【摘要】：目的:觀察電針結(jié)合光電治療肥胖型PCOS脂代謝紊亂的臨床療效,為臨床上改善肥胖型多囊卵巢綜合征脂代謝紊亂提供更好的治療方案。方法:將65例伴有脂代謝紊亂的肥胖型PCOS患者隨機(jī)分為兩組,光電組33例,電針組32例,分別采用電針結(jié)合光電治療和單純電針治療,共治療3個(gè)療程,治療結(jié)束后觀察兩組患者中醫(yī)癥候、體重、體質(zhì)指數(shù)(BMI)、月經(jīng)周期、性激素(LH、FSH、T)、脂代謝(TG、TC、LDL-C、HDL-C)各項(xiàng)指標(biāo)的變化,比較兩種治療方法的療效差異。結(jié)果:共納入65例脂代謝紊亂的肥胖型PCOS患者,其中高膽固醇血癥11例,高甘油三脂血癥28例,混合型高脂血癥5例,低HDL-C血癥21例。最終完成治療60例,懷孕1例,脫落4例,脫落率為7.7%。(1)中醫(yī)癥狀評(píng)分:治療后兩組中醫(yī)癥狀評(píng)分均較前降低(p0.01),且光電組低于電針組(p0.05)。光電組總有效率86.67%,電針組總有效率80%,兩組療效差異無統(tǒng)計(jì)學(xué)意義(p0.05)。(2)體重、BMI:與治療前比較,兩組體重、BMI均顯著下降(p0.01);兩組間比較,差異無統(tǒng)計(jì)學(xué)意義(p0.05)。(3)月經(jīng)周期:治療后兩組月經(jīng)周期有明顯改善(p0.05),且光電組療效優(yōu)于電針組(p0.05)。(4)性激素水平:治療后兩組LH、T數(shù)值顯著下降(p0.01),且光電組LH和T下降幅度大于電針組,差異有統(tǒng)計(jì)學(xué)意義(p0.05)。兩組FSH與治療前比較差異無統(tǒng)計(jì)學(xué)意義(p0.05)。(5)脂代謝:治療后兩組脂代謝水平均有顯著改善,與治療前比較TG、TC、LDL-C降低和HDL-C升高明顯,差異有統(tǒng)計(jì)學(xué)意義(p0.01)。光電組在降低TG、升高HDL-C方面更優(yōu)于電針組(p0.05),在降低TC、LDL-C方面兩組療效相當(dāng)(p0.05)。光電組改善脂代謝的總有效率為90%,電針組為86.67%,兩組比較無統(tǒng)計(jì)學(xué)差異(p0.05)。結(jié)論:(1)電針、電針結(jié)合光電治療均能改善肥胖型PCOS的血脂異常,均為臨床上治療肥胖型PCOS脂代謝紊亂的有效方法。(2)電針結(jié)合光電治療在降低TG、升高HDL-C方面療效優(yōu)于單純電針,降低TC、LDL-C的方面兩種方法療效相當(dāng)。(3)電針結(jié)合光電治療在改善肥胖型PCOS患者中醫(yī)癥狀、性激素水平及調(diào)整月經(jīng)周期方面療效優(yōu)于單純電針治療。
[Abstract]:Objective: to observe the clinical efficacy of electroacupuncture combined with photoelectricity in the treatment of obese PCOS lipid metabolism disorder, and to provide a better treatment scheme for obesity polycystic ovary syndrome (PCOS) lipid metabolism disorder. Methods: 65 obese PCOS patients with lipid metabolism disorder were randomly divided into two groups: photoelectric group (n = 33) and electroacupuncture group (n = 32). After treatment, the changes of TCM symptoms, body weight, body mass index (BMI),) menstrual cycle, sex hormone (LH,FSH,T) and lipid metabolism (TG,TC,LDL-C,HDL-C) were observed. Results: a total of 65 obese PCOS patients with dyslipidemia were included, including 11 cases of hypercholesterolemia, 28 cases of hypertriglyceridemia, 5 cases of mixed hyperlipidemia and 21 cases of hypoglycemia. The final treatment was completed in 60 cases, pregnancy in 1 case, shedding in 4 cases. (1) TCM symptom score: after treatment, the TCM symptom score of both groups was lower than that of the former (p0.01), and that of the photoelectric group was lower than that of the electroacupuncture group (p0.05). The total effective rate of photoelectric group was 86.67 and the total effective rate of electroacupuncture group was 80. There was no significant difference in the curative effect between the two groups (p0.05). (2) body weight. Compared with before treatment, the body weight and BMI of BMI: group decreased significantly (p0.01), the difference between the two groups was significant (p0.01). There was no significant difference in menstrual cycle (p0. 05). (3): after treatment, the menstrual cycle of the two groups was significantly improved (p0. 05), and the therapeutic effect of the photoelectric group was better than that of the electroacupuncture group (p0. 05). (4). After treatment, the LH,T value of the two groups decreased significantly (p0. 01), and the decrease of LH and T in the photoelectric group was greater than that in the electroacupuncture group. The difference was statistically significant (p0.05). There was no significant difference in lipid metabolism between the two groups before and after treatment (p0.05). (5). After treatment, the lipid metabolism level of the two groups was significantly improved, and the TG,TC,LDL-C decreased and HDL-C increased significantly (p0.01). The optoelectronic group was better than the electroacupuncture group in decreasing TG, and increasing HDL-C (p0.05), and the two groups had the same effect in reducing TC,LDL-C (p0.05). The total effective rate of improving lipid metabolism in photoelectric group was 90 and that in electroacupuncture group was 86.67. There was no significant difference between the two groups (p0.05). Conclusion: (1) Electro-acupuncture and electro-acupuncture combined with photoelectric therapy can improve the abnormal blood lipid of obese PCOS and are effective methods for the treatment of lipid metabolism disorder in obese PCOS. (2) the curative effect of electroacupuncture combined with photoelectric therapy on reducing the increase of HDL-C in TG, is better than that of electroacupuncture alone. (3) electroacupuncture combined with photoelectric therapy is superior to electroacupuncture in improving TCM symptoms, sex hormone levels and menstrual cycle adjustment in obese PCOS patients.
【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)】：R246.3

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