穴位埋线联合补肾利湿活血汤治疗PCOS合并IR  

Acupoint Embedding Therapy Combined with Bushen Lishi Huoxue Decoction in Treatment of PCOS-IR

作　　者：李香玉 李久现[1] 孙烁 王浩贤 刘妍 LI Xiangyu;LI Jiuxian;SUN Shuo;WANG Haoxian;LIU Yan(Department of Obstetrics and Gynecology,The First Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450000;The First Clinical Medical College,Henan University of Chinese Medicine,Zhengzhou Henan China 450000)

机构地区：[1]河南中医药大学第一附属医院妇产科,河南郑州450000 [2]河南中医药大学第一临床医学院,河南郑州450000

出　　处：《中医学报》2025年第4期876-883,共8页Acta Chinese Medicine

基　　金：河南省中医药科学研究专项课题项目(2022ZY2011);河南省卫生健康委员会国家中医临床研究基地科研专项项目(2022JDZX011);河南省医学科技攻关计划项目(LHGJ20230689);第七批全国老中医药专家学术经验继承项目{国中医药人教函〔2022〕76号}。

摘　　要：目的:观察穴位埋线联合补肾利湿活血汤治疗肾虚痰瘀型多囊卵巢综合征(polycystic ovary syndrome,PCOS)伴胰岛素抵抗(insulin resistance,IR)的临床疗效,并观察其对糖脂代谢、性激素、炎症因子的影响。方法:选取60例肾虚痰瘀型PCOS伴IR患者,并将其随机分为试验组和对照组,每组各30例。试验组给予穴位埋线联合补肾利湿活血汤口服治疗,对照组给予二甲双胍口服治疗。两组均治疗12周,比较两组患者治疗后体质量指数(body mass index,BMI),糖脂代谢相关指标:空腹血糖(fasting plasma glucose,FPG)、空腹胰岛素(fasting insulin,FINS)、胰岛素抵抗指数(homeostatic model assessment of insulin resistance,HOMA-IR)、总胆固醇(total cholesterol,TC)、甘油三酯(triglycerides,TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDLC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDLC),血清性激素:促卵泡生成素(follicle-stimulating hormone,FSH)、促黄体生成素(luteinizing hormone,LH)、睾酮(testosterone,T)、LH/FSH,炎症因子:白细胞介素-6(interleukin-6,IL-6)、白细胞介素-1β(interleukin-1 beta,IL-1β)、肿瘤坏死因子-α(tumor necrosis factor-alpha,TNF-α)、哺乳动物酪氨酸激酶2信使核糖核酸(Janus kinase 2 messenger ribonucleic acid,JAK2 mRNA)、信号转导和转录激活因子3信使核糖核酸(signal transducer and activator of transcription 3 messenger ribonucleic acid,STAT3 mRNA)水平,中医证候积分及临床疗效。结果:(1)治疗后,两组患者BMI水平显著降低,试验组BMI水平为(24.11±0.59)kg·m^(-2),低于同期对照组(P<0.05)。(2)治疗后,两组患者糖脂代谢相关指标:FPG、FINS、HOMA-IR、TC、TG、LDL均显著降低,HDL水平显著升高;试验组FPG(4.86±0.04)mmol·L^(-1)、FINS(6.89±0.51)mIU·L^(-1)、HOMA-IR(1.49±0.11)、TC(4.14±0.11)mmol·L^(-1)、TG(1.29±0.06)mmol·L^(-1)、LDL(1.98±0.04)mmol·L^(-1),均低于同期对照组,HDL(1.58±0.03)mmol·L^(-1)高于同�Objective:To observe the clinical efficacy of acupuncture point embedding combined with Bushen Lishi Huoxue Decoction in treating polycystic ovary syndrome(PCOS)with insulin resistance(IR)of Kidney deficiency and Phlegm stasis syndrome,as well as to observe the effects on glucose and lipid metabolism,sex hormones,and inflammatory factors.Methods:Sixty patients with Kidney deficiency,PCOS with IR case with Phlegm stasis syndrome were selected and randomly divided into the test group and control group,with 30 cases in each group.The experimental group was given acupoint embedding combined with Bushen Lishi Huoxue Decoction for oral treatment,and the control group was given metformin for oral treatment.Both groups were treated for 12 weeks,and the body mass index(BMI),glucose and lipid metabolism related indexes:fasting plasma glucose(FPG),fasting insulin(FINS),homeostatic model assessment of insulin resistance(HRI)and insulin resistance index(IRI)were compared between the two groups.model assessment of insulin resistance(HOMA-IR),total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDLC),and triglycerides(TG).cholesterol(HDLC),low-density lipoprotein cholesterol(LDLC),serum sex hormones:Follicle-stimulating hormone(FSH),luteinizing hormone(LH),testosterone(T),LH/FSH,inflammatory factors:interleukin-6(IL-6),JAK2 mRNA,signal transducer and activator of transcription 3 messenger ribonucleic acid(STAT3 mRNA)levels,Chinese medicine points and clinical efficacy.Results:(1)After treatment,the BMI levels of patients in the two groups were significantly reduced,and the BMI level of the experimental group was(24.11±0.59)kg·m^(-2),which was lower than that of the control group in the same period(P<0.05).(2)After treatment,the glycemic and lipid metabolism-related indexes of patients in both groups:FPG,FINS,HOMA-IR,TC,TG,LDL were significantly reduced,and the HDL level was significantly increased;in the test group,the levels of FPG(4.86±0.04)mmol·L^(-1),FINS(6.89±0.51)mIU·L^(-1),HOMA-IR(1.49±0.11

关 键 词：多囊卵巢综合征 胰岛素抵抗 肾虚痰瘀证 穴位埋线 补肾利湿活血汤 炎症因子 

分 类 号：R271.911.75[医药卫生—中西医结合]