营养治疗联合穴位埋线治疗肥胖型多囊卵巢综合征临床观察  

Clinical Observation of Nutritional Therapy Combined with Acupoint Catgut Embedding in the Treatment of Obese Polycystic Ovary Syndrome

作　　者：闫大晶[1] 张玲玲 张兵[2] 刘琨 薛晓馥[1] 张雪 周倩倩 李勇[1] 滑丽美[4] YAN Da-jing;ZHANG Ling-ling;ZHANG Bing;LIU Kun;XUE Xiao-fu;ZHANG Xue;ZHOU Qian-qian;LI Yong;HUA Li-mei(Department of Obstetrics and Gynecology, Hospital of Liaoning Armed Police Corps, Shenyang 110034, China;Preparation Management Department of Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang 110032, China;Department of Health, Logistics and Security, Liaoning Armed Police Corps, Shenyang 110000, China;Department of Nutrition, Bethune International Peace Hospital of PLA, Shijiazhuang 050082, China)

机构地区：[1]武警辽宁总队医院妇产科,沈阳110034 [2]辽宁中医药大学附属医院制剂管理部,沈阳110032 [3]武警辽宁总队后勤保障部卫生处,沈阳110000 [4]解放军白求恩国际和平医院营养科,石家庄050082

出　　处：《临床误诊误治》2018年第12期70-75,共6页Clinical Misdiagnosis & Mistherapy

基　　金：河北省卫计委科研基金面上课题(20150387)

摘　　要：目的观察营养治疗并艾塞那肽联合穴位埋线治疗肥胖型多囊卵巢综合征(polycystic ovary syndrome,PCOS)的临床效果。方法选择2013年5月—2016年5月收治的肥胖型PCOS 120例,剔除临床资料不完整者,最终入选90例,随机分为对照组与观察组,每组各45例。两组均予营养治疗+二甲双胍+艾塞那肽,观察组在此基础上予穴位埋线。两组均连续治疗3个月,比较治疗前后体重指数(body mass index,BMI)、腰臀比(waist-to-hipratio,WHR)、血脂[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)、总胆固醇(TC)]、血糖[空腹血糖(FPG)、餐后2 h血糖(2 h PBG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]、激素[卵泡刺激素(FSH)、黄体生成素(LH)、雌激素(E2)、睾酮(T)]水平变化,记录排卵、妊娠及不良反应情况。结果与本组治疗前比较,两组治疗后FPG、2 h PBG、FINS、HOMA-IR、TG、LDL-C、TC、BMI、WHR、LH、LH/FSH、E2、T均降低,HDL-C、FSH均升高,差异有统计学意义(P <0. 05);与对照组比较,观察组治疗后FPG、2 h PBG、FINS、HOMA-IR、TG、LDL-C、TC、BMI、WHR、LH、LH/FSH、E2、T均显著下降,HDL-C、FSH均显著升高,差异有统计学意义(P <0. 05)。对照组、观察组排卵率分别为68. 89%(31/45)、82. 22%(37/45);随访1年,对照组、观察组妊娠率分别为42. 22%(19/45)、62. 22%(28/45),比较差异均有统计学意义(P <0. 05)。两组不良反应发生率比较差异无统计学意义(P=0. 267)。结论营养治疗并艾塞那肽联合穴位埋线治疗通过改善肥胖型PCOS患者的糖脂代谢与外周激素水平,以提高排卵率与妊娠率。Objective To observe the clinical effect of nutritional therapy and exenatide combined with acupoint catgut embedding(ACE)in the treatment of obese polycystic ovary syndrome(PCOS).Methods A total of120cases of obese PCOS infertility admitted to our hospital from May2013to May2016were selected,and90cases were selected after excluding incomplete clinical data.They were randomly divided into control group and observation group,with45cases in each group.Both groups were given nutrition therapy+metformin+exenatide therapy,while the observation group was given catgut embedding at acupoints on this basis.Both groups were treated continuously for3months.The changes of body mass index(BMI),waist-to-hip ratio(WHR),blood lipid[triglycerides(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),and total cholesterol(TC)],blood glucose[fasting plasma glucose(FPG),2h postprandial blood glucose(2hPBG),fasting plasma insulin(FINS),and homeostasis model-insulin resistance(HOMA-IR)],and hormone[follicle-stimulating hormone(FSH),luteinizing hormone(LH),estrogen(E2),and testosterone(T)]were compared before and after treatment,and ovulation,pregnancy(followed up for1year)and adverse reactions were recorded.Results Compared with those before treatment,FPG,2hPBG,FINS,HOMA-IR,TG,LDL-C,TC,BMI,WHR,LH,LH/FSH,E2,and T were decreased,whereas HDL-C and FSH were increased after treatment,and the difference was statistically significant(P<0.05).Compared with the control group,FPG,2hPBG,FINS,HOMA-IR,TG,LDL-C,TC,BMI,WHR,LH,LH/FSH,E2,and T in the observation group were decreased significantly after treatment,while HDL-C and FSH were increased significantly,and the difference was statistically significant(P<0.05).The ovulation rate was68.89%(31/45)in the control group and82.22%(37/45)in the observation group.They were followed up for one year.and the pregnancy rate of control group and observation group was42.22%(19/45)and62.22%(28/45)respectively,suggesting significant difference(P<0.05).There was no significan

关 键 词：多囊卵巢综合征 肥胖症 穴位疗法 

分 类 号：R711.75[医药卫生—妇产科学]