J Am Osteopath Assoc. 2020 May 1;120(5):310-321. doi: 10.7556/jaoa.2020.051.
Polycystic ovary syndrome (PCOS), a common hormone disorder affecting reproductive and metabolic health of reproductive-age women, was shown in a previous study from these authors to be associated with increased sympathetic tone. Increased sympathetic tone contributes to long-term health risks for cardiovascular disease and promotes PCOS pathogenesis.
To determine whether weekly osteopathic manipulative treatment (OMT) improves physiologic measures of sympathetic tone in women with PCOS.
In the second phase of a larger study from this author group, 25 women with PCOS, aged 22 to 43 years, living in Erie, Pennsylvania, were recruited to participate in a randomized, controlled evaluation of OMT intervention. Participants were randomly assigned to either an OMT intervention or control group. The OMT group received weekly manipulation of Chapman points and rib-raising for viscerosomatic reflexes associated with the ovaries, adrenal glands, and heart for 12 consecutive weeks. Physiologic measures of sympathetic tone were collected, along with metabolic, endocrine, and reproductive measurements, both before the 3-month intervention and within 1 week of completing the intervention. Measurements included heart rate and blood pressure at rest and after 15 minutes of aerobic exercise, heart rate recovery after exercise, resting heart rate variability, serum androgen levels, body mass index, fasting blood glucose and insulin levels, and menstrual cycle length.
Nineteen women completed the study. Comparing pre- and postintervention parameters, women with PCOS in the OMT intervention group experienced an improvement in postexercise systolic blood pressure (135.8 vs 129.1 mm Hg) and a trend toward heart rate recovery (23.2 vs 29.4 seconds). No significant improvements were found in the control group or in any other physiologic parameters measured. No significant improvements were found in the endocrine, metabolic, or reproductive parameters measured, although free testosterone was slightly lower after 3 months of weekly OMT (5.69 vs 4.64 pg/mL).
Improvements in sympathetic tone after OMT suggest that weekly manipulation of Chapman points and viscerosomatic reflexes can be a useful adjunctive therapeutic option for women with PCOS. (ClinicalTrials.gov No. NCT03383484).
多囊卵巢综合征（PCOS）是一种常见的激素紊乱疾病，影响生殖年龄女性的生殖和代谢健康，此前作者的一项研究表明，其与交感神经张力增加有关。交感神经张力增加会导致心血管疾病的长期健康风险，并促进 PCOS 的发病机制。
确定每周整骨治疗（OMT）是否能改善 PCOS 女性的交感神经张力生理指标。
在作者小组的更大规模研究的第二阶段，招募了 25 名年龄在 22 至 43 岁之间、居住在宾夕法尼亚州伊利的 PCOS 女性参与 OMT 干预的随机对照评估。参与者被随机分配到 OMT 干预组或对照组。OMT 组接受为期 12 周的每周 Chapman 点和肋骨提升手法，以调节与卵巢、肾上腺和心脏相关的内脏躯体反射。在 3 个月的干预前和干预结束后 1 周内，收集生理交感神经张力指标，以及代谢、内分泌和生殖测量值。测量包括静息和运动 15 分钟后的心率和血压、运动后心率恢复、静息心率变异性、血清雄激素水平、体重指数、空腹血糖和胰岛素水平以及月经周期长度。
19 名女性完成了研究。与干预前相比，OMT 干预组的 PCOS 女性在运动后收缩压（135.8 对 129.1mmHg）和心率恢复趋势（23.2 对 29.4 秒）方面有所改善。对照组或任何其他测量的生理参数均未发现显著改善。测量的内分泌、代谢或生殖参数也没有明显改善，尽管经过 3 个月的每周 OMT 治疗，游离睾酮略低（5.69 对 4.64pg/ml）。
OMT 后交感神经张力的改善表明，Chapman 点和内脏躯体反射的每周手法治疗可能是 PCOS 女性的一种有用的辅助治疗选择。（ClinicalTrials.gov 编号：NCT03383484）。
