针刺联合中西药治疗肝郁肾虚型月经后期的疗效观察  

Therapeutic observation of acupuncture plus Chinese and Western medications for delayed menstrual period due to liver Qi stagnation with kidney deficiency

作　　者：何丹[1] 李媛媛 刘咏梅[1] HE Dan;LI Yuanyuan;LIU Yongmei(Dazhou Central Hospital,Dazhou 625000,China)

机构地区：[1]达州市中心医院,达州635000

出　　处：《上海针灸杂志》2024年第3期246-253,共8页Shanghai Journal of Acupuncture and Moxibustion

摘　　要：目的 观察针刺联合中西药治疗肝郁肾虚型月经后期的临床疗效。方法 将88例肝郁肾虚型月经后期患者随机分为对照组(29例)、针刺组(29例)和联合组(30例)。对照组给予雌孕激素序贯疗法,针刺组在对照组基础上给予疏肝补肾针刺法,联合组在针刺组基础上给予疏肝益肾通瘀方治疗。观察3组治疗前后中医证候积分、性激素水平[雌二醇(estradial, E2)、促卵泡生成素(follicle-stimulating hormone, FSH)、促黄体生成素(luteinizing hormone, LH)水平、睾酮(testosterone, T)和催乳素(prolactin, PRL)]、卵巢功能(卵巢体积、卵泡最大直径、卵泡数量)和磷脂酰肌醇3-激酶(phosphoinositide 3-kinase, PI3K)/蛋白激酶B(protein kinase B, AKT)/哺乳动物雷帕霉素靶蛋白(mammalian target of rapamycin, mTOR)信号通路相关蛋白的变化,并比较3组临床疗效及安全性。结果 联合组总有效率为96.7%,高于对照组的72.4%(P<0.05);联合组与针刺组、针刺组与对照组比较,差异无统计学意义(P>0.05)。3组治疗后经色暗淡、腰骶酸痛、头晕耳鸣、性欲淡漠及烦躁易怒积分均低于治疗前(P<0.05);且联合组治疗后经色暗淡、腰骶酸痛、头晕耳鸣、性欲淡漠及烦躁易怒积分低于针刺组和对照组(P<0.05),针刺组低于对照组(P<0.05)。3组治疗后E2水平均高于治疗前(P<0.05),FSH、T、LH、PRL水平均低于治疗前(P<0.05);且联合组治疗后E2水平高于针刺组和对照组(P<0.05),针刺组高于对照组(P<0.05);联合组治疗后FSH、T、LH、PRL水平低于针刺组和对照组(P<0.05),针刺组低于对照组(P<0.05)。3组治疗后卵泡最大直径和卵泡数量均大于治疗前(P<0.05);且联合组治疗后卵泡最大直径和卵泡数量大于针刺组和对照组(P<0.05),针刺组大于对照组(P<0.05)。3组治疗前后卵巢体积比较,差异无统计学意义(P>0.05)。3组治疗后PI3K、Akt和m TOR蛋白表达浓度均高于治疗前(P<0.05);且联合组治疗后PI3K、Akt�Objective To observe the clinical efficacy of acupuncture plus Chinese and Western medications in treating delayed menstrual period due to liver Qi stagnation with kidney deficiency.Method Eighty-eight patients with delayed menstrual period due to liver Qi stagnation with kidney deficiency were randomized into a control group(29 cases),an acupuncture group(29 cases),and a joint group(30 cases).The control group received sequential estrogen and progesterone therapy.Based on the treatment in the control group,the acupuncture group was given Shu Gan Bu Shen(soothing the liver and reinforcing the kidney)acupuncture,and the joint group was offered the same acupuncture treatment and Shu Gan Yi Shen Tong Yu prescription.Before and after the treatment,the symptom scores of traditional Chinese medicine(TCM),sex hormone levels[estradial(E2),follicle-stimulating hormone(FSH),luteinizing hormone(LH),testosterone(T),and prolactin(PRL)],ovarian function(ovary volume,maximum follicle diameter,and the number of follicles),and(phosphoinositide 3-kinase,PI3K)(protein kinase B,Akt)(mammalian target of rapamycin,mTOR)signaling pathway proteins were observed.The clinical efficacy and safety assessment of the three groups were also compared.Result The total effective rate was 96.7%in the joint group,higher than 72.4%in the control group(P<0.05);the differences between the joint group and the acupuncture group and between the acupuncture and control groups were statistically insignificant(P>0.05).After the treatment,the scores of dark menses,dull aching in the lower back,dizziness and tinnitus,hypoactive sexual desire,and irritation decreased in the three groups(P<0.05);the scores of dark menses,dull aching in the lower back,dizziness and tinnitus,hypoactive sexual desire,and irritation were lower in the joint group than in the acupuncture group and control group(P<0.05)and were lower in the acupuncture group than in the control group(P<0.05).The level of E2 increased(P<0.05),and the levels of FSH,T,LH,and PRL dropped(P<0.05)in all thr

关 键 词：针刺疗法 针药并用 月经失调 肝郁肾虚 性激素 卵巢功能 PI3K/Akt/mTOR信号通路 

分 类 号：R246.3[医药卫生—针灸推拿学]