【作者】 黄彬城；

【导师】 陈秀华；

【作者基本信息】 广州中医药大学 ， 中西医结合临床， 2009， 硕士

【摘要】 研究目的多囊卵巢综合征发病率高,病因复杂,临床治疗棘手,目前尚无特效的治疗方法。本研究旨在探索腹针结合中药调节多囊卵巢综合征激素水平的临床有效性和安全性,为更大样本的临床多中心研究提供可鉴依据,同时为多囊卵巢综合征的临床治疗提供新的治疗方法。材料与方法选择符合本课题纳入标准及除外排除标准的多囊卵巢综合征的患者90例,按临床随机分为腹针结合中药治疗组、中药治疗组及西药治疗组,三组按1:1:1比例。三组给予以下治疗:腹针结合中药治疗组(A组):腹针处方——引气归元(中脘、下脘、气海、关元)、中极、大赫(双)、外陵(双),下风湿点(双),水道(双),中药处方——导痰种子1号或导痰种子2号;中药治疗组(B组):中药处方——导痰种子1号、导痰种子2号;西药治疗组(C组):西药——克罗米酚。所有患者均治疗3个月和随访3个月,均在治疗前、治疗后分别进行检测生殖激素水平(促卵泡生成素、促黄体生成素、雌二醇、睾酮)和胰岛素水平、监测BBT及临床症状观察(中医证候、多毛、痤疮、体重指数、受孕情况等),根据治疗前后患者的FSH(促卵泡生成素)、LH(促黄体生成素)、E2(雌二醇)、T(睾酮)和INS(胰岛素)水平来评价腹针结合中药调节多囊卵巢综合征激素水平的临床疗效。结果通过3个月的治疗,对三组患者自身治疗前后的FSH水平、LH水平、E2水平、T水平和INS水平及BBT相进行比较,同时比较三组治疗疗效的差异,得出以下结果:三组治疗方案对多囊卵巢综合征患者激素水平方面均是有降低作用,同时疗效也存在几点差异性:一、在改善患者临床症状方面三组治疗均是有效的(P<0.05),在改善患者多毛症状方面疗效相当(P>0.05),在改善患者中医证候、痤疮及肥胖方面腹针结合中药治疗疗效优于单纯运用中药或单纯运用西药治疗(P<0.05),而单纯运用中药与单纯运用西药治疗疗效相当(P>0.05)。二、在降低患者FSH水平方面腹针结合中药治疗是有效的(P<0.05),而单纯运用中药治疗或单纯运用西药治疗疗效不明显(P>0.05)。三、在降低患者LH水平、T水平、E2水平、INS水平方面三组治疗均是有效的(P<0.05),但腹针结合中药治疗疗效优于单纯运用中药或西药治疗(P<0.05),单纯运用中药治疗或单纯运用西药治疗疗效相当(P>0.05)。四、在恢复患者双相BBT方面,腹针结合中药治疗是有效的(P<0.05),而单纯运用中药或单纯运用西药治疗疗效不明显(P>0.05)。结论腹针结合中药治疗多囊卵巢综合征能有效地恢复患者的激素水平,其综合疗效优于单纯运用中药或西药治疗,能全面改善患者的临床症状,降低血FSH、LH、T、E2、INS,及部分恢复双相BBT,腹针疗法结合中药是治疗多囊卵巢综合征的一种新理论、新方法,腹针疗法对多囊卵巢综合征的治疗具有深远的指导意义,值得进一步研究和推广。更多还原

【Abstract】 ObjectiveTo investigate the clinical effect and safety for abdominal acupuncture combined with Chinese medicine to regulate hormone level of Stein-Leventhal syndrome patients.Material and MethodsNinety Stein-Leventhal syndrome patients were randomly divided into three groups:Abdominal Acupuncture Combined with Chinese Medicine Group,Chinese Medicine Group and Western Medicine Group.Three groups received treatments as follows:1.Abdominal Acupuncture Combined with Chinese Medicine Group(A Group): abdominal acupuncture prescription:Zhongwan(Ren 12),Xiawan(Ren 10), Qihai(Ren 6),Guanyuan(Ren 4);Dahe(KI 12),Wailing(ST 26),Xiafengshidian, Shuidao(ST 28)of both sides,Zhongji(RN 3). Chinese medicine prescription:Driving Phlegm Seed One or Driving Phlegm Seed Two.2.Chinese Medicine Group(B Group):Chinese medicine prescription:Driving Phlegm Seed One and Driving Phlegm Seed Two.3.Western Medicine Group(C Group):western medicine prescription:Clomiphene.All patients received treatments for 3 months and were revisited 3 months after treatments.They were evaluated by reproduction hormone level(FSH,LH, E2,T),INS,BBT,clinical symptom observation(Chinese medicine clinical symptoms,hairy situation,acne situation,body weight index,pregnant situation,ect).According to patients’ level of FSH,LH,E2,T and INS before and after treatment,the clinical effect for abdominal acupuncture combined with Chinese medicine to regulate hormone level of Stein-Leventhal syndrome patients was evaluated.ResultsAfter three months’ treatment,three kinds of treatments were effective on improving hormone level(FSH、LH、T、E2),INS level and BBT of Stein-Leventhal syndrome patients,but there were differences about their clinical effect:1.Three kinds of treatments were effective on improving clinical symptoms (P＜0.05).Three kinds of treatments had the same effect on improving hairy symptoms(P＞0.05).Abdominal Acupuncture Combined with Chinese Medicine Group did better than other groups in improving Chinese medicine clinical symptoms, acne situation and in reducing body weight(P＜0.05).The effect of other groups were the same(P＞0.05).2.On reducing FSH level,abdominal acupuncture combined with Chinese medicine was effective(P＜0.05),while the other therapeutic schedules were not so effective(P＞0.05).3.On reducing level of LH,T,E2 and INS,three groups were effective(P<0.05). Abdominal Acupuncture Combined with Chinese Medicine Group did better than other groups(P＜0.05),and the effect of the other two groups were the same (P>0.05).4.Abdominal Acupuncture Combined with Chinese Medicine Group was effective in regaining biphase BBT(P＜0.05),but Chinese Medicine Group or Western Medicine Group was not so effective(P＞0.05).ConclusionsAbdominal Acupuncture Combined with Chinese Medicine did better than Chinese medicine or western medicine for improving clinical symptoms of Stein-Leventhal syndrome patients.It could reduce hormone level(FSH、LH、T、E2),INS level and help regaining biphase BBT partly.As a new theory and method,abdominal acupuncture treatment is of profound significance for Stein-Leventhal syndrome,and it is worth further studying and extending.更多还原