropic hormone,LH)、促卵泡成熟激素(follicle-stimulating hormone,FSH)、睾酮(testosterone,T)、LH/FSH的变化情况。结果:治疗组有效率92.19%,对照组有效率73.44%,两组比较,差异有统计学意义(P0.05);与治疗前相比,治疗后两组APN水平升高,LEP、血清瘦素/脂联素比值(leptin/adiponectin,L/A)、空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素(fasting insulin fins,FINS)、HOMA-IR、LH、T及LH/FSH水平均显著降低(P0.05);卵巢体积缩小,窦卵泡数目减少,子宫内膜厚度增加、BMI指数减少,差异具有统计学意义(P0.05);与对照组相比,治疗组患者APN水平较高,LEP、L/A、FPG、FINS、HOMA-IR、LH、T及LH/FSH水平显著降低(P0.05),卵巢体积、窦卵泡数目、子宫内膜厚度及BMI指数等指标均优于对照组(P0.05)。结论:针灸治疗的实施可有效提高肥胖型多囊卵巢综合征的有效率,改善临床症状,提高患者生活质量,推测其机制可能与APN水平的升高,LEP、L/A、FPG、FINS、HOMA-IR、血清性激素水平的降低有关。

Effects of Acupuncture and Moxibustion Therapy on Adiponectin,Leptin and Insulin Resistance in Obese Patients with Polycystic Ovary Syndrome

Objective:To investigate the effects of acupuncture and moxibustion therapy on adiponectin,leptin and insulin resistance in obese patients with polycystic ovary syndrome.Methods:128 patients with polycystic ovary syndrome treated in Department of endocrinology of our hospital were selected and randomly divided into the control group and the experiment group,with 64 cases in each group.The control group was given metformin sustained-release tablets 0.5 g/times,1 times/day,while the experiment group was treated with acupuncture in addition to that of the control group.The two groups were treated with 30 courses with 1 course being 30 days.The clinical effective rate,APN,serum leptin (LEP),HOMA-IR,BMI index and serum sex hormone levels(LH,T,LH/FSH) of both groups before and after treatment were compared.Result:The total effective rate of the experiment group (92.19％) was higher than that(73.44％) of the control group(P ＜ 0.05).Compared with that before treatment,the levels of APN of the two groups increased,while LEP,L/A,FPG,FINS,HOMA-IR,LH,T and LH/FSH levels were decreased after treatment (P ＜ O.05);the volume of ovary was reduced,the number of antral follicles was decreased,the thickness of endometrium was increased,and the BMI index was decreased.The differences were statistically significant(P ＜ 0.05).Compared with that of the control group,the patients the levels of APN was significantly higher,while levels of LEP,L/A,FPG,FINS,HOMA-IR,LH,T and LH/FSH in the treatment group was significantly lower(P ＜ 0.05);the ovarian volume,number of antral follicle and endometrial thickness and BMI index were significantly better than those of the control group respectively (P ＜ 0.05).Conclusion:acupuncture treatment can effectively improve the obese women with polycystic ovary syndrome and the treatment efficiency,improve clinical symptoms,improve the quality of life of patients,the mechanism of which might be related to the elevated levels of APN and the decreased levels of LEP,L/A,a FPG,FINS,HOMA-IR,serum sex hormone.