本文選題：多囊卵巢綜合征　切入點(diǎn)：胰島素抵抗　出處：《南京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:探討并闡述針?biāo)幝?lián)合治療腎虛痰瘀型多囊卵巢綜合征(polycystic ovarian syndrome,PCOS)伴胰島素抵抗(insulinresistance,IR)的臨床療效與單純使用西藥以及中西藥結(jié)合治療腎虛痰瘀型PCOS-IR的臨床療效的對(duì)比;證實(shí)針?biāo)幝?lián)合治療腎虛痰瘀型PCOS-IR具有良好的效果與優(yōu)勢(shì)。方法:按診斷標(biāo)準(zhǔn)收集腎虛痰瘀型PCOS-IR患者,分為三組,即對(duì)照組、治療1組、治療2組,分別給予二甲雙胍,首烏僵芪湯加減聯(lián)合二甲雙胍,首烏僵芪湯加減聯(lián)合針灸、二甲雙胍治療,分別治療3個(gè)月經(jīng)周期。觀察三組患者治療前后的月經(jīng)周期、多毛及痤瘡情況,血清T、LH、FSH、E2值的變化,空腹血糖、空腹胰島素及胰島素抵抗情況,體重指數(shù)(body mass index,BMI)變化,基礎(chǔ)體溫(basal body temperature,BBT)的變化。結(jié)果:(1)在改善中醫(yī)證候方面,治療1組與治療2組療效相當(dāng),但都優(yōu)于對(duì)照組。(2)治療1組、治療2組治療后月經(jīng)周期、多毛、痤瘡情況較治療前均有明顯改善(P值均0.05),對(duì)照組治療前后對(duì)比均無明顯改善(P值均0.05)。在改善月經(jīng)周期、多毛方面,治療1組與治療2組療效相當(dāng)(P0.05);在改善痤瘡方面,治療2組的療效優(yōu)于治療 1 組(P0.05)。(3)三組均能降低T、LH水平(P值均0.05),但三組的FSH、E2值治療后均無明顯改善(P值均0.05)。在降低T、LH水平方面,治療2組的療效優(yōu)于另外兩組,另兩組療效相當(dāng)。(4)三組的空腹血糖治療后均無明顯改善(P值均0.05),但三組均能降低空腹胰島素水平及HOMA-IR(P值均0.05)。在降低空腹胰島素水平及HOMA-IR方面,治療2組的療效優(yōu)于治療1組,且治療1組優(yōu)于對(duì)照組。(5)三組均能降低BMI(P值均0.05)。在降低BMI方面,治療2組的療效優(yōu)于治療1組,且治療1組優(yōu)于對(duì)照組。(6)三組均能改善BBT情況(P值均0.05)。在改善BBT方面,治療2組的療效優(yōu)于治療1組,且治療1組優(yōu)于對(duì)照組。(7)三組總療效比較,治療2組的療效優(yōu)于另外兩組,另兩組療效相當(dāng)。結(jié)論:首烏僵芪湯聯(lián)合二甲雙胍及針刺的方法治療腎虛痰瘀型PCOS-IR,能有效改善中醫(yī)癥候、月經(jīng)周期、多毛及痤瘡情況,調(diào)節(jié)性激素水平,改善胰島素抵抗,降低體重指數(shù),恢復(fù)BBT雙相,效果顯著。表明針?biāo)幝?lián)合治療腎虛痰瘀型PCOS-IR療效確切,效果優(yōu)于中西藥結(jié)合治療或單純使用西藥治療腎虛痰瘀型PCOS-IR。
[Abstract]:Objective: to explore the clinical efficacy of acupuncture and medicine combined with acupuncture and medicine in the treatment of polycystic ovarian syndrome (PCOS) with insulin resistance (IRR) in patients with kidney deficiency and phlegm stasis syndrome, and to compare the clinical efficacy of traditional Chinese medicine and western medicine in the treatment of PCOS-IR with kidney deficiency and phlegm stasis. Methods: according to the diagnostic criteria, the patients with PCOS-IR with kidney deficiency and phlegm stasis were divided into three groups: control group, treatment group 1, treatment group 2, respectively, given metformin. The patients in the three groups were treated with acupuncture and moxibustion and metformin respectively. The changes of menstrual cycle, hirsutism and acne were observed before and after treatment. Fasting blood glucose, fasting insulin and insulin resistance, body mass index (BMI), body mass index (BMI), and basic body temperature (BBT) were changed. Results: in improving TCM syndromes, the curative effect of treatment group 1 was equal to that of treatment group 2. The menstrual cycle, hirsutism and acne in the treatment group were all significantly improved than before, and the P value in the control group was not significantly improved before and after treatment, and the menstrual cycle was improved by 0.05% in the control group before and after treatment, and the menstrual cycle was improved in the control group, and there was no significant improvement in the menstrual cycle in the control group before and after treatment. In terms of hirsutism, the curative effect of treatment group 1 was comparable to that of treatment group 2 (P0.05A); in improving acne, The therapeutic effect of treatment group 2 was better than that of group 1 (P 0.05, P = 0.05), but the value of FSHE _ 2 was not significantly improved after treatment. In reducing the level of TLH, the curative effect of treatment group 2 was better than that of other two groups, and the effect of treatment group was better than that of other two groups, and the effect of treatment group was better than that of other two groups. There was no significant improvement in fasting blood glucose after treatment in the other two groups (P < 0.05), but the fasting insulin level and the HOMA-IR(P value were all decreased in the three groups. The curative effect of the two groups was better than that of the first group in decreasing the fasting insulin level and the HOMA-IR level, and the effect of the treatment group was better than that of the control group (P < 0.05), which was better than that of the control group (P < 0.05). The treatment group 1 was better than the control group (P < 0.05). In the aspect of decreasing BMI, the curative effect of treatment group 2 was better than that of treatment group 1, and treatment group 1 was superior to control group. The curative effect of the treatment group 2 was better than that of the treatment group 1, and the treatment group 1 was superior to the control group. Conclusion: the treatment of kidney deficiency and phlegm stasis type PCOS-IRs can effectively improve the symptoms of TCM, menstrual cycle, hair and acne, regulate the level of sex hormone, and improve insulin resistance, conclusion: the treatment of Shouwujiangqi decoction combined with metformin and acupuncture can effectively improve the symptoms of TCM, menstrual cycle, hair and acne, regulate sex hormone level, and improve insulin resistance. The results showed that the combination of acupuncture and medicine was effective in the treatment of kidney deficiency and phlegm stasis type PCOS-IR, and the effect was better than that of traditional Chinese medicine combined with western medicine or western medicine alone in the treatment of kidney deficiency phlegm stasis type PCOS-IRR.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R271.9

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