| This research based on the clinical study of the acupuncture and moxibustion in the treatment of polycystic ovary syndrome for many years.Polycystic ovary syndrome(PCOS)is a period of women of childbearing age clinical common disease,frequently-occurring disease.According to reports,rate could reach 4%~8%.Clinical mainly thin hair ovulation or no ovulation,serum endocrine abnormalities,as well as polycystic ovarian sample change characterized;Its pathogenesis is very complex,at present is not yet clear,relevant studies suggest the occurrence of the disease involve many factors such as endocrine,metabolic and genetic,but the main pathophysiological defect for gonadotropins abnormalities,such as high androgen hematic disease,hyperinsulinemia.Patients with this disease if not active treatment can lead to menstrual disorder(including menstrual thin hair or amenorrhea,often less than half of the amount before amenorrhoea or menstrual thin hair,dysfunctional uterine bleeding),infertility,hairy,obesity,acne and acanthosis nigricans,etc.,and bilateral or unilateral ovarian show polycystic change and the change of hormone levels,the long-term complications have cardiovascular disease,diabetes,ovarian cancer,endometrial cancer,etc.The main treatment of modern medicine for the disease treatment,including stimulate ovulation drugs,androgen deprivation therapy,to reduce the resistance to insulin therapy and surgical treatment,because of the long-term use of this class of drugs will produce larger side effects,the serious influence the patient's quality of life and bring large economic burden.And in improving patients' clinical symptoms of traditional Chinese medicine and has good curative effect,life quality,therefore,actively explore effective prevention and treatment of traditional Chinese medicine,has important economic and social significance.PCOS specific etiology is unclear,studies have shown that consists of some genetic factors and the surrounding environment caused by many factors such as interaction.Genetic factors:(1)the phenomenon of PCOS has certain familial aggregation,therefore,is considered a polygenic disease,caused by the current study more genes including insulin-like related genes,high androgen closely related genes and chronic inflammation factors,etc.;Family study shows that family members have a crowd of PCOS prevalence of PCOS patients was obviously higher than that of the general population;And studies show that patients with PCOS brothers and sisters also show androgens exception.In addition,patients with PCOS symptoms,and abnormal insulin secretion of insulin resistance may also be associated with genetic gene regulation,between the sisters of PCOS patients,including associated with PCOS or periods regular but with high testosterone levels,sisters and normal sisters,will significantly lower the insulin sensitivity.(2)the environment factors,these factors include intrauterine high androgen,the use of antiepileptic drugs,geographical factors,nutritional status and way of life,and so on,all may be at high risk of PCOS,risk factors,should be well designed epidemiological investigation,to determine the relationship between the environment and the disease.Treatment basically has the following several aspects:(1)adjust lifestyle:whether patients with clear requirements,shall be appropriately adjust the way of life,including a reasonable diet,exercise,change bad way of life,through the various behaviors of adjustment,and weight control to the normal range can improve the insulin resistance.In addition,weight control to the normal range in a certain extent,can also prevent the serious consequences caused by the long-term development of the disease,metabolic syndrome,for example,related research is believed to be obese patients weight to reduce the weight of 5%or more,can to a certain extent,improve menstrual disorders,hairy and the symptom such as acne,and help the treatment of infertility;(2)to improve the high androgen hematic disease:can use oral cyproterone acetate(taie-35)and so on all sorts of short-acting contraceptives,mainly is suitable for the high testosterone levels,and accompanied by high androgen in patients with clinical manifestations of the disease.(3)to prevent endometrial hyperplasia:by cyclical progestational hormone treatment and low dose of short-acting oral contraceptives or use the female,progestational hormone to adjust the menstrual cycle,cycle sequential therapy can effectively inhibit the excessive hyperplasia of endometrium and endometrial cancer.(4)promote the ovulation treatment;(5)improve the insulin sensitivity,etc.A large number of literature of traditional Chinese medicine has good curative effect to the disease,but this team to a large number of related disease clinical and basic research,and treatment for the disease is of certain clinical experience,has the stable patient group,clinical research provides the basis for the disease.Objective:Based on the previous clinical studies,on the basis of this study by observing the jia wei wu ling san Combined Acupuncture and Moxibustion on the clinical effect of the treatment of kidney and phlegm stasis type polycystic ovary syndrome,in order to further study the mechanism of action of traditional Chinese medicine for the disease to provide clinical basis.Methods:1.This study collected 60 cases of cases of clinical observation,diagnostic criteria are from conway,TCM gynecology clinic medical record collection time for between January 2016 and January 2016.Cases according to the inclusion criteria and exclusion criteria included in observation,fill in according to requirements of the clinical observation table scattered joint flavored five three acupuncture patient's clinical symptoms improved after intervention,carried out a statistical analysis.2.Inclusion criteria:(1)conform to the PCOS diagnostic criteria;western medicine(2)type kidney empty phlegm and blood stasis of TCM syndrome differentiation standard;(3)the age range of 20~40 years old;(4)informed consent and voluntary treatment,and can track observation.3.Rule out criteria:(1)do not accord with standard of western medicine diagnosis and syndrome differentiation of traditional Chinese medicine;(2)under age 20,and more than 40 years old;(3)related department of gynaecology indicates a uterus and accessories have implement qualitative sex pathological change.(4)with severe internal,surgical,and other primary disease;(5)with other reasons,such as the ovaries or adrenal tumours,theca cell hyperplasia with shaofu zhuyu tang disease caused by the similar clinical manifestations of the disease with the disease;Within 3 months(6)used drugs to affect the endocrine hormone secretion,(7)for related research drug allergy is;(8),not according to stipulations cannot judge the curative effect,or because of data not congruent affect curative effect judgment result analysis.4.Loss cases fall off and processing:(1)standard:upon passing the patients signed the informed consent,screening and has entered a randomized clinical trial of patients,such as in the treatment of severe adverse reactions during or severe complications or;And for other reasons can't cooperate with treatment;(2)case processing:(1)such as certain subjects fall off,the researchers can take such as arrives,phone calls and letters can contact subjects,record the reasons and duration,as far as possible to complete relevant evaluation.(2)patients with allergies and other adverse reactions or exit by treatment is invalid,the researchers to corresponding therapy according to the actual situation.(3)for loss cases the researcher should be record and keep the relevant information in detail,and analyse the detailed description,reduced as a result of loss without additional participants.5.Remove the standard:(1)with severe trial related records are not perfect;(2)has serious external interference factors;(3)failure to complete treatment in accordance with the requirements of relevant test;(4)failed to according to the test plan.6.Standard cases to suspend the research:(1)in the process of clinical trials,the subjects such as complications occur,or special physiological changes,the researchers think not appropriate to continue the test;(2)in the process of study subjects using impact study drug efficacy and safety of other drugs;(3)serious adverse events,objectively not appropriate to continue the researchers;(4)the subjects poor adherence,researchers cannot be carried out in accordance with the specification.Results:(1)Treatment group minimum age is 21 years old,the maximum is 39 years old,the average age was(30.33 ± 2.56);Control the youngest is 20 years old,the maximum is 39 years old,the average age was(28.7±1.98);Two groups of patients with no significant statistical differences in age distribution(P>0.05),shows that two groups of patients with comparable age distribution;(2)Treatment group patients with shortest duration for 3 months,the longest for 8 years,the average course was(3.98±0.25)years;Control group patients in the course of the shortest for 3 months,the longest for 8 years,the average course was(3.55 ± 0.32)years;On the distribution of two groups of patients during the course of the no significant statistical difference(P>0.05),shows on the distribution of two groups of patients during the course of comparable;(3)Two groups of patients with symptom scores of traditional Chinese medicine treatment group patients for at least nine points,up to 19 points,the average(12.63 ± 1.65);In the control group patients at least 9 points,18 points,maximum average(12.52± 1.56);Two groups of patients with TCM symptom scores distribution has no obvious difference(P>0.05),shows that two groups of patients in the TCM symptom scores comparable;(4)Two groups of patients with comprehensive comparative effectiveness,of which the treatment group:16 cases were cured,7 cases had marked effect,4 cases were effective,ineffective 3 cases;Control group:10 cases cured,5 cases were markedly effective,6 cases effective,invalid 9 cases;The nonparametric test analysis,two groups of comprehensive curative effect was statistically significant difference(P<0.05),shows that comprehensive treatment group curative effect is better than the control group.(5)Two groups of patients before and after treatment of traditional Chinese medicine symptom integral comparison:the treatment group the average integral was(11.93±2.288)before treatment and after treatment the average integral was(3.10 ± 1.423);Control the average integral was(11.93 ± 1.946)before treatment,after treatment the average integral was(3.93 ± 1.143);Patients with TCM symptomatology points down,compared with before treatment were significantly differences statistically significant(P<0.05),the difference between the two way is statistically significant(P<0.05),inferior to think control group the treatment group;(6)Two groups of patients in the basal body temperature change,the treatment group(21 cases cured,7 cases,ineffective in 2 cases;Control group 30 cases,15 cases cured,effective in 5 cases,10 cases were invalid;The nonparametric test,statistically significant difference(P<0.05),in regulating the basal body temperature shows that the treatment group curative effect is better than the control group;(7)Pregnancy cases to compare the two groups after treatment,the treatment group of 16 cases of pregnancy;Control group in 8 cases of pregnancy;The nonparametric test,comparative effectiveness is similar between the two groups have statistical significance(P<0.05),the treatment group the pregnancy curative effect is better than the control group;(8)Two groups of patients before and after treatment serum pituitary hormone level comparison:the two groups after treatment of endocrine hormone in serum LH,LH/FSH was decreased,and the two way in comparison with statistical significance(P<0.05);In the two groups after treatment serum FSH was has the obvious rise,the two way comparison was statistically significant(P<0.05);Compared the two groups after treatment in treatment group than the control group:LH,FSH and LH/FSH were significantly improved,and compare the two difference between groups was statistically significant(P<0.05);(9)In the two groups after treatment serum E2 levels were significantly elevated,its inside two way to compare all had statistical significance(P<0.05);The two groups after treatment the levels of serum T are significantly lower than before treatment,and comparison in the group were statistically significant(P<0.05);Comparison between the two groups after treatment group E2 and T levels,the treatment group than the control group have obviously improved,the difference was statistically significant(P<0.05);(10)The two groups after treatment serum levels of INS,compares group,the difference had statistical significance(P<0.05),treatment of effective;Comparison between the two way difference was statistically significant(P<0.05),the treatment group is better than the control group.Conclusion:Flavored five three scattered combined acupuncture and moxibustion on kidney and phlegm stasis type polycystic ovary syndrome has good treatment effect,improvement the action such as menstruation,increase pregnancy rate,possibly through adjust the endocrine function of the body,from the overall level adjust ovarian endocrine environment,improve the insulin resistance and high androgen hematic disease,is the effective agent for the treatment of polycystic ovary syndrome.The research results of although this study has been made,but there are also some disadvantages,first of all,clinical research is relatively few clinical cases in polycystic ovary syndrome patients;Second,restricted by many conditions,large sample research also has certain difficulty,it needs more than we do in the next step of research center of cooperation and try to be large sample randomized controlled studies,in order to get high quality clinical results. |
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