摘要
目的探究理痰汤加味联合八段锦对多囊卵巢综合征(polycystic ovary syndrome,PCOS)胰岛素抵抗(insulin resistance,IR)及血清抗缪勒管激素(anti-mullerian hormone,AMH)、雌二醇(estradiol,E_(2))水平影响。方法选取2021年7月—2024年6月于该院进行治疗的痰湿型PCOS患者92例为研究对象,采用抛硬币法将其随机分为研究组和对照组,各46例,对照组患者采用常规西药联合八段锦治疗,研究组患者在对照组基础之上联合理痰汤加味,两组患者均治疗3个月。统计两组患者治疗前后中医症状积分,观察两组患者治疗前后糖代谢指标[空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2 h postprandial blood glucose,2hPG)、糖化血红蛋白(glycosylated hemoglobin,Hb A1c)]、脂代谢指标[总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,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)、游离脂肪酸(free fatty acid,FFA)]水平、IR指标[空腹胰岛素(fasting insulin,FINS)、2h(2-hour insulin,2hINS)、稳态模型的IR(homeostasis model assessment of IR,HOMA-IR)指数]、血清性激素水平[AMH、E_(2)、促黄体生成素(luteinizing hormone,LH)、卵泡刺激素(follicle stimulating hormone,FSH)、睾酮(testosterone,T)]。结果治疗后,两组形体肥胖、心悸气短积分较治疗前差异无统计学意义,且两组间形体肥胖、心悸气短积分差异无统计学意义(P>0.05),对照组倦怠乏力积分较治疗前比较差异无统计学意义(P>0.05),研究组患者该积分较治疗前差异有统计学意义,且研究组患者该积分低于对照组(P<0.05);其余积分均降低,且研究组患者积分均低于对照组;治疗后,两组患者FBG、2hPG、Hb A1c均降低,两组间差异无统计学意义(P>0.05);治疗后,两组患者TC、TG、LDLC、FFA水平较治疗前降低,HDLC均升高,研究组患者TC、TG水平较对照组更低(P<0.05),两组间HDLC、LDLC、FFA水平差异无统计学意义(P>0.05);治疗后,两组患者FINS、2hINS、HOMA-IR下降,且研究组患者FINS、2hINS、HOMA-IR较对照组更低(P<0.05);治疗后,两组患者AMH、E_(2)、LH、T水平均降低,E_(2)均上升,且研究组患者AMH、LH、T水平较对照组更低(P<0.05),E_(2)更高(P<0.05)两组患者FSH水平差异无统计学意义(P>0.05)。结论理痰汤加味联合八段锦治疗痰湿型PCOS效果突出,能有效缓解临床症状,改善脂代谢情况并减轻IR,对调节性激素水平大有裨益。
Objective To explore the influence of Modified Litan Decoction(理痰汤加味)combined with Baduanjin on insulin resistance(IR)and the serum levels of anti-mullerian hormone(AMH)and estradiol(E_(2))in patients with polycystic ovary syndrome(PCOS).Methods Ninety-two patients with phlegm-dampness type of PCOS who received treatment in the hospital were selected from July 2021 to June 2024 as the research subjects,and were randomly divided into study group(46 cases)and control group(46 cases)by coin tossing method.The control group was treated with conventional western medicine combined with Baduanjin,while the study group was combined with Modified Litan Decoction on the basis of the control group.Both groups were treated for 3 months.The TCM symptoms scores in the two groups before and after treatment were counted.The levels of glucose metabolism indicators[fasting blood glucose(FBG),2 h postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c)],lipid metabolism indicators[total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDLC),low density lipoprotein cholesterol(LDLC),free fatty acid(FFA)],IR indexes[fasting insulin(FINS),2-hour insulin(2 h INS),homeostasis model assessment of IR(HOMA-IR)index]and serum sex hormones[AMH,E_(2),luteinizing hormone(LH),follicle stimulating hormone(FSH),testosterone(T)]were observed before and after treatment in the two groups.Results After treatment,the scores of body obesity and palpitation and shortness of breath in both groups were not statistically different from those before treatment,and the two scores revealed no statistical differences between the two groups(P>0.05),and the score of fatigue and lack of strength in the control group had no statistical significance compared with that before treatment(P>0.05)while the score in the study group was statistically different compared with that before treatment,and the score in the study group was lower than that in the control group(P<0.05).The scores of other symptoms were reduced,and the scores in the study group were lower than those in the control group.The levels of FBG,2 h PG and HbA1c were declined in both groups after treatment,and there were no statistical differences between groups(P>0.05).The levels of TC,TG,LDLC and FFA in both groups were declined after treatment compared with those before treatment,and the levels of TC and TG in the study group were lower than those in the control group(P<0.05),but there were no significant differences in HDLC,LDLC or FFA between two groups(P>0.05).After treatment,the levels of FINS,2 h INS and HOMA-IR were decreased in both groups,and the above indicators in the study group were lower than those in the control group(P<0.05).After treatment,the levels of AMH,LH and T were reduced in both groups while the level of E_(2) was enhanced,and the AMH,LH and T levels in study group were lower than with those in control group while the E_(2) level was higher(P<0.05).There was no obvious difference in the level of FSH between two groups(P>0.05).Conclusion Modified Litan Decoction combined with Baduanjin has a prominent effect in the treatment of phlegm-dampness type of PCOS.It can effectively relieve the clinical symptoms,improve the lipid metabolism and relieve the IR,and it is of great benefit to regulating sex hormones levels.
作者
周洁
张慧丽
王旭东
ZHOU Jie;ZHANG Huili;WANG Xudong(Nantong First People′s Hospital,Nantong 226006,Jiangsu,China)
出处
《辽宁中医杂志》
北大核心
2025年第8期103-108,共6页
Liaoning Journal of Traditional Chinese Medicine
基金
南通市科技局课题项目(JC2020003)。
关键词
理痰汤加味
八段锦
多囊卵巢综合征
痰湿型
胰岛素抵抗
血清性激素
Modified Litan Decoction(理痰汤加味)
Baduanjin
polycystic ovary syndrome
phlegm-dampness type
insulin resistance
serum sex hormones
