苍附导痰汤联合通元针法对脾虚痰湿型多囊卵巢综合征患者脂代谢、性激素和子宫内膜容受性的影响

摘要 目的：探讨苍附导痰汤联合通元针法对脾虚痰湿型多囊卵巢综合征（PCOS）患者脂代谢、性激素和子宫内膜容受性的影响。方法：选取2019年3月~2021年11月期间我院收治的PCOS患者87例,均辨证分型为脾虚痰湿。根据随机数字表法分为对照组（常规药物治疗,43例）和研究组（对照组基础上接受苍附导痰汤联合通元针法,44例）。对比两组临床疗效、中医证候积分、脂代谢指标、性激素指标和子宫内膜容受性变化情况。结果：研究组的临床总有效率为86.36%,高于对照组的62.79%,差异有统计学意义（P<0.05）。治疗后研究组中医证候积分较对照组低（P<0.05）。研究组治疗后的腰臀比（WHR）和体质量指数（BMI）、胰岛素抵抗指数（HOMA-IR）低于对照组（P<0.05）。研究组治疗后的卵巢体积小于对照组,内膜厚度厚于对照组（P<0.05）。研究组治疗后的黄体生成素（LH）、雌二醇（E₂）、卵泡刺激素（FSH）和抗苗勒管激素（AMH）低于对照组（P<0.05）。研究组治疗后的高密度脂蛋白胆固醇（HDL-C）高于对照组,总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）低于对照组（P<0.05）。结论：苍附导痰汤联合通元针法治疗脾虚痰湿型PCOS患者,可改善患者的脂代谢、性激素和子宫内膜容受性。

Effects of Cangfu Daotan Decoction Combined with Tongyuan Acupuncture on Lipid Metabolism, Sex Hormones and Endometrial Receptivity in Patients with Polycystic Ovary Syndrome of Spleen Deficiency and Phlegm Dampness Type

ABSTRACT Objective: To investigate the effect of Cangfu Daotan decoction combined with Tongyuan acupuncture on lipid metabolism, sex hormones and endometrial receptivity in patients with polycystic ovary syndrome (PCOS) of spleen deficiency and phlegm dampness type. Methods: 87 patients with PCOS who were admitted to our hospital from March 2019 to November 2021 were selected, all of whom were dialectically classified as spleen deficiency and phlegm dampness. According to the random number table method, they were divided into control group (conventional drug treatment, 43 cases) and study group (n=44, received Cangfu Daotan decoction combined with Tongyuan acupuncture method on the control group, 44 cases). The clinical efficacy, TCM syndrome score, lipid metabolism index, sex hormones index and endometrial receptivity were compared between the two groups. Results: The total effective rate in study group was 86.36%, which was higher than 62.79% in control group, and the difference was statistically significant (P<0.05). The TCM syndrome score in study group after treatment was lower than that in control group (P<0.05). After treatment, the waist-hip ratio (WHR), body mass index (BMI) and insulin resistance index (HOMA-IR) in the study group were lower than those in the control group (P<0.05). The endometrial thickness in the study group after treatment was thicker than that in the control group, and the ovarian volume was smaller than that in the control group (P<0.05). The levels of luteinizing hormone (LH), estradiol (E2), follicle stimulating hormone (FSH) and antimullerian hormone (AMH) in the study group after treatment were lower than those in the control group (P<0.05). After treatment, high density lipoprotein cholesterol (HDL-C) was higher than that in the control group, while total cholesterol (TC), triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) in the study group were lower than those in the control group (P<0.05). Conclusion: Cangfu Daotan decoction combined with Tongyuan acupuncture in the treatment of patients with PCOS of spleen deficiency and phlegm dampness type can improve their lipid metabolism, sex hormones and endometrial receptivity.