首页|补肾化痰祛瘀法联合运动体疗治疗超重/肥胖型多囊卵巢综合征的临床研究

补肾化痰祛瘀法联合运动体疗治疗超重/肥胖型多囊卵巢综合征的临床研究

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目的:观察补肾化痰祛瘀法联合运动体疗治疗超重/肥胖型多囊卵巢综合征(PCOS)的临床疗效.方法:纳入超重/肥胖型PCOS患者 72 例,随机分为治疗组和对照组,每组各 36 例.治疗组患者予补肾化痰祛瘀方联合运动治疗,对照组患者予补肾化痰祛瘀方治疗,两组疗程均为 3 个月.比较两组患者的临床疗效;干预前后,评估并比较两组患者的月经情况评分、Ferriman-Gallwey多毛评分、痤疮pillsbuny分级法评分、黑棘皮评分及焦虑自评量表(SAS)评分;干预前后,检测所有患者的性激素[包括促黄体生成素(LH)、卵泡刺激素(FSH)、睾酮(T)、抗缪勒激素(AMH)、LH/FSH比值]水平、糖脂代谢指标[包括空腹血糖(FPG)、空腹胰岛素(FINS)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、胰岛素抵抗指数(HOMA-IR)]水平及血清瘦素水平;干预前后,超声检测两组患者的卵巢面积.结果:①干预后,治疗组的临床总有效率为 83.34%,对照组为50.00%,治疗组的疗效优于对照组(P<0.05).②干预后,两组患者的月经情况、多毛、痤疮评分及SAS评分较干预前均明显下降(P<0.05,P<0.01),且治疗组患者的月经情况、多毛评分及SAS评分明显低于对照组(P<0.05).③干预后,两组患者的LH、T、AMH水平及LH/FSH比值较干预前均降低(P<0.05,P<0.01),但两组患者的各项性激素水平组间比较差异无统计学意义(P>0.05).④干预后,两组患者的FINS、HOMA-IR水平较干预前均明显降低(P<0.01),但各项糖代谢指标水平组间比较差异无统计学意义(P>0.05).⑤干预后,治疗组患者的TG、TC、LDL-C水平明显降低(P<0.05,P<0.01),HDL-C水平升高(P<0.05),对照组患者的TC、LDL-C水平亦明显降低(P<0.05),且治疗组患者的HDL-C水平高于对照组(P<0.01).⑥干预后,两组患者的血清瘦素水平较干预前均明显降低(P<0.01),且治疗组患者的血清瘦素水平明显低于对照组(P<0.01).⑦干预前后,两组患者的卵巢面积组间及组内比较,差异均无统计学意义(P>0.05).结论:补肾化痰祛瘀法联合运动体疗可有效改善超重/肥胖型PCOS患者的相关症状及体征,降低体质量,纠正糖脂代谢紊乱,减轻瘦素抵抗,提高临床疗效.
Clinical study on tonifying kidney,reducing phlegm and removing blood stasis method combined with physical exercise in treatment of overweight/obese polycystic ovary syndrome
Objective:To observe the clinical efficacy of tonifying kidney,reducing phlegm and removing blood stasis method combined with physical exercise in the treatment of overweight/obese polycystic ovary syndrome(PCOS).Methods:A total of 72 patients with overweight/obese PCOS were included and randomly divided into the treatment group and control group,36 cases in each group.The patients in the treatment group were treated with tonifying kidney,reducing phlegm and removing blood stasis formula combined with physical exercise,and the patients in the control group were treated with tonifying kidney,reducing phlegm and removing blood stasis formula,with a course of 3 months.The clinical efficacy was compared between the two groups.Before and after intervention,the menstrual condition scores,Ferriman-Gallwey hirsutism scores,acne grading scores,acanthosis nigricans scores,and Self-Rating Anxiety Scale(SAS)scores of both groups were evaluated and compared.Before and after intervention,the levels of sex hormones[including luteinizing hormone(LH),follicle-stimulating hormone(FSH),testosterone(T),anti-Müllerian hormone(AMH),and LH/FSH ratio],glucose and lipid metabolism indicators[including fasting plasma glucose(FPG),fasting insulin(FINS),total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),and insulin resistance index(HOMA-IR)],and serum leptin were detected.Before and after intervention,the ovarian area of patients in both groups was measured by ultrasound.Results:①After intervention,the total clinical effective rate was 83.34%in the treatment group and 50.00%in the control group.The efficacy of the treatment group was better than that of the control group(P<0.05).②After intervention,the scores of menstrual condition,hirsutism,and acne,and SAS scores in both groups were significantly decreased compared with those before intervention(P<0.05,P<0.01),and the scores of menstrual condition and hirsutism,and SAS score in the treatment group were significantly lower than those in the control group(P<0.05).③After intervention,the levels of LH,T and AMH,and the LH/FSH ratio in both groups were decreased compared with those before intervention(P<0.05,P<0.01).However,there were no statistically significant differences in the levels of sex hormones between the two groups(P>0.05).④After intervention,the levels of FINS and HOMA-IR in both groups were significantly decreased compared with those before intervention(P<0.01).However,there were no statistically significant differences in the levels of glucose metabolism indicators between the two groups(P>0.05).⑤After intervention,the levels of TG,TC,and LDL-C in the treatment group were significantly decreased(P<0.05,P<0.01),the HDL-C level was increased(P<0.05),the levels of TC and LDL-C in the control group were also significantly decreased(P<0.05),and the HDL-C level of the treatment group was higher than that of the control group(P<0.01).⑥After intervention,the serum leptin levels of both groups were significantly decreased compared with those before intervention(P<0.01),and the serum leptin level of the treatment group was significantly lower than that of the control group(P<0.01).⑦Before and after intervention,there were no statistically significant differences in the ovarian area between and within the two groups(P>0.05).Conclusion:Tonifying kidney,reducing phlegm and removing blood stasis method combined with physical exercise can effectively improve the related symptoms and signs in overweight/obese patients with PCOS,reduce the body mass,correct the glucose and lipid metabolism disorders,alleviate the leptin resistance,and enhance the clinical efficacy.

polycystic ovarian syndromeoverweight/obesekidney-deficiency and phlegm-dampness typetonifying kidney,reducing phlegm and removing blood stasisphysical exercise

崔延婕、朱心怡、杜尘、曾薇薇、李天娇、刘向云、张婷婷、曹阳

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上海中医药大学附属岳阳中西医结合医院妇科(上海 200437)

上海中医药大学附属曙光医院妇产科(上海 201203)

上海体育大学(上海 200438)

多囊卵巢综合征 超重/肥胖 肾虚痰湿型 补肾化痰祛瘀 运动

2024

上海中医药大学学报
上海中医药大学,上海市中医药研究院

上海中医药大学学报

CSTPCD
影响因子:0.788
ISSN:1008-861X
年,卷(期):2024.38(6)