腹针对肥胖型多囊卵巢综合征患者内分泌及糖脂代谢的影响

目的:观察腹针疗法对肥胖型多囊卵巢综合征(PCOS)内分泌、代谢指标的影响,探讨腹针治疗该病的部分机制。方法:86例肥胖型PCOS患者随机分为西药组和腹针组各43例。西药组予二甲双胍治疗,腹针组针刺中脘、下脘、气海等穴,治疗6个月。比较两组月经恢复情况、体重指数(BMI)、腰臀围比值(WHR)、多毛评分(F-G评分)、卵巢体积、生殖内分泌激素及糖、脂代谢指标等,并观察两组治疗期间不良反应。结果:治疗后,两组BMI、WHR、F-G评分、黄体生成素(LH)、LH/FSH、游离睾酮(T)均下降,卵巢体积变小,空腹血糖、餐后2h血糖、空腹胰岛素、餐后2h胰岛素、胰岛素抵抗指数、总胆固醇、甘油三脂、低密度脂蛋白胆固醇均下降,高密度脂蛋白胆固醇上升,月经情况好转(均P0.05),两组的促卵泡激素(FSH)治疗前后差异无统计学意义(P0.05);治疗后腹针组BMI、WHR、T的下降幅度比西药组明显,月经恢复情况好于西药组(P0.05)。西药组治疗后部分患者出现胃肠道反应,无其它不适症状,治疗6个月随访肝肾功能均正常,腹针组无不良反应。结论:腹针在改善肥胖型PCOS患者的内分泌及代谢紊乱方面与二甲双胍有类似的效果,同时腹针在恢复月经,降低BMI、WHR、T水平方面优于二甲双胍,且无副作用,是治疗肥胖型PCOS安全有效的方法。

Effect of Adominal Acupuncture Therapy on the Endocrine and Metabolism in Obesity-type Polycystic Ovarian Syndrome Patients

Objective To observe the effect of abdominal acupuncture on the endocrine and metabolic level in obesity-type polycystic ovarian syndrome (PCOS) patients. Methods Eighty-six PCOS patients were randomly and equally divided into medication group and abdominal acupuncture group.Patients of medication group were treated with metformin (250 mg/time,t. i. d. in the 1 st week,and 500 mg/time,t. i. d. thereafter) for 6 months,and those of abdominal acupuncture group were treated by abdominal acupuncture Zhongwan (CV 12),Liangmen (ST 21),etc.,once daily for 6 months]. Changes of the body height,body Mass index (BMI),waist-hip ratio (WHR),Ferriman-Galleey score (FGS),menstrual frequency (MF) and ovarian volume (OV) were determined. Serum luteotrophic hormone (LH),free testosterone (T),follicle-stimulating hormone (FSH) contents were detected with radioimmunoassay.Fasting blood glucose (FBG),fasting insulin (FIN),total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),high density lipoprotein cholesterol (HDL-C),Homa insulin resistance index (IRI) were detected with chromatometry respectively. Results After the treatment,BMI,WHR,FGS and OV were reduced significantly in both medication and abdominal acupuncture groups ( P<0.05 ),while MF of the two groups increased evidently ( P<0.05 ),and the effects of abdominal acupuncture group were significantly superior to those of medication group in down-regulating BMI,WHR and upregulating MF ( P<0.05 ). Regarding the reproductive hormons,serum LH,LH/FSH and T levels in the two groups decreased significantly ( P<0.05 ),and the effect of abdominal acupuncture was superior to that of medication group in reducing serum T level ( P<0.05 ). Following the treatment,FBG,BG and FIN and INS contents 2 h after meal,and Homa IR in both medication and abdominal acupuncture groups all decreased considerably ( P<0.05 ),but without significant differences between them ( P>0.05 ). Regarding the blood lipid levels after the treatment,serum TC,TG,and LDL-C levels of the two groups decreased significantly ( P<0.05 ),while serum HDL-C level increased remarkably ( P<0.05 ),without significant differences between the two groups in these indexes ( P>0.05 ). Conclusion Abdominal acupuncture treatment can improve the endocrine and metabolic function of patients with obesity-type PCOS.