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电针对胰岛素抵抗型多囊卵巢综合征的疗效及机制

[Efficacy and mechanism of electroacupuncture on insulin resistant polycystic ovary syndrome].

作者信息

Yu Li-Qing, Cao Lian-Ying, Xie Jing, Shi Yin, Zhou Li-Yan, He Tian-Feng, Chu Xiao-Yan

机构信息

Acupuncture- Moxibustion Department, Shanghai Tianshan Hospital of TCM, Shanghai 200051, China.

Gynecology Department, Shanghai Tianshan Hospital of TCM, Shanghai 200051, China.

出版信息

Zhongguo Zhen Jiu. 2020 Apr 12;40(4):379-83. doi: 10.13703/j.0255-2930.20190903-k0003.

Abstract

OBJECTIVE

To explore the therapeutic effect and partial mechanism of electroacupuncture (EA) for patients with insulin resistance (IR) polycystic ovary syndrome (PCOS).

METHODS

Seventy patients with IR-PCOS were randomly divided into an EA group (36 cases, 5 cases dropped off) and a medication group (34 cases, 4 cases dropped off). The patients in the medication group were treated with oral administration of metformin hydrochloride, 500 mg each time, twice a day. The patients in the EA group were treated with EA (continuous wave, 2 Hz of frequency) at Zusanli (ST 36), Zhongwan (CV 12), Qihai (CV 6), Yishu (EX-B 3), Shenshu (BL 23), Pishu (BL 20), Ciliao (BL 32) for 30 min, three times a week. One menstrual cycle or 4 weeks were taken as a course of treatment, and 3 continuous courses were given. The follow-up was 3 months. The lipid metabolism indexes of triacylglycerol (TG), total cholesterol (TC), high-density lipoprotein (HDL) and low-density lipoprotein (LDL), homeostasis model assessment-insulin resistance index (HOMA-IR) and testosterone (T) in serum were compared before and after treatment, and the clinical effects of the two groups were evaluated during the follow-up.

RESULTS

The total effective rate was 67.7% (21/31) in the EA group and 60.0% (18/30) in the medication group, with no significant difference between the two groups (>0.05). After treatment, the levels of serum T, HOMA-IR, LDL, TG and TC were decreased significantly in the two groups (<0.01, <0.05), and HDL was increased significantly (<0.01); the levels of TC in the EA group after treatment was lower than that in the medication group (<0.05).

CONCLUSION

EA may adjust some dyslipidemia in patients to correct IR and improve endocrine disorder of PCOS, which had superior/similar effects to metformin.

摘要

目的

探讨电针(EA)对胰岛素抵抗(IR)型多囊卵巢综合征(PCOS)患者的治疗效果及部分作用机制。

方法

将70例IR-PCOS患者随机分为电针组(36例,脱落5例)和药物组(34例,脱落4例)。药物组患者口服盐酸二甲双胍治疗,每次500mg,每日2次。电针组患者采用电针(连续波,频率2Hz)针刺足三里(ST 36)、中脘(CV 12)、气海(CV 6)、胰俞(EX-B 3)、肾俞(BL 23)、脾俞(BL 20)、次髎(BL 32),留针30min,每周3次。以1个月经周期或4周为1个疗程,连续治疗3个疗程。随访3个月。比较两组治疗前后血清三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)等脂代谢指标、稳态模型评估胰岛素抵抗指数(HOMA-IR)及睾酮(T)水平,并在随访期间评价两组的临床疗效。

结果

电针组总有效率为67.7%(21/31),药物组为60.0%(18/30),两组比较差异无统计学意义(>0.05)。治疗后,两组血清T、HOMA-IR、LDL、TG及TC水平均显著降低(<0.01,<0.05),HDL水平显著升高(<0.01);电针组治疗后TC水平低于药物组(<0.05)。

结论

电针可能通过调节患者部分血脂异常来纠正IR,改善PCOS的内分泌紊乱,其效果与二甲双胍相当或更优。

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