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多囊卵巢综合征女性中,通过磁共振成像评估血清抗苗勒管激素和卵巢形态对针灸及运动的反应:一项随机对照试验的二次分析

Serum anti-Müllerian hormone and ovarian morphology assessed by magnetic resonance imaging in response to acupuncture and exercise in women with polycystic ovary syndrome: secondary analyses of a randomized controlled trial.

作者信息

Leonhardt Henrik, Hellström Mikael, Gull Berit, Lind Anna-Karin, Nilsson Lars, Janson Per Olof, Stener-Victorin Elisabet

机构信息

Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden.

出版信息

Acta Obstet Gynecol Scand. 2015 Mar;94(3):279-87. doi: 10.1111/aogs.12571. Epub 2015 Jan 28.

Abstract

OBJECTIVE

To investigate whether electro-acupuncture or physical exercise influence serum anti-Müllerian hormone (AMH), antral follicle count (AFC) or ovarian volume in women with polycystic ovary syndrome (PCOS).

DESIGN

Secondary analyses of a prospective, randomized controlled clinical trial.

SETTING

University Hospital, Sweden.

PATIENTS

Seventy-four women with PCOS recruited from the general population.

INTERVENTIONS

Women with PCOS were randomized to 16 weeks of electro-acupuncture (14 treatments), exercise (at least three times/week), or no intervention.

MAIN OUTCOME MEASURES

Serum AMH recorded at baseline, after 16 weeks of intervention, and at follow up at 32 weeks. AFC, and ovarian volume assessed by magnetic resonance imaging at baseline and at follow up at 32 weeks.

RESULTS

After 16 weeks of intervention, serum levels of AMH were significantly decreased in the electro-acupuncture group by 17.5% (p < 0.001), and differed from the change in the exercise group. AMH remained decreased by 15% (p = 0.004) also at follow up at 32 weeks, but did not differ from the exercise or the no intervention groups. There was a decrease by 8.5% (p = 0.015) in ovarian volume between baseline and follow up in the electro-acupuncture group, and by 11.7% (p = 0.01) in AFC in the physical exercise group. No other variables were affected.

CONCLUSIONS

This study is the first to demonstrate that acupuncture reduces serum AMH levels and ovarian volume. Physical exercise did not influence circulating AMH or ovarian volume. Despite a within-group decrease in AFC, exercise did not lead to a between-group difference.

摘要

目的

探讨电针或体育锻炼对多囊卵巢综合征(PCOS)女性血清抗苗勒管激素(AMH)、窦卵泡计数(AFC)或卵巢体积的影响。

设计

一项前瞻性随机对照临床试验的二次分析。

地点

瑞典大学医院。

患者

从普通人群中招募的74例PCOS女性。

干预措施

PCOS女性被随机分为接受16周电针治疗(14次治疗)、锻炼(每周至少三次)或不干预。

主要观察指标

在基线、干预16周后及32周随访时记录血清AMH。在基线及32周随访时通过磁共振成像评估AFC和卵巢体积。

结果

干预16周后,电针组血清AMH水平显著降低17.5%(p<0.001),且与锻炼组的变化不同。在32周随访时,AMH仍降低15%(p = 0.004),但与锻炼组或不干预组无差异。电针组基线至随访时卵巢体积降低8.5%(p = 0.015),体育锻炼组AFC降低11.7%(p = 0.01)。其他变量未受影响。

结论

本研究首次证明针刺可降低血清AMH水平和卵巢体积。体育锻炼未影响循环AMH或卵巢体积。尽管锻炼组内AFC有所降低,但未导致组间差异。

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